Karin Hangsleben is a staff nurse-midwife at Riverside ob-gyn in Minneapolis, Minnesota. She formerly taught in the University of Minnesota nurse-midwifery educational program.
VBAC PROGRAM IN A NURSE-MIDWIFERY SERVICE Five Years of Experience
Article first published online: 6 JAN 2011
1989 American College of Nurse Midwives
Journal of Nurse-Midwifery
Volume 34, Issue 4, pages 179–184, July-August 1989
How to Cite
Hangsleben, K. L., Taylor, M. A. and Lynn, N. M. (1989), VBAC PROGRAM IN A NURSE-MIDWIFERY SERVICE Five Years of Experience. Journal of Nurse-Midwifery, 34: 179–184. doi: 10.1016/0091-2182(89)90078-5
- Issue published online: 6 JAN 2011
- Article first published online: 6 JAN 2011
Vaginal birth after cesarean (VBAC) is well documented by research studies to be safe and, in many cases, better for women with a previous cesarean birth than a repeat cesarean. The article describes one nurse-midwifery service's policies and procedures for helping women to prepare for and have a trial of labor. During the intrapartal period women with a uterine scar are managed similar to those without a scar except for closer monitoring, lab studies, and intravenous heparin lock. An obstetrician is always in the hospital and available for consultation. Of 53 women attempting VBAC, 83% had a vaginal birth. Those with a previous cesarean for failure to progress had the lowest vaginal birth after cesarean rate of 65%. Maternal and newborn morbidity was low. The authors conclude that nurse-midwifery management of vaginal birth after cesarean candidates is safe and very successful when appropriate physician consultation and hospital services are readily available.