VBAC PROGRAM IN A NURSE-MIDWIFERY SERVICE Five Years of Experience

Authors

  • Karin Larson Hangsleben cnm, ms,

    Corresponding author
      Riverside ob-gyn, 701 25th Avenue South, Suite 302, Minneapolis, MN 55454.
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    • 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.

  • Margaret A. Taylor cnm, ms,

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    • Margaret Taylor was the first nurse-midwife in private practice in Minnesota when she established Riverside OB-GYN in 1982. She is currently ACNM Region 4 Representative.

  • Nancy M. Lynn cnm, ms

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    • Nancy Lynn is a staff nurse-midwife at Riverside ob-gyn in Minneapolis, Minnesota. She has been active in teaching workshops for the Minneapolis-St. Paul Childbirth Education Association.


Riverside ob-gyn, 701 25th Avenue South, Suite 302, Minneapolis, MN 55454.

ABSTRACT

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.

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