Catherine Carr completed the family nurse practitioner and nurse-midwifery program at Frontier School of Nurse-Midwifery and Family Nursing in 1979 and the DrPH at the University of Michigan in 1993. She is Assistant Professor, Family and Child Nursing at the University of Washington, Seattle where she teaches in the midwifery program. She is a member of the Division of Research, a member of the Board of Review of the Division of Accreditation, and continues to participate in clinical practice.
VAGINAL BIRTH AFTER CESAREAN BIRTH: A NATIONAL SURVEY OF U.S. MIDWIFERY PRACTICE
Article first published online: 24 DEC 2010
2002 American College of Nurse Midwives
Journal of Midwifery & Womens Health
Volume 47, Issue 5, pages 347–352, September-October 2002
How to Cite
Carr, C. A., Burkhardt, P. and Avery, M. (2002), VAGINAL BIRTH AFTER CESAREAN BIRTH: A NATIONAL SURVEY OF U.S. MIDWIFERY PRACTICE. Journal of Midwifery & Womens Health, 47: 347–352. doi: 10.1016/S1526-9523(02)00286-6
- Issue published online: 24 DEC 2010
- Article first published online: 24 DEC 2010
Midwives have been providing care for women choosing vaginal birth after cesarean birth (VBAC) for over 20 years. The 1999 American College of Obstetrician Gynecologist (ACOG) guidelines and recent studies questioning the relative safety of VBAC have raised concerns about continuing to offer this option. As part of an effort to understand VBAC care provided by midwives, this study used a national survey sample to examine practices, scope, and recent changes in the provision of VBAC care. The survey, which included demographic and practice items was mailed in late 2000 to a purposeful sample of 325 midwifery practices. The return rate was 62%. Nearly all (94%) of the responding practices were providing VBAC care, and almost half of them (43%) stated that their ability to do so had changed within the past 2 years secondary to recent studies in the obstetric literature, the 1999 ACOG statement, and concerns from third-party payers. Criteria for offering VBAC are stricter, and consent forms are more extensive. Other changes included the need for additional or more intensive support services, in-house anesthesia, and surgery backup. Midwives continue to provide VBAC care, although with some increased restrictions. This study provides background for future research that will determine how midwifery care affects the rate of successful VBACs.