Gwen Latendresse, CNM, MS, is an auxiliary faculty member at the University of Utah College of Nursing, where she is currently enrolled in full-time study toward a PhD degree under a doctoral fellowship program.
A Description of the Management and Outcomes of Vaginal Birth After Cesarean Birth in the Homebirth Setting
Version of Record online: 24 DEC 2010
2005 American College of Nurse Midwives
Journal of Midwifery & Womens Health
Volume 50, Issue 5, pages 386–391, September-October 2005
How to Cite
Latendresse, G., Murphy, P. A. and Fullerton, J. T. (2005), A Description of the Management and Outcomes of Vaginal Birth After Cesarean Birth in the Homebirth Setting. Journal of Midwifery & Womens Health, 50: 386–391. doi: 10.1016/j.jmwh.2005.02.012
- Issue online: 24 DEC 2010
- Version of Record online: 24 DEC 2010
- vaginal birth after cesarean birth;
- certified nurse-midwives
Our objective was to describe the outcomes of intended home birth among 57 women with a previous cesarean birth. Data were drawn from a larger prospective study of intended homebirth in nurse-midwifery practice. Available data included demographics, perinatal risk information, and outcomes of prenatal, intrapartum, postpartum, and neonatal care. The hospital course was reviewed for those transferred to the hospital setting. Fifty-three of 57 women (93%) had a spontaneous vaginal birth, 1 had a vacuum-assisted birth, and 3 (5.3%) had a repeat cesarean birth. Thirty-one of 32 (97%) women who had a previous vaginal birth after cesarean birth (VBAC) had a successful VBAC; 22 of 25 (88%) women without a history of VBAC successfully delivered vaginally. Fifty (87.7%) of these women delivered in the home setting, whereas 7 (12.3%) delivered in the hospital setting. None of the women experienced uterine rupture or dehiscence. One infant was stillborn. This event was attributed to a postdates pregnancy with meconium. Certified nurse-midwives with homebirth practices must be knowledgeable about the risks for mother and baby, screen clientele appropriately, and be able to counsel patients with regard to potential adverse outcomes. Given what is presently known, VBAC is not recommended in the homebirth setting. It is imperative in the light of current evidence and practice climate to advocate for the availability of certified nurse-midwife services and woman-centered care in the hospital setting.