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If the U.S. cesarean delivery rate were to keep rising at its current pace, that rate would exceed 50% by 2020. Strategies to curb this trend must focus not only on limiting primary cesarean rates, but also on devising rational strategies for lowering rates of repeat cesarean deliveries. Dr. James Scott, Editor-in-Chief of Obstetrics & Gynecology, has drawn together several approaches in an encapsulation of evidence-based professional recommendations.
The NIH Consensus Development Conference on Vaginal Birth after Cesarean (VBAC) was convened in 2010 to address declining VBAC rates. Key points included the following:
Some women are denied access to trials of labor after cesarean (TOLAC).
Risks associated with TOLAC and VBAC are low.
Immediate a…