We seem to have spent the last few years reeling from assault after assault on the concept of normal birth. Have you wondered, as I have, what is going on? Why is our side of the story nowhere to be heard? Why, for example, isn't the rising cesarean rate—which translates into about half a million unnecessary major operations per year at a cost of over $1 billion to our health care system—consid...

The rate of cesarean delivery has increased to more than 32%. To reduce this rate and provide more delivery options, it is necessary to provide greater access to physicians and facilities that can manage labor after cesarean delivery (LAC) and vaginal birth after cesarean delivery (VBAC). This guideline from the American Academy of Family Physicians (AAFP), which provides information on health ...

This paper describes associations among delivery-location, training of birth attendants, birthing practices, and early postpartum morbidity in women in slum areas of Dhaka, Bangladesh. During November 1993-May 1995, data on delivery-location, training of birth attendants, birthing practices, delivery-related complications, and postpartum morbidity were collected through interviews with 1,506 wo...

BACKGROUND Empirical evidence regarding maternal quality and safety outcomes across heterogeneous Asian and Pacific Islanders subgroups in the United States is limited, despite the importance of this topic to health disparities research and quality improvement efforts. METHODS Detailed discharge data from all Hawai'i childbirth hospitalizations (n = 75,725) from 2008 to 2012 were considered. ...

OBJECTIVE To examine trends and characteristics of home vaginal birth after cesarean delivery (VBAC) in the United States and selected states from 1990-2008. METHODS Birth certificate data were used to track trends in home and hospital VBACs from 1990-2008. Data on planned home VBAC were analyzed by sociodemographic and medical characteristics for the 25 states reporting this information in 2...

BACKGROUND Cultural and ethnic roots impact women's fertility and delivery preferences This study investigated whether the likelihood of cesarean delivery, primary cesarean, and vaginal delivery after cesarean (VBAC) varies by maternal national origin. METHODS We conducted a nation-wide, population-based, observational study using secondary data from Taiwan. De-identified data were obtained o...

A review of the literature and analysis of the National Inpatient Sample Database was performed to describe the trends in vaginal birth after cesarean availability in the United States and the factors associated with changing use. Vaginal birth after cesarean increased after the first National Institutes of Health Consensus Conference on Cesarean Childbirth in 1981. It increased from 3% to a ma...

OBJECTIVE To develop a model to predict vaginal birth after cesarean (VBAC) in our population and to compare the accuracy of this model to the accuracy of a previously published widely used model. MATERIALS AND METHODS Women attempting trial of labor after cesarean delivery (TOLAC) at our institution from January 1, 2000 through May 30, 2010 were evaluated for inclusion. Demographic and clini...

OBJECTIVE The purpose of this study was to evaluate the relative cost-effectiveness of attempted vaginal birth after cesarean delivery compared with elective repeat cesarean delivery. STUDY DESIGN We performed an historic cohort analysis of women with a single prior cesarean delivery who were delivered at our institution during 1999. Inclusion criteria were > or =36 weeks' gestation and carry...