Planned Home VBAC in the United States, 2004-2009: Outcomes, Maternity Care Practices, and Implications for Shared Decision Making

Background In the United States, the number of planned home vaginal births after cesarean (VBACs) has increased. This study describes the maternal and neonatal outcomes for women who planned a VBAC at home with midwives who were contributing data to the Midwives Alliance of North America Statistics...

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Bibliographic Details
Published in:Birth (Berkeley, Calif.) Calif.), 2015-12, Vol.42 (4), p.299-308
Main Authors: Cox, Kim J., Bovbjerg, Marit L., Cheyney, Melissa, Leeman, Lawrence M.
Format: Article
Language:English
Subjects:
Adult
Births
Blood
Cesarean section
Childbirth
Collaborative decision making
Decision Making
Demography
Female
Home birth
Home Childbirth - adverse effects
Home Childbirth - methods
Home Childbirth - statistics & numerical data
Humans
Infant
Infant Mortality
Infant, Newborn
Intensive care
Intensive care units
Intensive Care Units, Neonatal - statistics & numerical data
Midwifery
Midwives
Neonatal care
Neonatal units
Obstetric Labor Complications - epidemiology
Obstetric Labor Complications - etiology
Obstetric Labor Complications - therapy
Postpartum women
Pregnancy
Pregnancy Outcome - epidemiology
Retrospective Studies
Sensitivity
Sensitivity analysis
Socioeconomic Factors
trial of labor
United States - epidemiology
Vaginal birth
vaginal birth after cesarean
Vaginal Birth after Cesarean - adverse effects
Vaginal Birth after Cesarean - methods
Vaginal Birth after Cesarean - statistics & numerical data
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Summary:Background In the United States, the number of planned home vaginal births after cesarean (VBACs) has increased. This study describes the maternal and neonatal outcomes for women who planned a VBAC at home with midwives who were contributing data to the Midwives Alliance of North America Statistics Project 2.0 cohort during the years 2004–2009. Method Two subsamples were created from the parent cohort: 12,092 multiparous women without a prior cesarean and 1,052 women with a prior cesarean. Descriptive statistics were calculated for maternal and neonatal outcomes for both groups. Sensitivity analyses comparing women with a prior vaginal birth and those who were at the lowest risk with various subgroups in the parent cohort were also conducted. Results Women with a prior cesarean had a VBAC rate of 87 percent, although transfer rates were higher compared with women without a prior cesarean (18% vs 7%, p 
ISSN:0730-7659
1523-536X
DOI:10.1111/birt.12188