ABSTRACT
The objective of this study is to review the safety and success of a trial of labor
after cesarean in a group of patients managed by a solo practitioner in a rural community.
This was a retrospective review of all deliveries performed over an 11-year period
by a single practitioner in a rural community. Standard contraindications for attempt
at vaginal birth after cesarean were observed. Between January 1, 1989 and December
31, 1999, there were 5015 total deliveries. Women with at least one previous cesarean
delivery accounted for 11.8% (593) of all patients. Trial of labor was attempted in
413 (74.5%) of these patients, and resulted in vaginal delivery in 308 (75%). Maternal
complications were similar between the groups. There was no incidence of uterine rupture,
maternal deaths, or neonatal deaths. Vaginal birth after cesarean can be performed
safely in isolated rural hospitals with a high success rate.
KEYWORDS
Rural community - cesarean - VBAC