Vaginal Birth After Previous Cesarean Birth: A Comparison of 3 National Guidelines

Importance Vaginal birth after previous cesarean birth (VBAC) is a reasonable option for many women with previous cesarean delivery. Objective The aim of this study was to summarize evidence and compare recommendations from national guidelines regarding VBAC. Evidence Acquisition A descriptive review of 3 national guidelines on VBAC was conducted: Royal College of Obstetricians and Gynaecologists on Birth After Previous Caesarean Birth, American College of Obstetricians and Gynecologists on Vaginal Birth After Cesarean Delivery, and Society of Obstetricians and Gynaecologists of Canada on Guidelines for Vaginal Birth After Previous Caesarean Birth. These guidelines were summarized and compared in terms of the recommended antenatal and intrapartum care of women. Recommendations and strength of evidence were also reviewed based on method of reporting. Results The variations mentioned on the different guidelines reflect the heterogeneity of the published data on the management of VBAC during the antenatal and intrapartum care. Conclusions Evidence-based medicine could support the conception of international recommendations for VBAC, which may improve both safety and efficacy of this procedure. Target Audience Obstetricians and gynecologists, family physicians. Learning Objectives After completing this activity, the learner should be better able to (1) examine all the aspects of vaginal birth after cesarean birth: indications and contradictions; (2) summarize antenatal care recommendations in cases of vaginal birth after cesarean delivery; and (3) propose the necessary intrapartum care in cases of vaginal birth after cesarean birth.