National Institutes of Health Consensus Development Conference Statement: …

Vaginal birth after cesarean (VBAC) describes vagi-nal delivery by a woman who has had a previous cesarean delivery. For most of the twentieth century, once a woman had undergone a cesarean delivery, clinicians believed that her future pregnancies re-quired cesarean delivery. Studies from the 1960s suggested that this practice may not always be neces-sary. In 1980, a National Institutes of Health (NIH) Consensus Development Conference Panel ques-tioned the necessity of routine repeat cesarean deliv-eries and outlined situations in which VBAC could be considered. The option for a woman with a previous cesarean delivery to have a trial of labor was offered and exercised more often in the 1980s through 1996. Since 1996, however, the number of VBACs has de-clined, contributing to the overall increase in cesar-ean delivery (Figure 1). Although we recognize that primary cesarean deliveries are the driving force be-hind the total cesarean delivery rates, the focus of this report is on trial of labor and repeat cesarean deliveries.

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