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Current Status

W. Benson Harer, Jr, MD,DHL

JAMA. 2002;287:2627-2630.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INTRODUCTION

The dictum "Once a cesarean, always a cesarean" ruled for most of the 20th century.¹ Nevertheless, in the 1970s a small group of women who had prior cesarean deliveries were eager to experience vaginal birth and risked a trial of labor (a purposeful attempt to permit active labor development with progression to vaginal delivery).² Success in such cases led the National Institutes of Health in 1981 to promote trial of labor for patients who had previous cesarean deliveries.²

In 1981, the US rate of successful vaginal birth after a prior cesarean delivery (VBAC) was only 3%, with the overall cesarean delivery rate of 17.9%. By 1997, the incidence of VBAC rose steadily to 27.4%. Despite this dramatic increase in VBACs, the total US cesarean delivery rate rose to only 20.8% during the same time period (Figure 1).^3-4 The American College of Obstetricians and . . . [Full Text of this Article]

Current Standards

Risks of Vaginal Delivery

Conclusion

Author Affiliation: Department of Women's Health Care, Riverside County Regional Medical Center, Moreno Valley, Calif.

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