VAGINAL BIRTH AFTER CESAREAN - PHYSICIANS PERCEPTIONS AND PRACTICE

OBJECTIVE: To determine physician's perceptions about vaginal birth af ter cesarean section and compare them to the physicians' actual practi ce experience. STUDY DESIGN: Physicians responded to a questionnaire o n their perceptions of vaginal birth after cesarean section. Between J uly 1, 1991, and June 30, 1992, all attempts at vaginal birth after ce sarean section were reviewed. All cesarean deliveries were also review ed to determine which repeat cesarean sections could have been avoided . RESULTS: One hundred twenty-four patients attempted vaginal birth af ter cesarean section, and 95 (76.6%) were successful. Physician percep tions revealed a success rate of 73.6%. Those patients whose labor was induced in their attempt at vaginal birth after cesarean section were less successful (41.9%) than those who did not require induction (88. 2%) (P < .001). Upon review, 47% of patients who underwent elective re peat cesarean section did not have a contraindication to a trial of la bor. CONCLUSION: Physicians had an accurate perception of the success of vaginal birth after cesarean section in their practices. Vaginal bi rth after cesarean section success rates were consistent with those re ported in the literature. Despite a high attempt rate (72.5%) among th ose eligible for vaginal birth after cesarean section, almost half the patients undergoing a repeat elective cesarean section did not have a contraindication to a trial of labor.