THE EFFECT OF THE ACOG GUIDELINE ON VAGINAL BIRTHS AFTER CESAREAN

In October 1988, the American College of Obstetricians and Gynecologis ts (ACOG) issued a physician practice guideline stating that a prior c esarean section is no longer a reason for performing a repeat C-sectio n. Using a panel data set consisting of 55 Massachusetts hospitals ove r the years 1987 to 1991, this study examines if the ACOG guideline ha d any impact on the practice of vaginal births after cesarean (VBACs) at the typical hospital. The empirical results suggest that the ACOG g uideline led to a permanent 5.6 percentage point increase in the VBAC rate, ceteris paribus. As a result, the study suggests that practice g uidelines do sometimes work. The information dissemination role of the popular press may provide the reason why the AGOG guideline influence d the practice of VBACs.