Document Type

Honors Thesis

Publication Date

Spring 2019

Abstract

C-sections are an extremely common procedure in modern day America, and while there are serious indications for cesarean delivery including complications for mother and baby, there are likely far more cesareans performed each year than medically necessary. This A comprehensive literature analysis was compared to individual data collection from the Center for Disease Control and Prevention’s National Vital Statistics System. Both the analysis of the literature and the individual data collection confirmed that cesarean deliveries in the US have increased to from less than 10% in the 1970s, to over 30% in the years following 2005. Vaginal birth after cesarean delivery (VBAC) is an alternative option to elective repeat cesarean deliveries. The VBAC rate in the US has decreased since 1996 opposing the rise of cesarean deliveries. A review of the literature showed that this decline in VBAC is due to a lack of women attempting Trial of Labor After Cesarean (TOLAC). A decline in TOLAC is seen from 1995 to 2006. The rate of TOLAC success has remained constant over the past 30 years. This indicates that the reason for TOLAC decline is not a decline in success rates but rather due to other factors such as, maternal fear of labor, risks including uterine rupture or provider mentality, lack of training or concern for malpractice.

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