Affiliation:
1. Department of Health Management and Systems Sciences , University of Louisville, School of Public Health and Information Sciences , Louisville , KY , USA
Abstract
Abstract
Introduction
Increasing the number of vaginal birth after cesarean (VBAC) deliveries is one strategy to reduce the cesarean rate in the United States. Despite evidence of its safety, access to trial of labor after cesarean (TOLAC) and VBAC are limited by many clinical and non-clinical factors. We used a scoping review methodology to identify barriers to access of TOLAC and VBAC in the United States and extract potential leverage points from the literature.
Content
We searched PubMed, Embase, Cochrane, and CINAHL for peer-reviewed, English-language studies published after 1990, focusing on access to TOLAC and/or VBAC in the United States. Themes and potential leverage points were mapped onto the Minority Health and Health Disparities Research Framework. The search yielded 21 peer-reviewed papers.
Summary
Barriers varied across levels of influence and included factors related to restrictive clinical guidelines, provider reluctance, geographic disparities, and midwifery scopes of practice. While barriers varied in levels of influence, the majority were related to systemic and interpersonal factors.
Outlook
Barriers to TOLAC and VBAC exist at many levels and are both clinical and non-clinical in nature. The existing body of literature can benefit from more research examining the impact of recent revisions to clinical guidelines related to VBAC as well as additional qualitative studies to more deeply understand the complexity of provider reluctance.
Subject
Obstetrics and Gynecology,Pediatrics, Perinatology and Child Health
Reference38 articles.
1. United States Government Accountability Office. Maternal Health: Outcomes Worsened and Disparities Persisted During the Pandemic. Report to Congressional Addressees; 2022. Report No.: GAO-23-105871. Available from: https://www.gao.gov/assets/gao-23-105871.pdf. [Accessed 10 Jan 2023]
2. Sobhy, S, Arroyo-Manzano, D, Murugesu, N, Karthikeyan, G, Kumar, V, Kaur, I, et al.. Maternal and perinatal mortality and complications associated with caesarean section in low-income and middle-income countries: a systematic review and meta-analysis. Lancet 2019;393:1973–82. https://doi.org/10.1016/s0140-6736(18)32386-9.
3. Miller, ES, Hahn, K, Grobman, WA. Consequences of a primary elective cesarean delivery across the reproductive life. Obstet Gynecol 2013;121:789–97. https://doi.org/10.1097/01.ogx.0000433844.03709.01.
4. Sandall, J, Tribe, RM, Avery, L, Mola, G, Visser, GH, Homer, CS, et al.. Short-term and long-term effects of caesarean section on the health of women and children. Lancet 2018;392:1349–57. https://doi.org/10.1016/s0140-6736(18)31930-5.
5. Keag, OE, Norman, JE, Stock, SJ. Long-term risks and benefits associated with cesarean delivery for mother, baby, and subsequent pregnancies: systematic review and meta-analysis. PLoS Med 2018;15:e1002494. https://doi.org/10.1371/journal.pmed.1002494.
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