Maternal and Perinatal Outcomes Associated with a Trial of Labor after Prior Cesarean Delivery

In this multicenter, four-year observational study of women with a history of cesarean section and a singleton gestation, a trial of labor was associated with a higher risk of symptomatic uterine rupture in the mother and hypoxic–ischemic encephalopathy in the infant than was elective cesarean delivery, although the absolute risks of these complications were low. The findings from this study should help inform women about their choices regarding the type of delivery after a prior cesarean section. The findings from this study should help inform women about their choices regarding the type of delivery after a prior cesarean section. The overall rate of cesarean delivery in the United States has risen dramatically, from 5 percent of all deliveries in 1970 to a high of 26 percent in 2002. 1 Efforts to reduce the number of cesarean births, although initially successful, failed to achieve the U.S. Public Health Service goals, set in 1990. These goals included achieving an overall rate of cesarean delivery of 15 percent, and a rate of vaginal birth after previous cesarean section of 35 percent of deliveries after previous cesarean sections, by the year 2000. 2 The Healthy People 2010 report published in 2000 proposes a target rate . . .