High VBAC rates linked to low primary cesarean delivery rates


Hospitals with high vaginal birth after delivery rates also tend to perform fewer cesarean deliveries in the first place, concludes a new study published in Obstetrics & Gynecology. The findings suggest that hospitals in which VBACs are performed may have an organizational culture that places a higher value on vaginal birth, say the authors. The researchers looked at all term, singleton births in 255 California hospitals in 2009, categorizing the hospitals in quartiles by VBAC rate. They then identified any associations between VBAC rate and primary cesarean delivery rate among 125,471 low-risk, term, nulliparous, singleton deliveries. When adjusted for maternal and hospital characteristics, women who gave birth in hospitals in the highest VBAC quartile were nearly half as likely to have a cesarean delivery compared to women at hospitals with the lowest VBAC rates. They also found that each 1% increase in a hospital's VBAC rate was associated with a 0.65% decrease in the rate of low-risk, nulliparous, term singleton cesarean deliveries. Read the article.

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