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Title: NEWS
Year: 2015
Abstract: Clinical practice guidelines for planning for labor and vaginal birth after cesarean (VBAC) have been released by the American Academy of Family Physicians. The guidelines state that VBAC is safe and appropriate for most women with one or two prior cesareans and that clinicians should counsel, encourage, and facilitate planned VBAC. If planned VBAC is not locally available then women desiring it should be offered referral to a facility and/or clinician who can offer the service. Clinicians should develop an individualized assessment of risks and benefits of VBAC for each woman, and discuss it with her prior to delivery; see: http://www.annfammed. org/content/13/1/80.short?rss=1. Cesarean rates vary widely between European countries, ranging from 14.8 percent of births in Iceland to 52.2 percent of births in Cyprus, according to a recent study. The differences were still apparent when the data were stratified by common risk factors for cesarean. These findings highlight a lack of consensus among European countries as to correct obstetric practice; see: 0528.13284/epdf. Children born via cesarean section have significantly increased risks of several chronic immune diseases, including asthma, systemic connective tissue disorders, juvenile arthritis, inflammatory bowel disease, immune deficiencies, and leukemia, according to a Danish study of 2 million term children over a 35-year period; see: abstract?sid=6ca64410-f232-41c6-8aed-98dca2678d1b. The organization of maternity care services can have a large impact on cesarean and VBAC rates, according to a recent study presented at the 2015 Society for Maternal- Fetal Medicine conference. A community hospital changed from a private practice care model to a 24-hour obstetrician-midwife hospitalist model in 2011. The cesarean rate for low-risk women (nulliparous, term, singleton, vertex) dropped from 32.2 percent before the change, to 25.0 percent after, while the VBAC rate
Appears in Collections:Birth 2015

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