In a drive towards Lowering C-section rate, providing consistent information to women and promoting ‘Normality’, a VBAC clinic was establised in York Teaching Hospital Foundation Hospital. The clinic also aims to provide an opprtunity to discuss women’s previous birth experiences, help distinguish ‘facts from fiction’ and beliefs, enabling informed choice for patients. The clinic is run by three midwives with a particular interest in VBAC. Patients are seen at around 14 weeks gestation following referrel by Community Midwives following a dating/NT scan. This ensures women receive consistent information before their 20 week appointment with their named Consultant.
Results 193 patients were seen in VBAC clinic since its commencement in Nov 2011. Mean CS rate for the duration till March 2013 was 64.28% (30–88% range) and vaginal delivery rate of 35.8% (7.69%–70% range). Previous Vaginal delivery rates in York following attempted VBAC prior to introduction of VBAC Clinic was 34% in 2012. There was a slight increase in the success rate following Spontaneous onset of labour at term overall.
Challenges we face:
Conflicting opinions from obstetricians from varying clinical experience.
Women being seen at 14 weeks gestation and then not again by VBAC midwives; Women’s expectations and time spent in VBAC clinic and external factors.
Confidence of medical and midwifery practitioner looking after VBAC.
Women who had a spontaneous onset of labour went on to have a her women in labour.
Need for evalauating introduction of Telemetry and use of Pool for labouring women with revision of guidelines.
Need for a lead VBAC consultant to ensure consistent policy for care of VBAC.
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