VBAC Consent by cXVwb19

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									A planned vaginal birth after caesarean section (VBAC) is recommended for women whose first
  caesarean was by lower segment transverse incision, and who have no other indication for
                          caesarean section in the present pregnancy.i
Every woman should review her previous birth with her healthcare practitioner and decide which
method of delivery is best for this birth. If you had a previous caesarean section, it is important to
understand your options and the risks and benefits associated with each delivery choice.

I understand that the benefits of a successful VBAC include:
    Reduced risk to the mother including:
        Reduced maternal mortality and morbidity
        Decreased blood loss
        Elimination of operative injuries and complications such as infection
        No anaesthesia risks
        Reduced risk to subsequent fertility
        Faster postnatal recovery including less postoperative pain & easier infant care/bonding.
   Reduced risks to the baby including:
        Less incidence of respiratory distress
        Reduced incidence of pre-term birth due to dating errors

I understand that the risks associated with a VBAC may include, but are not limited to:
    Rupture of the uterus:
        Uterine rupture rates range from 0.2% to 1.5% after 1 transverse lower-uterine-segment
           incision.ii
        The risk of uterine rupture in women with more than 1 previous low transverse Caesarean
           section are between 0% and 3.7%iii
        Uterine rupture is a serious event and can have catastrophic outcomes including injury or
         death for my baby or myself.
    Unsuccessful vaginal delivery:
       Results in Caesarean section
       Increased risk of infection

I understand that symptoms of uterine rupture, which requires immediate intervention, may include,
but are not limited to:
     Abnormal uterine pain
     Vaginal bleeding
     Abnormal fetal heart rate
     Deterioration of maternal vital signs


I also understand that I may request an elective repeat cesarean section at any time during
my pregnancy or labour.

                                           Cont’d on Page 2
I understand that current obstetrical guidelines for women choosing VBAC include:
     Labour and delivery in a hospital where immediate caesarean section is available
     Continuous electronic fetal monitoring to assess fetal well being and for symptoms of a
       uterine rupture
     Intravenous line initiated to allow for ease of access in the event of an emergency


MY CHOICES:
I have been offered a referral for consultation with a specialist to discuss a vaginal birth after
caesarean or an elective repeat caesarean section and have
                               □ ACCEPTED                     □ DECLINED

I _______________________________________________ (print full name)
have had____ previous caesarean section(s) and ____ previous vaginal birth(s) and have been given
information and a full explanation regarding the benefits and risks of a vaginal birth after caesarean
(VBAC).

      □ I have chosen to plan a vaginal birth after caesarean (VBAC) with midwifery care in a hospital
        setting and have read and understand the current guidelines and recommendations.

      □ I have chosen to plan an elective repeat caesarean section with midwifery care and have read
        and understand the current guidelines and recommendations.

      □ I have chosen to plan a vaginal birth after caesarean (VBAC) with midwifery care in an out-of–
        hospital setting. I understand and acknowledge that current guidelines recommend all VBAC’s
        occur in a hospital setting. I understand that I will not have immediate access to emergency
        obstetrical care in the event of a uterine rupture or other catastrophic event.

       Date___________ Signed __________________________________(Woman)

       Date___________ Signed __________________________________(Partner)

       Date___________ Signed __________________________________(Midwife)




i
      Guidelines for Vaginal Birth After Caesarean Section, Society of Obstetrician and Gynaecologists Clinic Practice
      Guidelines, July 2004..
ii
      ibid
iii
      Guidelines for Vaginal Birth After Caesarean Section, Society of Obstetrician and Gynaecologists Clinic Practice
      Guidelines, July 2004

								
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