Article Figures & Data
Figures
- Figure 1.
Age (N = 927 deliveries) of women at the time of each delivery.
- Figure 2.
Parity (N = 927 deliveries) of women at time of each delivery.
Tables
Supplemental Tables & Figure
Supplemental Table 1. Maternal Complications; Supplemental Table 2. Perinatal Deaths; Supplemental Figure 1. LaFarge Birthing Center.
Files in this Data Supplement:
- Supplemental data: Tables 1-2 - PDF file, 2 pages, 164 KB
- Supplemental data: Figure - PDF file, 1 page, 7.5 MB
The Article in Brief
Lee T. Dresang , and colleagues
Background Women's risk of mortality is decreased by vaginal birth after cesarean (VBAC) compared with repeat cesarean delivery, yet the cesarean rate in the US has risen dramatically. A Wisconsin birthing center serving Amish women provides an opportunity to look at the effects of local culture and practices that support vaginal birth and trial of labor after cesarean (TOLAC). This study describes childbirth and perinatal outcomes over 17 years in LaFarge, Wisconsin.
What This Study Found Analyzing data on 927 deliveries in this nonhospital setting, the authors found a cesarean rate of 3.8% (compared with 33% in the United States in 2009), a TOLAC rate of 100%, and a VBAC rate of 95% (compared with 8% in the United States in 2006). There were no cases of uterine rupture or maternal death, and the neonatal mortality rate of 5.4 of 1,000 was comparable to that of Wisconsin (4.6 of 1,000 in 2008) and the United States (4.5 of 1,000).
Implications
- These findings show that, in the right circumstances and practice environment, cesarean rates can be decreased and VBAC rates increased in a safe and evidence-based manner.
- The authors suggest that these results support a low-tech approach to delivery.
