Subject: Planned Vaginal Birth After Cesarean, VBAC

VBAC checklist for antepartum care

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1.   All of the following will be present in a potential VBAC client:

o Yes   o No     One or less prior low transverse cesarean section.

o Yes   o No     Ultrasound performed that determines the location of the placenta and places it outside the scarring location as determined by previous care records of the cesarean birth.

o Yes   o No     Travel time to the hospital for emergency care must be less than 30 minutes.

o Yes   o No     Completed approved VBAC course prior to delivery.

   o Yes   o No     Signed VBAC consent form.

2.   All of the following will NOT be present in a potential VBAC client:

  o Yes   o No     More than one cesarean section.

  o Yes   o No     Cesarean section with other than a low transverse or unknown incision type (ie: classical or T-shaped).

  o Yes   o No     History of extensive fundal uterine surgery of previous uterine rupture.

  o Yes   o No     Diagnosed macrosomia or clinically inadequate pelvis.

  o Yes   o No     Uncontrolled gestational diabetes.

  o Yes   o No     Pregnancy induced hypertention.

  o Yes   o No     Gestation <37 weeks or greater than 41 weeks.

  o Yes   o No     Other medical or obstetric complicationns that would preclude a safe vaginal delivery.

VBAC checklist for intrapartum care:

1.   All of the following will be present in a potential VBAC client:

  o Yes   o No     Provider in facility for entire labor and immediate post partum period.

  o Yes   o No     Prenatal records will be complete with documentation of all required prenatal testing, counselling and signed consent form.

  o Yes   o No     Labor will fit within the parameters of normal as described in the Labor monitoring protocol.

  o Yes   o No     Spontaneous labor between 37 and 41 weeks of gestation.

2.   All of the following will NOT be present in a potential VBAC client:

  o Yes   o No     Labor stimulation by mechanical or chemical means such as nipple stimulation and herbal treatments.

  o Yes   o No     Evidence of severe abdominal pain, especially if persisting between contractions.

  o Yes   o No     Chest or shoulder tip pain or sudden onset of shortness of breath.

  o Yes   o No     Acute onset of scar tenderness.

  o Yes   o No     Abnormal vaginal bleeding or hematuria.

  o Yes   o No     Maternal tachycardia, hypotension or shock.

  o Yes   o No   Loss of station of the presenting part.

  o Yes   o No     Fetal bradycardia or abnormal FHT’s