Updated 20th October 2015.
1. Could you provide a copy of your guidelines for the management of vaginal births after caesarean (VBAC)?
2. Please can you supply a list of any exclusions and/or restrictions you would apply to a VBAC birth? i.e. would you accommodate home births, water births, access to your midwifery-led unit or birth centre?
3. Could you also please advise on how these practice points alter (if at all) should the vbac follow multiple caesareans?
VBAC following multiple sections are referred to the consultant midwife for an individual plan.
4. The most recent statistics (2013, 2014 and 2015 to date) relating to how many women choose to have an elective caesarean after they’ve previously had one or more caesareans?
Since the introduction of a new electronic system accurate data is only available up to October 2014. We can’t tell you at present how many women chose to have an elective caesarean after previously having one or more caesareans.
Queried, updated 20.10.15: Due to the introduction of the Trusts Electronic Patient Record System October 2015 it has not been possible to extract all statistical information into ‘report’ format. Our maternity information’s specialist midwife has been working with the EPIC team to resolve this.
Noted from pg2 of The Rosie VBAC Guidelines: 66% of women having a repeat elective caesarean are women with ‘previous CS’, April 2012 – March 2013
Noted from data provided in Q6: VBAC uptake was 31.3% therefore repeat elective caesarean rate is 68.7%
5. Could you provide your most up to date VBAC success rate statistics?
70.7% (April 2013 – October 2013)
74.2% (April 2012 – March 2013, from pg6 of The Rosie VBAC Guidelines)
6. If available, statistics relating to how many planned VBACs resulted in vaginal birth and how many in caesarean birth? (2013, 2014 and 2015 to date)
7. How many women have obtained permission from the consultant midwife to have a VBAC birth in the Rosie Birth Centre? (2013, 2014 and 2015 to date)
2014 = 1
2015 = 24 (to 28.8.15), many of these have not yet delivered
Queried 2013 data, update 20.10.15: I can confirm that during 2013 there were no women who obtained permission from the consultant midwife to have a VBAC birth in the Rosie Birth Centre.
[We will query this again; we know one woman who obtained permission to birth in RBC in 2013]
8. How many VBAC women have transferred from the Rosie Birth Centre to Delivery Unit? Of these how many had a vaginal birth, how many had an assisted birth, how many had a caesarean birth? (2013, 2014 and 2015 to date)
2014 = 1 woman had a VBAC at the Rosie Birth Centre
2015 = 4 women had a VBAC in the Rosie Birth Centre (to 28.8.15).
Six women transferred to delivery unit, of these four had a vaginal birth and two women had emergency caesarean section.
[We will query this again; we know two woman who had a VBAC birth in RBC in 2013]
9. How many women attempting a VBAC experienced a true uterine rupture? Of these, where was the women (delivery unit, midwife-led unit or home) and what was the outcome for mother and baby? (2013, 2014 and 2015 to date)
2013 there were no reported ruptured uteruses of any kind.
2014 there was one ruptured uterus in a planned VBAC: not in active labour and delivered in response to CTG changes by caesarean section.
2015 to date there was one rupture in a planned VBAC: not in active labour and delivered in response to CTG changes by caesarean section
10. Could you provide details of any meetings where VBAC women’s’ access to the Rosie Birth Centre was discussed, including dates of meetings, minutes of meetings and key decisions.
The strategy was proposed to the Multi-disciplinary team on 25th April 2014 and agreed at the variation of care consultants meeting at 2nd May 2015.
Cambridge VBAC Friends submitted Freedom of Information requests to five local hospitals: The Rosie Hospital in Cambridge; Hinchingbrooke Hospital in Huntingdon; Peterborough City Hospital; The Lister Hospital in Stevenage and The West Suffolk Hospital in Bury St Edmunds. We’ll be publishing the findings in full and they’ll also be available in our private online support group.