Milestones Newsletter | Issue 8, Fall 2024
The Vaginal Birth After Caesarean (VBAC) Quality Standard has been updated to align with the most recent clinical evidence and current practice in Ontario.
Originally published in 2018 by Ontario Health in collaboration with the Provincial Council for Maternal and Child Health (PCMCH), the updated VBAC quality standard, placemat, and patient guide describe high-quality care for people who have had a Caesarean birth and are planning their next birth.
Most people who have had a Caesarean birth can have a VBAC, with evidence suggesting that VBAC is safe for most eligible pregnant people. However, data from BORN Ontario show that the rate of planned VBACs in Ontario has decreased – from 41 per cent in fiscal year 2014/15 to 39 per cent in fiscal year 2022/23. There is also notable variation in the rates of planned VBACs across Ontario regions.
The VBAC quality standard outlines the following opportunities to improve care for pregnant people who have had a previous Caesarean birth and are planning their next birth:
- Access to vaginal birth after Caesarean
- Discussion after Caesarean birth
- Shared decision-making
- Previous vaginal birth
- Operative reports and incision type
- Timely access to Caesarean birth
- Unplanned labour
- Induction and augmentation of labour
- Signs and symptoms of uterine rupture
There are many opportunities to improve care for people who are considering a VBAC. Please review and share the updated quality standard, placemat, and patient guide with your networks. For more information, please contact QualityStandards@OntarioHealth.ca.
This article was published in Milestones - PCMCH's official quarterly newsletter. Subscribe to Milestones.