Hello,
What is the difference when recording data between successful VBAC and successful attempted VBAC?
I was looking at these stats http://www.mass.gov/Eeohhs2/docs//dhcfp/excel/mass_maternity_stats.xls
(quite fascinating and please note the birth center stats...) and was wondering.
I wish every State would do this!
Thanks,
maria. By: maria

Oops, sorry, dubbel clicked without writing...
I was wondering where I could find the statistics for the Netherlands regarding births at home and at hospitals, mortality, cesarian rates etc. Went to the Dutch Bureau of Statistics (CBS) but there is just too much to wade through :-)
The Dutch system is often referred to as a model, but being from The Netherlands it seems to me more and more mothers are birthing in a hospital these days (I have read only 40% homebirth?)
Thank you,
maria. By: maria

And just to be able to compare: what are the number of homebirths in the US?
mara. By: maria

Maria,
I saw your question and thought I would tackle to give Henci more time to address some of your other great questions. I am familiar with the Massachusetts Maternity Statistics Program (having done part of my midwifery training in a Mass hospital where we collected these stats each month). Elsewhere on their website you can find definitions of all of the statistical terms. Here are the two you wondered about:

Successful Attempted Vaginal Births after Cesarean (VBAC): When a woman who had a Cesarean delivery for a previous baby attempts a trial of labor to deliver this baby vaginally and is successful. The successful attempted VBAC rate calculated as follows:

Number of women with previous Cesarean delivery who deliver vaginally
divided by
Number of women who attempted to deliver VBAC

Vaginal Births after Cesarean (VBAC): A vaginal birth by a woman who delivered a previous baby via Cesarean, but delivers this baby vaginally. The attempted VBAC rate is calculated as follows:

Number of women attempting a VBAC
divided by
(Number of repeat Cesareans) + (Number of successful VBACS)

Thanks again for your thoughtful questions!

Sincerely,
Amy Romano, MSN, CNM
Editor, Lamaze Institute for Normal Birth
By: Amy Romano

Thank you, Amy. I had found that as well, but I still don't understand the difference. LOL, I must be very dense!
Both end up giving birth vaginally. Why would the attempted ones be more succesful than the regular ones if you look at these stats. http://www.mass.gov/Eeohhs2/docs//dhcfp/excel/mass_maternity_stats.xls
Why are these being kept track of seperately?
I know there is something I am not getting :-) Can you explain this in different words?
Thank you!
maria.
By: maria

I don't know where you could get the Dutch statistics. You are correct that the Dutch home birth rate has declined. In fact, I don't think it is as high as 40%. I think it may be in the low 30%s.

I believe the home birth rate in the U.S. has held steady at about 1% of births for quite a while now. That's the number that is in my head, although I'd really have to hunt around to see where that number is coming from. In any case, because of legal issues such as states where it is not legal for midwives to attend home births and how birth certificate data are collected, I think it would be very difficult to ascertain the true number of planned home births with a qualified attendant in this country.

-- Henci By: Henci Goer

Maria,
Sorry for taking so long to get back to you. The way I understand it, the "Successful VBAC" rate is a measure that looks at how often someone who attempts VBAC succeeds. This rate is usually around 75-90% and will be in the high end of the range when the labor takes place in a setting that is supportive of VBAC and in women who have had a vaginal birth before, etc.

The "VBAC rate" refers to how many people attempt VBAC in the first place. This value can help us understand whether a hospital is supportive of choosing VBAC. In hospitals that restrict VBAC, this number is going to be low (or even zero if they deny women this choice outright.)

Both are valuable numbers to know about a hospital or birth setting (or individual provider) because they reflect the attitude toward attempting VBAC (VBAC rate) as well as the quality of care provided to women who plan a VBAC (successful VBAC rate).

I hope this helps clarify things. Good luck with your upcoming birth!

Best,
Amy By: Amy Romano

Thanks! I get it now!
And thank you for the good birth wishes. So looking forward to it :-)
maria. By: maria

I just thought I'd mention that Ray DeVries, the current president of Lamaze International, is an expert on the Dutch maternity care system and has an excellent book called A Pleasing Birth which I strongly recommend. By: Amy Romano