VBAC Revisited: Avoiding the Swinging Pendulum

Credits: 1.25

Course Description
The risks and benefits of VBAC present a complex challenge. Pressures to lower cesarean rates run headlong into the question of whether prompt operative intervention can be guaranteed in an emergency. The reconsideration of previously-established guidelines and appeals from natural childbirth advocates add to the complexity, especially as acceptable risk differs from patient to patient.

How should you counsel women about trial of labor after cesarean?
How should you manage their labor?

In this 1.25 hour webinar, obstetrical leader Dr. Steven L. Clark will address these questions through a reasoned approach to VBAC based on careful patient selection and a focus on patient safety.

Learning Objectives
Participants will leave this activity able to:
  • Implement careful pre-labor stratification of women considering VBAC.
  • Use predicted success rates and medical evidence to counsel prenatal patients with a prior cesarean birth.
  • Ensure immediate availability of emergency operative intervention for patients undergoing trial of labor after cesarean.
Faculty Information
Steven L. Clark, MD is a maternal-fetal medicine specialist and is Medical Director of Women's and Children's Clinical Services for the Hospital Corporation of America. He was formerly professor of Obstetrics and Gynecology at the University of Utah. He has served as president of the Society for Maternal Fetal Medicine, Chair of the ACOG Technical Bulletin Committee and as a board examiner. He has served on several ACOG task forces and committees, and as patient safety consultant to the U.S. Air Force Surgeon General. He currently serves on the Scientific Advisory Board for United Health Care, and on the Joint Commission Perinatal Advisory Panel. He has published over 200 scientific articles and chapters, and edited several textbooks, including Critical Care Obstetrics. He serves as a peer reviewer for 23 national and international scientific journals.

Planning Group
Angela Chien, MD, Obstetrics, EvergreenHealth, Kirkland, WA
Leslee Goetz, MN, RNC-OB, Manager Family Childbirth Center, Swedish Ballard, Seattle, WA
Kym Lewis Shepherd, Director, Complex Litigation, Physicians Insurance, Seattle, WA
Linda Robinson, MSN, RNC, Perinatal Clinical Nurse Specialist, Group Health Cooperative, Seattle, WA
Celia Smith, CHCP, Director, Continuing Medical Education, Physicians Insurance, Seattle, WA

Original release: January 2015
Last reviewed: January 2017
Expiration: January 2018

CME Information
Physicians in Washington who complete this course will fulfill the risk management-education requirement mandated by the Washington Health Services Act of 1993.

Category 1 credit is applicable throughout the United States.
Estimated time to complete this activity: 1 hour
Physicians Insurance/Experix members in Washington who complete this course will fulfill the risk management-education requirement mandated by the Washington Health Services Act of 1993.

Physicians Insurance/Experix is accredited by the Washington State Medical Association to provide continuing medical education for physicians.
Physicians Insurance/Experix designates this live activity for a maximum of 1.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
This activity meets the criteria for up to 1.25 hours of Category I CME credit to satisfy the relicensure requirements of the Washington State Medical Quality Assurance Commission.

All faculty, planning and peer-review group members have certified that neither they nor their spouses/partners have, nor have had within the health care goods or services consumed by or used on patients, with the exemption of non-profit or government organizations and non-health care related companies.

Resolution of Conflicts of Interest
Physicians Insurance/Experix has implemented a process to resolve conflicts of interest for each continuing medical education activity, to help ensure content objectivity, independence, fair balance, and content that is aligned with the interest of the public. Conflicts, if any, are resolved through a peer-review process.

* If you are a member of Physicians Insurance, all CME courses are included with your premium. Click here to access members-only CME.