Utah Admin. Code R156-77-602 - Informed Consent
In addition to the standards for informed consent established in Subsection 58-77-601(1)(b), an informed consent for a client with a previous c-section, must include the following information about a VBAC:
(1) TOLAC is associated with the risk of
uterine rupture. Uterine rupture can cause brain damage or death of the baby
and result in serious hemorrhage or hysterectomy in the mother.
(2) VBAC poses more medical risks to the baby
than a scheduled repeat c-section.
(3) Repeat c-section poses more medical risks
to the mother than VBAC.
(4)
C-section after a failed TOLAC is associated with more risks than a c-section
done before labor has begun.
(5) If
a complication occurs from a TOLAC outside of a hospital setting, the risk to
mother and baby may be higher due to the inherent delay in obtaining access to
hospital care.
(6) Multiple
c-sections are associated with increased risks due to abnormal placental
implantation, hemorrhage requiring hysterectomy, and other surgical and
postoperative complications.
(7)
The risks associated with TOLAC after two c-sections are greater than those
after one c-section.
(8) Risks
associated with TOLAC when the type of uterine scar is unknown are greater than
when the uterine scar is known to be low transverse.
(9) The 2004 National Birth Center study
revealed women who attempt TOLAC in a birth center setting have an overall
transfer rate of 24%, and a vaginal delivery rate of 87%.
(10) A woman with no previous vaginal birth
and two previous c-sections for documented failure to progress, has a very low
vaginal delivery success rate.
Notes
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