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Revisiting the Care Pathway for Trial of Labour After Cesarean: The Decision-to-Delivery Interval Is Key

Published:September 30, 2020DOI:https://doi.org/10.1016/j.jogc.2020.05.017

      Abstract

      Centres providing maternity care and offering a trial of labour after cesarean must develop and use maternal educational and consent processes that emphasize choice and autonomy related to options for and decisions surrounding vaginal birth after cesarean and elective repeat cesarean delivery. These centres should have administrative systems and processes that take into account local resources for cesarean delivery services, including team-based complex maternity risk support and an urgency consensus on the fetal, maternal, and maternal–fetal indications for a surgical delivery to ensure an appropriate decision-to-delivery interval.

      Résumé

      Les centres qui prodiguent des soins de maternité et offrent l’épreuve de travail après césarienne doivent mettre au point et utiliser des processus d’éducation et de consentement maternels. Ces processus doivent mettre l'accent sur le choix et l'autonomie par rapport aux options et aux décisions entourant l'accouchement vaginal après césarienne ou la césarienne itérative planifiée. Ces centres doivent avoir des systèmes et processus administratifs qui tiennent compte de la disponibilité des ressources locales pour l'accouchement par césarienne. Ces systèmes et processus doivent intégrer un soutien collaboratif en matière de risques maternels complexes et un consensus d'urgence sur les indications fœtales, maternelles et fœto-maternelles de l'accouchement chirurgicale afin d'assurer un intervalle décision-accouchement adéquat.

      Keywords

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