Originally written in 2004 and recently reaffirmed in 2009, the ACOG provides a practice bulletin that reviews the literature on VBACs and offers guidelines for assessing the risks and benefits of TOLAC to individual patients in specific situations. The following are selection criteria based on good and consistent scientific data for VBAC candidates:
• Only one previous low-transverse cesarean delivery
• Clinically adequate pelvis
• No other uterine scars or previous ruptures
• MD immediately available throughout active labor who is capable of an emergent cesarean delivery
• Availability of anesthesia and personnel for emergent cesarean delivery
• No other contraindication to vaginal delivery
Other guidelines with limited or inconsistent evidence exist for individual situations outside of these.
Specific guidelines have been endorsed by the American College of Obstetricians and Gynecologists (ACOG) to identify women who are candidates for trials of labor after cesarean sections..
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