BAC - Birth After Caesarean: Planned vaginal birth or planned elective repeat caesarean for women at term with a single previous caesarean section.

This trial has completed recruitment and follow up to 18 months is continuing.

In Australia in 2003, 28.5% of infants were born by caesarean section. As in most other developed countries the caesarean rate in Australia has continued to rise. Previous caesarean is the main reason (56.6%) for an elective caesarean and 13.9% of caesareans are in women who have had a previous caesarean. Specific clinical initiatives in several countries have focused on reducing the number of caesareans which includes increasing rates for vaginal birth after caesarean. However, recent reports of vaginal birth after caesarean have highlighted risks of increased morbidity including uterine rupture. VBAC rates are declining. There is renewed debate over the relative safety of vaginal birth after caesarean. Two policies of care are standard in current clinical practice within Australia: planned vaginal birth after caesarean (VBAC), and planned elective repeat caesarean. Current evidence from observational studies has limitations indicating a need for a study to assess the infant and maternal health outcomes in these two forms of care. This study will help provide better information about the safety of these two forms of care.

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