Abstract
(Am J Obstet Gynecol. 2019;220:98.e1–98.e14) Although elective repeat cesarean is commonly performed to prevent uterine rupture during labor and other complications, cesarean delivery carries risks for mother and fetus, including increased risk of maternal and neonatal morbidity. Trial of labor after cesarean (TOLAC) delivery is recommended by the American College of Obstetricians and Gynecologists for women with no contraindications. The practice of TOLAC can be influenced by factors such as provider litigation concerns, patient preference and hospital support. The aim of this study was to understand varying utilization of TOLAC in California hospitals and how this affected patient outcomes. In addition, institutional characteristics associated with varying TOLAC utilization and success rates were analyzed.
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