VBAC: safety for the patient and the nurse.

During the 1970s and 1980s, some women fought for the opportunity to deliver vaginally after a cesarean birth (VBAC). The American College of Obstetricians and Gynecologists initially supported VBAC for many low-risk women. Interventions increased and complications of VBAC were reported, however, and recommendations changed. VBAC should be performed in hospitals equipped to care for women at high risk. Nurses caring for patients undergoing VBAC should be able to recognize and respond to the signs and symptoms of uterine rupture, including the most common symptom, which is a nonreassuring fetal monitor tracing. Nurses also should be aware of the necessity for 24-hour blood banking, electronic fetal monitoring, on-site anesthesia coverage, and continuous presence of a surgeon.