NOW UPDATED: Ontario Health’s Vaginal Birth After Caesarean quality standard (updated in
2024, originally published in 2018) addresses care for people who have had
a Caesarean birth and are planning their next birth. It focuses on care for
people who are pregnant with 1 baby who is head-down and at full term. The
primary goals of this quality standard are to improve access to safe vaginal
birth after Caesarean (VBAC) and promote informed, shared decision-making.
Achieving these objectives is also expected to increase Ontario’s rate of
planned VBACs over time.
The quality standard includes 9 quality statements addressing areas that have high
potential to improve the quality of care in Ontario for people considering a VBAC.
Below are some tools and resources that may help you
implement the VBAC quality statements in your practice, organized by purpose.
Many of these tools can be used to support multiple quality statements.
Are there other tools or resources you use? Do you have
experience implementing these or other tools? If so, please share your thoughts
in the comments section below.
Tools to Support Clinical Practice
- No. 382: Trial of Labour After Caesarean – clinical
guidelines for VBAC approved by the Clinical Practice Obstetrics Committee and
the Board of the Society of Obstetricians and Gynaecologists of Canada
- Perinatal, Birthing and Newborn Levels of Care – a resource from the Provincial
Council for Maternal and Child Health that outlines the level of care available
at each Ontario hospital
- VBAC Quality Standard Report– an easy-to-use summary
developed by Better Outcomes Registry and Network (BORN) Ontario to help
Ontario hospitals assess their performance on indicators related to VBAC
Shared Decision-Making Aids
Resources for Patients and Families
- Patient Guide: Vaginal Birth After Caesarean – a resource
by Ontario Health to help people who have had a Caesarean birth and are
planning their next birth to know what high-quality care looks like and ask
informed questions about their care
- PregnancyInfo.ca: Birth – a resource website by the Society of Obstetricians and Gynaecologists of Canada that
provides pregnant people with information about birth, including labour,
delivery, and special considerations
- Trial of Labour After Caesarean Section video – a patient
information video created by the Southern Ontario Obstetrical Network that
discusses the risks, benefits, and details of a trial of labour after Caesarean
section
- Elective Repeat Caesarean Section video – a patient
information video created by the Southern Ontario Obstetrical Network that
discusses the risks, benefits, and details of an elective repeat Caesarean section
- My Next Birth – an online decision-making tool developed by Perinatal Services
BC that can help people consider their values and goals for their next birth
after a Caesarean section
- OMama
– a website and mobile application developed by the Better Outcomes Registry
and Network (BORN) Ontario that connects people with trusted, evidence-based
information on many pregnancy-related topics, including VBAC
- Patient handouts – educational handouts on Trial of Labour After Caesarean,
including a decision aid, are available in 9 languages: English, French,
Arabic, Farsi, Korean, Simplified Chinese, Traditional Chinese, Russian, and
Spanish
Other Tools and Resources
Comment below to describe your experience with these tools
or share any others you have found useful!