The original tool, called the Vaginal Birth After Cesarean calculator, included a modifier assigning a higher risk of a complicated vaginal delivery to Black or Hispanic women with previous surgical C-sections compared to other women. The calculator led physicians to be more likely to recommend C-sections to Black or Hispanic women with a history of the procedures.
University of Maryland Medicine created an updated assessment tool that excludes race or ethnicity as a risk factor and adds consideration for a history of hypertension. This revised calculator, named VBAC 2.0, is endorsed by the American College of Obstetricians and Gynecologists.
“Consideration of a trial of labor toward vaginal birth can and should be a part of an informed, patient-centered discussion and shared decision-making process,” said May Hsieh Blanchard, MD, chief of general obstetrics and gynecology at the University of Maryland Medical Center. “Taking race and ethnicity out of the decision-making equation is an important step toward eliminating racial and ethnic disparities in maternal health and I’m proud that UMMS and UMSOM are among the leading institutions to decisively take this action.”
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