Midwife-led antenatal care for women with a previous caesarean section

Rising caesarean section rates are of national and international concern. There are inherent costs associated with operative birth; these are financial as well as involving the health outcomes of mothers and babies. Vaginal birth after a caesarean (VBAC) is purported to be a safe option to reduce caesarean section rates. Antenatal care in a pregnancy after a caesarean section is based on both a risk assessment, which aims to establish if it is suitable for a woman to attempt VBAC, and then enabling the woman to make an informed decision about mode of birth. With suitable training it is believed that midwives are the most appropriate health professionals to provide this care. This article outlines the initiation of midwife led antenatal care for women who have had a previous caesarean section and was undertaken as a service improvement project when I was a consultant midwife trainee at Southampton University Hospitals Trust. Training was provided that acknowledged the midwives' expertise in caring for women with a previous caesarean section and provided them with up to date, relevant information and documentation aids to provide the care. As with any change in services, there were benefits but also challenges. The benefits include the promotion of normality for women with a previous caesarean throughout their pregnancy, continuity of information to increase informed choice, and better continuity of carer. As for the challenges, read on[horizontal ellipsis]