Prior Cesarean: A Contraindication to Labor Induction?MAULDIN, JILL G. MD; NEWMAN, ROGER B. MDClinical Obstetrics and Gynecology: September 2006 - Volume 49 - Issue 3 - p 684-697 Original Articles Abstract Author Information In 2004, cesarean rates were the highest ever in the United States. Simultaneously, the vaginal birth after cesarean (VBAC) rate fell, largely a result of reports of uterine rupture associated with VBAC attempts. This chapter reviews the efficacy and safety of VBAC associated with labor induction. Mechanical and pharmacologic methods of labor induction (notably misoprostol) are associated with increased maternal and perinatal morbidity compared with spontaneous VBAC attempts. However, the absolute risks remain low. Labor induction is not contraindicated in women with a prior cesarean but sound judgment, clinical precautions and specific consent are required. Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, South Carolina Correspondence: Jill Mauldin, MD, Department of Obstetrics and Gynecology, Medical University of SC, 96 Jonathan Lucas Street, Suite 634, PO Box 250619, Charleston, SC 29425. E-mail: firstname.lastname@example.org Copyright © 2006 Wolters Kluwer Health, Inc. All rights reserved.