RN Nursing · Vaginal Birth After Cesarean · Practice question
A nurse is caring for a client who wants to know if it is possible to have a vaginal birth after a cesarean birth (VBAC). Which of the following statements by the nurse is appropriate?
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"It's too soon for you to be worrying about that now."
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"There are so many variables that you'll have to ask your provider."
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"A repeat cesarean section would be safer for both you and your baby."
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✓
"The primary consideration is what type of incision you had."
Answer & explanation
Correct: "The primary consideration is what type of incision you had."
When a client asks about vaginal birth after cesarean (VBAC), the most appropriate and evidence-based nursing response is that the primary consideration is the type of uterine incision from the prior cesarean birth. A low transverse uterine incision is generally considered compatible with a trial of labor after cesarean (TOLAC), whereas a classical (vertical) or T-shaped uterine incision carries a significantly higher risk of uterine rupture and is typically a contraindication to VBAC. This information empowers the client and is factually accurate. Telling the client it is too soon to worry is dismissive and blocks therapeutic communication. Saying the client must ask the provider without offering any information is an unhelpful deflection that does not educate the client. Stating that repeat cesarean is safer for both mother and baby is an opinion not supported by current evidence for all clients and is outside the nurse's scope to advise. The nurse's role is to provide accurate, supportive education, and identifying the uterine incision type as the primary determinant is both appropriate and clinically correct.
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- The nurse is educating a G2P1 client who had a cesarean section with her previous pregnancy due to labor dystocia and wants to have a vaginal delivery with this pregnancy. Which statement by the client indicates the need for further education regarding a trial of labor after cesarean (TOLAC)?
- A nurse is caring for a client who wants to know if it is possible to have a vaginal birth after a cesarean birth (VBAC). Which of the following statements by the nurse is appropriate?