Section R156-77-602 - Informed ConsentIn addition to the standards for informed consent established in Subsection 58-77-601(1)(b), an informed consent for a client with a previous c-section, must include the following information about a VBAC:
(1) TOLAC is associated with the risk of uterine rupture. Uterine rupture can cause brain damage or death of the baby and result in serious hemorrhage or hysterectomy in the mother.(2) VBAC poses more medical risks to the baby than a scheduled repeat c-section.(3) Repeat c-section poses more medical risks to the mother than VBAC.(4) C-section after a failed TOLAC is associated with more risks than a c-section done before labor has begun.(5) If a complication occurs from a TOLAC outside of a hospital setting, the risk to mother and baby may be higher due to the inherent delay in obtaining access to hospital care.(6) Multiple c-sections are associated with, but not limited to, increased risks due to abnormal placental implantation, hemorrhage requiring hysterectomy, and other surgical and postoperative complications.(7) The risks associated with TOLAC after two c-sections are greater than those after one c- section.(8) Risks associated with TOLAC when the type of uterine scar is unknown are greater than when the uterine scar is known to be low transverse.(9) The 2004 National Birth Center study revealed women who attempt TOLAC in a birth center setting have an overall transfer rate of 24%, and a vaginal delivery rate of 87%.(10) A woman with no previous vaginal birth and two previous c-sections for documented failure to progress, has a very low vaginal delivery success rate.Utah Admin. Code R156-77-602