The Evidence on Uterine Rupture

How do short birth intervals, going over 40 weeks, big babies, & two prior cesareans impact uterine rupture rates?

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Are you a birth professional? Or did you give birth by cesarean? Do you want to learn about the evidence on uterine rupture?

Hi, I'm Jen Kamel. I have helped thousands of parents who have had cesareans, and the professionals who care for them, understand the evidence on vaginal birth after cesarean (VBAC).

You became a birth professional because you believed in the right of every pregnant person to get the care that they need during the most important and vulnerable time of their life.

Yet there’s so much conflicting information out there that may compromise your ability to give the best professional advice or guidance possible.

For example have you heard that it's unsafe to have a VBAC with a short birth interval or after two cesareans?

Or that the risk of uterine rupture increases dramatically after 40 weeks or with a big baby?

Well, I’m here to dispel the myths and tell you what the evidence actually says.

Most professionals don’t have time or desire to dig through hundreds of pages of medical reports.

That’s why I’ve done the hard work for you and put into a 60-minute online training everything you need to understand about how four factors impact uterine rupture risk.

This course is included in the
VBAC Facts Membership for Professionals


This training was first presented at the March 3, 2017 Grand Rounds at California Hospital in Downtown Los Angeles, California.

I didn't expect to become a consumer advocate

But after I had my cesarean for footling breech, it all changed.

I learned how difficult it was for parents to find reliable information on VBAC and how challenging it was for professionals to stay on top of the ever growing mountain of evidence.

I wanted to help, so I founded VBAC Facts, an educational, training, and consulting firm.

For almost a decade, I have traveled the country as a continuing education provider offering educational courses for parents, trainings for professionals, and legislative consulting for organizations.

When I was asked to present Grand Rounds on uterine rupture at California Hospital, I jumped at the chance.


After dozens of hours digging through the medical literature and presenting it to rave reviews from obstetricians, maternal-fetal medicine specialists, and midwives, I knew I could help more people by making this lecture available online.

What you'll learn

In just one hour, you can leave the confusion behind and finally bring clarity to all the conflicting viewpoints around this topic.

We’ll review the evidence on how uterine rupture rates are influenced by:

  • short birth intervals,
  • macrosomia,
  • going beyond 40 weeks gestation, and
  • two prior cesareans.

We will also discuss the three ways to evaluate medical research on VBAC and navigating informed refusal when there are some increased risks.

This course is for you if:

  • You don't have the time to do the research yourself.
  • You are a professional who wants to align your VBAC policies with the evidence so you can provide a deeper level of care to your clients.
  • You are a parent who wants to learn more about uterine rupture and how to make the healthiest choice for your family.
  • You are an advocate who wants to change hospital policy to ensure that women aren’t forced into unnecessary cesareans that threaten their health.

This course is included in the
VBAC Facts Membership for Professionals


This online training
is available for
you to attend at
your leisure.

As a Maternal-Fetal Medicine specialist, I see hundreds and hundreds of women who are cared for by other OBs. Talking with women with prior cesarean deliveries, I have come to realize all the misinformation that is imparted to them, all in the interest of convincing them to agree to a repeat cesarean delivery (even when the woman strongly desires a trial of labor).

The reasons that these women have quoted to me as what their OB doctor told them why they cannot have a trial of labor are so varied that I know they cannot possibly be evidence based. I just haven't gotten around to doing a thorough literature search to know what exactly the evidence is on these issues.

I attended Jen Kamel's "The Evidence on Uterine Rupture" and - IN ONE HOUR - I now feel well informed on this issue. She presented all the relevant studies as well as reviewing their sample sizes, methodologies, definitions used, and confounding factors.

When I counsel my patients in the future, I will be able to do so with a much more authoritative command of the current literature. Thanks Jen!

Emiliano Chavira, MD, MPH, FACOG
Maternal-Fetal Medicine and Obstetrics & Gynecology
- Eisner Pediatric and Family Medical Center
- San Gabriel Valley Perinatal Medical Group
- MFM Associates

Adriane Weller
Birth Doula

I was not confident in my knowledge and understanding of the evidence pertaining to VBAC, and what best quality information and resources I would offer clients. Now I feel confident in both.

I wanted a better knowledge of actual statistics and got them. I work from the approach of informed consent and empowerment, but I do need to know the larger risks.

Jen Holland
Certified Professional Midwife & Childbirth Educator

This course is included in the
VBAC Facts Membership for Professionals

Your Instructor

Jen Kamel
Jen Kamel

As a nationally recognized consumer advocate and Founder of VBAC Facts, Jen Kamel helps birth professionals, and cesarean parents, achieve clarity on vaginal birth after cesarean (VBAC) through her educational courses, training programs, and consulting services. She speaks at conferences across the country, presents Grand Rounds at hospitals, advises advocates seeking legislative change in their state, and serves as a expert witness in legal proceedings. She envisions a time when every pregnant person seeking VBAC has access to unbiased information, respectful providers, and community support, so they can plan the birth of their choosing in the setting they desire.

Frequently Asked Questions

When does the training start and finish?
Upon joining the VBAC Facts Professional Membership, you will receive 24/7 access this self-paced online training. You decide when you start and when you finish.
Are there continuing education hours available?
Yes! This course has been approved for 1.1 nursing continuing education hours through the California Board of Registered Nursing. These are accepted by all nursing boards in the United States as well as many doula, childbirth education, and midwifery organizations. Provider approved by the California Board of Registered Nursing, Continuing Education Provider #16238, for 1.1 continuing education hours.

Let's do this!