This study analyzed VBAC incidence and outcomes across rural, urban non-teaching, and urban teaching hospitals using 2000 HCUP data (n=89,536). The overall VBAC rate was 19.5% and uterine rupture incidence 0.48%. VBAC rates were lowest in rural hospitals and highest in urban teaching settings. Maternal age and hospital type influenced rupture risk; women over 35 in rural hospitals had higher risk, while younger women in urban non-teaching hospitals had lower risk. Induction of labor significantly increased rupture risk. Maternal morbidity was not associated with hospital type, suggesting patient and clinical factors are more influential than setting.
