The hospital where I had my twins was an hour away...the main problem this presented was I left for hospital too early resulting in a stalled labour. I got there in the end without drugs but if I had been cared for by doctors rather than midwives I feel certain synto would have been recommended. That is always a danger when the hospital is far away, you either leave too early and labour stops, or you leave too late and risk giving birth by the roadside.
I would be concerned about a 41% VBAC rate though, that seems very low. I am sure the hospitals here aim for 60% - 70% successful VBAC's.

