Incidence and Predictors of Successful Vaginal Birth Among Women With a History of Cesarean Section in Public Health Facilities of Southern Ethiopia in 2021

Abstract

BACKGROUND:Even though a cesarean section (CS) performed greater than 15% has no significant association with a reduction in maternal and neonatal mortality, repeat elective CS continues to play a major role in unnecessary CS worldwide. Trial of labor after cesarean (TOLAC) is one of the strategies to reduce the rate of unnecessary CS. However, the selection of candidates for a TOLAC is not an easy task without evidence. This study was conducted to determine the incidence of successful vaginal birth after one CS and the associated factors in public health facilities in southern Ethiopia.METHODS:An institutional-based cross-sectional study was conducted from June 10, 2020, to December 10, 2021, on laboring women, and the data were collected using a pretested interviewer-administered questionnaire and a data extraction sheet. A binary logistic regression model was used to assess the factors associated with successful vaginal birth after cesarean (VBAC) section using SPSS version 25. Bivariate and multivariate analyses were performed, and independent variables withp< .05 along with an odd ratio and 95% confidence interval (CI) declare the associated factors.RESULTS:A total of 417 women participated in this study making a response rate of 98.8%. The incidence of vaginal births after cesarean was 51.1% (CI, 46%–56%). The likelihood of successful VBAC was observed in women with a history of vaginal delivery before CS (AOR, 3.7, CI = 1.06, 13.19), favorable Bishop score at admission (AOR, 19.1, CI = 2.69, 134.98), greater than 4-cm cervical dilation at admission (AOR, 171.3, CI = 1.8, 16,722), and clear color of amniotic fluid (AOR, .096, CI = .02, .38).CONCLUSION:The incidence of VBAC in this study is promising and should be practiced. In choosing a woman for the TOLAC, health professionals might need to pay attention to intrapartum variables, such as cervical dilation, Bishop score, and color of the amniotic fluid.