First Stage Of Labor Research Articles

PP38 Immersion in water during childbirth: A survey to the Spanish National Health System

IntroductionCertain doubts about immersion in water during birth mainly regarding the safety of the infant, warrant analysis of the data to determine whether immersion in water during childbirth is safe and effective. The aim is to describe the situation regarding the use of water immersion during childbirth in hospitals of the Spanish National Health System across Spanish Autonomous Regions and Cities.MethodsA questionnaire was developed to assess the use of water immersion on maternity wards of National Health System hospitals. The survey was reviewed by several categories of health professionals and stakeholders. The online questionnaire was distributed via email. A database was created using the Microsoft Excel 365® computer program. Quantitative results were described through percentages and frequency distributions. In the case of free responses, a content analysis was performed, coding the responses into different categories.ResultsRegarding the status of water birth in Spain, the availability of the option of water birth varies across hospitals of the National Health System. Forty-six hospitals in 13 autonomous regions indicated that they had birthing pools on their delivery wards. Among these hospitals, 20 percent reported having more than 10 years of experience in water births, 45 percent between five and 10 years and 35 percent less than five years. Of the 46 responses received, 78 percent of the hospitals indicated that there was a demand for information on waterbirth by pregnant women. Regarding the existence of criteria for the adequate selection of pregnant women who could opt for immersion in water during childbirth, 89 percent of the hospitals indicated that these did exist, while 11 percent indicated that they did not have agreed criteria for the selection of candidates for water birth.ConclusionsThe availability of the option of water birth varies in hospitals across the Spanish National System. All the hospitals that have birthing pools offer them in the first stage of labor (dilation), while 32 percent also use them in the pushing stage and 15 percent during delivery of the placenta. It would be advisable to have standardized protocols and training to ensure the possibility that all pregnant women, regardless of their place of residence, can safely opt for water immersion during childbirth with satisfactory results.

Effects of auricular point sticking on labor pain and anxiety

ObjectiveTo observe the effects of auricular point sticking on pain and anxiety during the latent period of the first stage of labor in primiparas.MethodsPrimiparas meeting eligibility criteria were recruited. The participants were randomized into an auricular point group, a placebo group, and a control group. The control group received daily care. The auricular point group received 120 min of auricular point sticking therapy. The placebo group received the same auricular plasters as the auricular point group but without pressing. Participants’ pain, anxiety, and uterine contractions were measured at enrollment and 30, 60, and 120 min of interventions.ResultsData from 78 participants were analyzed in this study. After uterine contraction was adjusted as a covariate, there was no significant difference among groups in the baseline anxiety, baseline pain, and anxiety at 30-min intervention (P>0.05), and no significant difference between the placebo group and the control group in each indicator at each time point (P>0.05). The anxiety scores of the auricular point group at 60 min and 120 min were lower than those of the placebo group and the control group (P<0.05). The pain in the auricular point group was less than that in the placebo group and the control group at 30, 60, and 120 min of interventions (P<0.05).ConclusionAuricular point sticking therapy can relieve anxiety and pain in women during the latent period of labor. Moreover, the effect is fast-acting. It can be used as a safe and effective complementary therapy.

Pengaruh Terapi Murotal Surat Ar-Rahman Terhadap Tingkat Kecemasan Ibu Bersalin Kala I Fase Aktif Di BPM Rika Rohaeni S.ST Kecamatan Muncang Kabupaten Lebak

Introduction: The feeling of anxiety for the mother in labor when thinking about the process of giving birth and the condition of the baby to be born does not only occur in her first pregnancy; but also, in subsequent pregnancies. Some actions that can be taken to overcome anxiety in pregnant women include using pharmacological and non-pharmacological therapies. In this study, researchers took action to overcome anxiety in mothers in the first stage of labor, one of which was the distraction technique, one of which was murotal therapy. Methods: The research design used was one group pre and post-test without a control group design, the sample of this study was 30 people. Results: The results of the average value of maternal anxiety during the first active phase before being given murotal surah Ar-Rahman therapy was 47,733; the minimum value was 33,0 the maximum value was 64,0 and the standard deviation was 8,582 (p-value = 0,015); while the average anxiety for mothers in labor. when 1 active phase after being given murotal surah Ar-Rahman therapy was 44,333 the minimum value was 30,0 the maximum value was 59,0 and the standard deviation was 7,866. The results of the Wilcoxon test showed the effect of giving murotal surah Ar-Rahman therapy on the anxiety level of mothers during the first active phase of childbirth at BPM Rika Rohaeni S.ST Muncang District, Lebak Regency in 2023 (p-value = 0,000). Discussion: Murotal therapy affects maternal anxiety so it is hoped that health workers can combine pharmacological and non-pharmacological therapy as a form of intervention in providing midwife services.

Unilateral Horner syndrome and trigeminal palsy after lumbar epidural analgesia during labor

Case report: The present case report explains a rare and unusual complication of self-limiting unilateral Horner syndrome and trigeminal palsy after Lumbar Epidural analgesia for Normal delivery. A 22-year-old healthy primigravida at 38 weeks gestation, with an unremarkable medical history and prenatal course, was admitted to the hospital in active labor. Epidural anesthesia was administered during the first stage of labor under oxytocin infusion. The procedure was uneventful, with the patient experiencing good pain relief and no motor block. However, approximately 25 minutes after epidural placement, the patient reported left eyelid heaviness, decreased sensation on the left cheek, miosis, ptosis, and redness in the left eye. Neurologic symptoms were limited to this presentation, and the patient's blood pressure dropped briefly but returned to normal with ephedrine. The patient's symptoms resolved after about 3 hours. Later, the epidural catheter was repositioned, and the patient experienced pain relief for a limited time before again developing eye symptoms. Despite stable hemodynamics, the infusion was stopped, and the patient received Entonox for pain relief. Due to a failure to progress, a cesarean delivery was performed, and the patient fully recovered from the epidural block. No further signs or symptoms of Horner's syndrome or trigeminal nerve palsy were observed postoperatively. Conclusion: This case underscores the importance of recognizing and managing rare neurological complications, such as Horner's syndrome and trigeminal nerve palsy, in the context of epidural anesthesia during labor. While the symptoms observed were transient and resolved postpartum, healthcare providers should remain vigilant and ready to respond to such adverse events, ensuring the safety and well-being of both the mother and the newborn.

Active pelvic movements on a Swiss ball reduced labour duration, pain, fatigue and anxiety in parturient women: a randomised trial

QuestionHow much do active pelvic movements on a Swiss ball during labour affect maternal and neonatal outcomes? MethodA randomised trial with concealed allocation, blinded assessors and intention-to-treat analysis. ParticipantsTwo-hundred parturient women. InterventionThe experimental group performed pelvic anteversion and retroversion, lateral pelvic tilts and circular hip movements according to individual obstetric evaluation (foetal station and position, cervical dilatation and the presence of early pushing urge) on a Swiss ball. The control group received usual care. Both groups were permitted to walk and shower. Outcome measuresThe primary outcome was the duration of the first stage of labour. The secondary outcomes were the duration of the second stage of labour, pain intensity, delivery mode, medication use, local swelling, fatigue, anxiety, satisfaction and neonatal outcomes. ResultsThe experimental intervention reduced the duration of labour by 179 minutes (95% CI 146 to 213) in stage one and 19 minutes (95% CI 13 to 25) in stage two. It decreased pain by approximately 2 points (95% CI 2 to 2) on a 0-to-10 scale at 30, 60 and 90 minutes. It reduced the risk of a caesarean section (ARR 0.14, 95% CI 0.03 to 0.25; NNT 7, 95% CI 4 to 32) and vulvar swelling (ARR 0.11, 95% CI 0.03 to 0.19; NNT 9, 95% CI 5 to 31). It reduced fatigue by 18 points (95% CI 16 to 21) on a 15-to-75-point scale and anxiety by 9 points (95% CI 8 to 11) on an 18-to-72-point scale. Other effects were negligible or unclear. ConclusionActive pelvic movements on a Swiss ball during labour reduced the duration of labour, pain intensity, and maternal fatigue and anxiety; they also lowered the risk of caesarean section and vulvar swelling. Several effects exceeded the smallest worthwhile effect. RegistrationNCT04124835.

Intrapartum transperineal ultrasound: angle of progression to evaluate and predict the mode of delivery and labor progression.

Intrapartum ultrasonography serves as a valuable tool for the objective evaluation of labor progression and effectively identifies underlying factors, such as asynclitism, in cases of abnormal labor progression. Among the various ultrasound measurement techniques, the angle of progression (AOP) demonstrates favorable reproducibility and accuracy in assessing fetal head descent. In the context of abnormal labor, interventions differ across different stages of labor, emphasizing the importance of investigating the utility of AOP according to labor stages in this review article. Pre-labor assessment of AOP can be beneficial in terms of counseling for the timing of induction of labor, while a wider AOP value during the prolonged first stage of labor has demonstrated a positive correlation with successful vaginal delivery and shorter time to delivery. In the second stage of labor, the AOP has exhibited efficacy in predicting the mode of delivery and complicated operative deliveries. Furthermore, it has assisted in predicting the duration of labor, thereby highlighting its potential as a decision-making model for labor progression. However, further research is needed to investigate aspects, such as the determination of cutoff values, of AOP, considering the multifaceted characteristics of labor progression, which are influenced by complex interactions among maternal, fetal, and other contributing factors.

Effect of Emotional Freedom Technique on Fear of Childbirth and Stress among Primiparous Women during the First Stage of Labor

Effect of Emotional Freedom Technique on Fear of Childbirth and Stress among Primiparous Women during the First Stage of Labor

The husband as a labor companion has a good influence on the duration of labor

Birth support can prevent prolonged labor. The husband can carry out this support as a delivery companion. This study aims to assess the effect of the husband's role as a labor companion on the duration of labor. This research is an observational analytic study with a cross-sectional design. The samples in this study were 60 pairs of mothers and their husbands who met the inclusion and exclusion criteria. Data were obtained using the observation sheet on the husband's role and partograph. The analysis used in this study was the chi-square test and logistic regression. Mothers in labor will have an increased risk of 2.85 to experience a prolonged first stage of labor if the husband does not provide sufficient support as a birth companion during labor (OR=2.8, 95% CI=1.52-5.16). Good labor companion by the husband will be able to prevent mothers from experiencing a long second stage of labor (OR = 0.34, 95% CI = 0.18-0.62). The role of a good husband as a birth companion is to maintain the expected time for the first and second stages of labor and prevent the long duration of labor.

Effects of combined spinal-epidural anesthesia on anxiety, labor analgesia and motor blocks in women during natural delivery

BACKGROUND The background of this study was analgesia in natural delivery. The combined spinal-epidural anesthesia has obvious analgesic effect on the parturients in natural labor, and combined spinal-epidural anesthesia has been widely used in anesthesia for various diseases. AIM To study the effects of combined spinal-epidural anesthesia on anxiety, labor analgesia, and motor blocks in parturients during natural delivery. METHODS A total of 120 women who gave birth at Changning District Maternal and Child Health Hospital between December 2021 to December 2022 were included; a random number table approach was employed to divide the women into a control group and a joint group, with each group consisting of 60 women. The control group was given epidural anesthesia, while the joint group was given combined spinal-epidural anesthesia. The visual analog scale (VAS) was used to evaluate the degree of maternal pain. Comparisons were made between the two groups’ conditions of childbirth and the duration of labor. Apgar scores were used to evaluate the status of the newborns at birth; Self-rating Anxiety Scale (SAS) and General Self-Efficacy Scale (GSES) scores, umbilical artery blood gas analysis indices and stress indices were compared between the two groups; and the frequencies of motor block and postpartum complications were analyzed. RESULTS In comparison to the control group, in the joint group, the VAS scores for the first, second, and third stages of labor were lower (P &lt; 0.05). The rates of conversion to cesarean section and postpartum blood loss in the joint group were lower than those in the control group (P &lt; 0.05). No significant differences were observed in the Apgar score, the duration of the first stage of labor, or the total duration of labor between the two groups (P &gt; 0.05). The second and third stages of labor in the joint group were shorter than those in the control group (P &lt; 0.05). When compared to the control group, the postpartum SAS score of the joint group was lower, while the GSES score was greater (P &lt; 0.05). Between the control group and the joint group, the differences observed in pH, arterial carbon dioxide partial pressure, arterial oxygen partial pressure, or arterial hydrogen ion concentration were not significant (P &gt; 0.05). Nitric oxide, cortisol, and adrenaline levels were lower in the joint group than in the control group (P &lt; 0.05). There were no substantial differences in Bromage grade or rate of complications between the two groups (P &gt; 0.05). CONCLUSION For parturients during natural delivery, combined spinal-epidural anesthesia can reduce anxiety, provide labor analgesia, shorten labor time, and reduce postoperative stress levels but did not result in a motor block.

The Effect of Counter Pressure and Birthball on The Time of The First Stage of Labor and Prevention of Perineal Rupture

Mothers with prolonged labor have a higher risk of bleeding. This study aimed to determine the effect of the counterpressure technique with a birthball on the length of the first stage of perineal rupture. This type of research is quantitative with a quasi-experimental design using an observation form conducted in Kendari City Hospital from May to August 2023. The design used was a two-group-only post-test, with a control group. The study population comprised multiparous mothers in the first active stage. The sample size consisting of 20 who were given the counterpressure technique with birthball, 20 who were only given the counterpressure technique, and 20 who received no treatment. The inclusion criteria were mothers who were willing to become respondents and mothers who gave birth with normal births. The samples were collected using purposive sampling. The t-test was used to determine the differences between the three groups. The results of the difference test in the length of active phase I between the group given the counterpressure technique with birthball (intervention I) and the control group were p-value (0.000). The results of the analysis for the group given the counterpressure technique (Intervention II) with the control group were p-value (0.000). The results of the analysis for the group given the counterpressure technique with birthball (Intervention I) with the counterpressure technique (Intervention II) were p-value (0.759). In Conclusions, Providing counterpressure techniques with a birthball or simply providing counterpressure techniques is effective in reducing the incidence of perineal ruptures.

Intrapartum care measures and indicators for monitoring the implementation of WHO recommendations for a positive childbirth experience: a scoping review

ObjectiveWe aimed to identify all available studies describing measures or indicators used to monitor 41 intrapartum care practices described in the 2018 WHO intrapartum care recommendations, with a view to...

Pengaruh Relaksasi Pernapasan Terhadap Intensitas Nyeri Pada Persalinan Kala I Di PMB Erlina Herawati Tahun 2023

Maternal who is difficult to adapt to the pain of labor can cause uncoordinated uterine contractions which can lead to prolongation of the first stage of labor and impaired fetal well-being. The purpose of this study was to see whether there was an effect of respiratory relaxation on the intensity of the first stage labor pain in the maternal love clinic Erlina Herawati, sub-district in 2023. This type of quantitative research used the One Group Pre Test- Post Test Design method with a population of all inpartum mothers in April 2023- June 2023 and a sample of 15 respondents. The results that have been obtained during the study including before the treatment showed mild pain by 2 respondents (13.3%), moderate pain by 6 respondents (40.0%), severe pain by 7 respondents (46.7%). Meanwhile, after treatment of mild pain 8 respondents (53.3%), moderate pain 4 respondents (26.7%), severe pain 3 respondents (20.0%). From the results of the study, it was found that the effect of before being treated and after being treated had a significant change in pain in the mother in labor. Therefore, it is hoped that in the future midwives in clinics will be able to facilitate mothers in giving birth by relaxing breathing it can reduce pain during labor, especially during the first stage of labor.

Edukasi dan Pendampingan Ibu Bersalin Kala 1 dalam Melakukan Mobilisasi di Ruang Bersalin Puskesmas Paiton

Childbirth is the birth of the baby, placenta and amniotic membranes from the uterus to the outside world. Long labor causes mothers to experience stress and fatigue for longer so that pain will increase. The causes of labor pain are caused by various factors such as uterine muscle contractions, stretching of the pelvic floor muscles, episotomy and psychological conditions, namely anxiety which can increase the incidence of stress. To overcome prolonged labor, active labor techniques have been introduced. The active labor method has actually been implemented as one of the care services during the birth process, namely in terms of mobilization which encourages the mother to choose the position that is considered the most comfortable with the aim of minimizing pain and which can affect the length of labor. labor. first and second stages of labor. In reality, there are still many mothers who give birth who experience difficulty in mobilizing and positioning and only focus on the pain and are afraid to move so they only stay in one position during the birth process, this can make the muscles stiff and cause pain. it is difficult for the fetus to descend into the pelvis. Based on research, pregnant women who carry out mobilizations such as walking lightly and arranging a comfortable position can speed up the descent of the head and the opening of the cervix. This service takes the form of providing education about the benefits of mobilization for mothers during the first stage of labor and providing assistance with mobilization in the delivery room. Providing education and assistance can help mothers in labor empower themselves in undergoing labor so that it is hoped that labor can run smoothly. This community service can help mothers in labor to empower themselves to mobilize in an effort to speed up the descent of the fetal head, speed up opening and the mother can adjust to a comfortable position so that the birth runs smoothly.

Effect of lavender aromatherapy mask on anxiety in the first stage of labour

The anxiety experienced by most maternity mothers arises because of fear of pain. During a pandemic, relaxation with lavender aromatherapy requires innovation. The purpose of this study was to analyze the effect of using lavender aromatherapy masks on anxiety in the first stage of labour. The design of this study was a true experiment with a randomized controlled clinical trial. The intervention group wore lavender aromatherapy masks with a 100% concentration dose content of 0.08 ml for 120 minutes. The study sampled 40 samples. The results of the study were that there was an effect of lavender aromatherapy masks on anxiety in the first stage of labour (p=0.000) with an effect size (d=1.319). Using a lavender aromatherapy mask can minimize the increase of anxiety during the first stage of labour.

Pengaruh Pemberian Kompres Hangat Terhadap Nyeri Persalinan Pada Inpartu Kala I Fase Aktif Di RSI Fatimah Banyuwangi Tahun 2022

Labor is the process by which the fetus and amniotic fluid are pushed out through the birth canal. During the birth process the mother will experience pain. Pain that is uncontrolled or excerssive and does not get proper treatment can cause problems with difficulty in childbirth. A non-pharmocological method that is quite safe was to determine the effect of giving warm compresses to labor pain in the active phase of the first stage of labor at Fatimah Banyuwangi Hospital in 2022. The research method used a pre-exsperimental one group pretest posttest on 30 respondents who met the inclusion criteria, namely pregnant women in the first active phase, singleton pregnancies, head presentations, term pregnancies, normal delivery plants, fetal interpretation between 2500-4000 grams, accompanied by their husbands or family. Data collection was carried out using the VAS observation sheet and warm compress SOP. Then the data is processed through the process of editing, coding,scring, tabulating and statistical analysis of the Wilcoxon test. The result showed that the level of labor pain before the intervention was mostly in the severe pain category by 53% and after the warm compress intervention there was a decrease in the pain level, namely in the moderate pain category by 70%. Wilcoxon test reslts Asymp. Sig. (2-tailed) 0,00 &lt; 0,05 means that there is a significant effect of giving warm compresses to labor pain in the active phase I parturition at RSI Fatimah Banyuwangi in 2022. Proper application of warm compresses according to the procedure gives a feeling of warmth and causes vasoconstriction so that labor pain in the first stage can be reduced. This method is safe and can be an alternative choice for midwives in the management of pain care during labor.

Effects of Virtual Reality Interventions on the Parameters of Normal Labor: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. A Meta-Analysis of Virtual Reality Interventions on the Parameters of Normal Labor

BackgroundClinical and experimental studies on virtual reality have shown that this easy-to-use and non-invasive method is a safe and effective strategy during normal labor. AimThis study aims to analyze the effects of virtual reality (VR) interventions on some of the parameters of normal labor. DesignSystematic review and meta-analysis. MethodHigher Education Council National Thesis Center, Scopus, PubMed, Google Scholar, and Science Direct databases were systematically searched for randomized controlled trials that administered VR to the intervention group but not to the control group and were published through January 2022. RevMan software was used to analyze the meta-analysis data. Pain, anxiety, satisfaction, and the duration of the first and second stages of labor were assessed as outcomes of normal labor. ResultsSeven randomized controlled trials, with a total of 756 women in total, met the inclusion criteria. Virtual reality interventions significantly reduced pain scores when cervical dilatation was ≤4 cm (MD = −0.43, 95% expansion here (CI [−0.65, −0.21], p < .001) and ≥9 cm (SMD = −1.91, 95% CI [−2.56, −1.26], p < .001). Anxiety scores significantly decreased (SMD = –1.08, 95% CI [–1.75, 0.41], p < .001), and childbirth satisfaction significantly increased (MD = 11.24, 95% CI [2.17, 20.30], p < .001) in the VR intervention groups. Finally, when compared to the control groups, the duration of the first stage of labor (SMD = –0.53, 95% CI [–0.83, –0.22], p < .01) and the second stage of labor (MD = –0.39, 95% CI [–0.76, –0.02], p = .001) were significantly decreased in the VR intervention groups. ConclusionsVirtual reality interventions are effective methods to reduce pain, anxiety, and the duration of the first and second stages of labor and to increase satisfaction with normal labor.

Rubbing Massage Provides Good Evidence in Reducing Pain in the First Stage of Labor

Pain is a common complaint felt by mothers during labor. Massage can be used as an intervention to reduce labor pain. The study contributes to determining the effect of rubbing massage on pain in the first phase of active labor in Pekalongan City. This quantitative research uses a quasi-experiment approach with a pretest and posttest without a control group design. The population was the first phase of active maternity mothers in Pekalongan, Central Java, Indonesia, in September-November 2017. Samples of 21 mothers were taken using purposive sampling. Statistical tests use the Wilcoxon test. Most respondents of the young age category (&gt; 26 years) are 12 mothers (57%). Respondents had the most junior high school education of 9 mothers (43%). The median of the pretest pain was six, and the posttest pain was 5. The bivariate results obtained a p-value of 0,000. The results showed that rubbing massage effectively reduces pain in first-phase active mothers.

Duration of the active first stage of labour and severe perineal lacerations and maternal postpartum complications: a population-based cohort study.

The impact of first stage labour duration on maternal outcomes is sparsely investigated. We aimed to study the association between a longer active first stage and maternal complications in the early postpartum period. A population-based cohort study. Regions of Stockholm and Gotland, Sweden, 2008-2020. A cohort of 159 459 term, singleton, vertex pregnancies, stratified by parity groups. The exposure was active first stage duration, categorised in percentiles. Poisson regression analysis was performed to estimate the adjusted relative risk (aRR) and the 95% confidence interval (95% CI). To investigate the effect of second stage duration on the outcome, mediation analysis was performed. Severe perineal lacerations (third or fourth degree), postpartum infection, urinary retention and haematoma in the birth canal or ruptured sutures. The risks of severe perineal laceration, postpartum infection and urinary retention increased with a longer active first stage, both overall and stratified by parity group. The aRR increased with a longer active first stage, using duration of <50th percentile as the reference. In the ≥90th percentile category, the aRR for postpartum infection was 1.64 (95% CI 1.46-1.84) in primiparous women, 2.43 (95% CI 1.98-2.98) in parous women with no previous caesarean delivery (CD) and 2.33 (95% CI 1.65-3.28) in parous women with a previous CD. The proportion mediated by second stage duration was 33.4% to 36.9% for the different outcomes in primiparous women. The risk of haematoma or ruptured sutures did not increased with a longer active first stage. Increasing active first stage duration is associated with maternal complications in the early postpartum period.

A Study to assess the effectiveness of back massage with Olive oil for pain relief among antenatal women during first stage of labor at Sangareddy Hospital, Ts

The present study aimed at A study to assess the effectiveness of back massage with Olive oil for pain relief among antenatal women during first stage of labor at Sangareddy, hospital, Ts. A quantitative evaluative research approach was used for this study. The conceptual framework used for this study was Modified Ludwig and Bertalanffy, general system theory. Random sampling technique was used to select the antenatal mother. Structured questionnaire was used to collect demographic data and Pretest and posttest pain assessment was done by using numeric pain rating scale. The discussion of the present study is based on the findings obtained from descriptive and inferential statistical analysis of collected data."

Delivery Progress, Labor Interventions and Perinatal Outcome in Spontaneous Vaginal Delivery of Singleton Pregnancies between Nulliparous and Primiparous Women with One Previous Elective Cesarean Section: A Retrospective Comparative Study.

This is a retrospective comparative study. Data were collected in a four-year period at the departments of Obstetrics and Gynecology at Kristianstad and Ystad hospitals in Sweden. Out of 14,925 deliveries, 106 primipara women with one previous elective LSCS and a spontaneous labor onset in the subsequent singleton pregnancy were identified. Of these women, 94 (88.7%) delivered vaginally and were included in the study (VBAC group). The comparison group included 212 randomly selected nulliparous women that had a normal singleton pregnancy, spontaneous labor onset and delivered vaginally. The rate of cervical dilation during the active first stage of labor as well as the duration of the second stage did not differ between the two groups. When adjusting for cervical dilation at admission, there was no significant difference between the two groups regarding the duration of the active phase of the first stage of labor. No significant differences were found in maternal-neonatal outcomes between the two groups except for higher birth weight in the VBAC group. The use of epidural analgesia was associated with slower dilation rhythm over the duration of the active phase and second stage of labor, need for labor augmentation, postpartum bleeding and need for transfusion at higher rates, irrespective of parity when epidural was used. Our study provides evidence that in women with one previous elective LSCS undergoing TOLAC in the subsequent pregnancy resulting in vaginal birth, the progress and duration of labor are not different from those in nulliparous women when labor is spontaneous and the it is a singleton pregnancy. The use of epidural was associated with prolonged labor, need for labor augmentation and higher postpartum bleeding, irrespective of parity. This information may be useful in patient counseling and labor management in TOLAC.