Factors affecting VBAC success at a tertiary level Hospital in Pretoria, South Africa

Abstract

There is growing concern about rising global caesarean delivery (CD) rates. One of the strategies to overcome this problem is to reduce primary caesarean section. A trial of labour following a previous CD is another option that may be explored. AIM The aim of the study was to determine the success rate and risk factors for women attempting vaginal birth after a prior caesarean delivery (VBAC). METHODS This was a retrospective analysis from 2013-2018 of women attempting a vaginal birth after caesarean section at a tertiary level hospital in Pretoria, South Africa. RESULTS The VBAC success rate was 36%. Factors that were associated with a successful VBAC were a third pregnancy, previous successful VBAC (61%), presentation in the active phase of labour and a neonatal birthweight of less than 3kg. CONCLUSION Pregnant women with a CD in a prior pregnancy should be appropriately counselled regarding delivery options. Risks and benefi ts of elective repeat caesarean delivery versus trial of labour should be clearly explained to expectant mothers.