Abstract:
Background: Vaginal delivery after cesarean section is considered to be an alternate option for pregnant women who have had a previous cesarean section. In recent years, the rate of vaginal birth following cesarean has decreased, leading in an increase in the necessity for elective repeat caesarean surgeries and its complications.
Objective: To assess the determinants of successful vaginal birth after previous cesarean section among pregnant women opted for labor trial at Holeta health facility, Oromia, Ethiopia, 2023.
Methods: An unmatched case-control study was conducted on a total of 268 samples (89 cases and 179 controls). Cases were selected consecutively; two controls following the cases were approached through simple random sampling technique. Data were collected using structured and interviewer administered questionnaire between the periods of February 1, 2023 to April 20, 2023. Data were coded and entered into Epi-data version 4.6.2 then exported to SPSS version 25 for analysis. Descriptive statistics were done to describe the relevant variables. Bivariate and multivariable logistic regressions were undertaken. An adjusted odds ratio along with a 95% CI was done to see association and statistical significant was declared at a p-value less than 0.05.
Results: Urban residence (AOR: 2.77, 95% CI (1.53- 4.99), maternal age < 25 years (AOR: 1.82, 95% CI (1.11-5.74), 25-34 years (AOR: 2.73, 95% CI (1.98-12.28), parity (AOR: 3.08, 95%CI (1.47-8.73)) , ≥4 times Antenatal care visit (AOR; 1.48, 95% CI (1.01-3.53), birth Interval ≥ 24 Months (AOR: 3.36, 95% CI (1.95- 7.24),history of spontaneous vaginal delivery (AOR; 2.30, 95% CI (1.27-4.14) , history of previous vaginal birth after cesarean section (AOR; 2.58, 95% CI (1.44-4.61), duration of labor of < 12 hours (AOR; 3.10, 95% CI (1.84-11.15), ≥ 5cm cervical dilation (AOR: 2.24, 95% CI (1.14- 4.40) were independent determinants of successful Vaginal birth after cesarean section.
Conclusion and recommendation: Determinant factors of successful vaginal birth after cesarean section are: Maternal age, having more than one birth, antenatal care visit, birth interval, and history of spontaneous vaginal delivery, previous vaginal birth after cesarean section, cervical dilation, and labor duration. Hospitals and obstetric care providers should strongly consider mothers with a history of previous vaginal delivery, cervical dilation ≥5 cm at admission, and young age during counseling and optimal selection to avert the rising rate of CS and its associated morbidity
