Factors associated with successful vaginal birth after cesarean section among mothers who gave birth in Ambo town, Oromia, Central Ethiopia, a case-control study

Abstract

Background: While Trial of labour after previous cesarean section for women with no contraindication for vaginal delivery is an important strategy to reduce short- and long-term morbidity related with repeated cesarean section, the rate of cesarean section and repeated cesarean section with its complication are increasing. Objective: The objective of the study was to assess factors associated with successful vaginal birth among women with previous cesarean delivery in public hospitals of Ambo town in 2019. Methods: A case-control study was conducted in Ambo public Hospitals in 2019. A total of 243 clients were included, of which 81 clients were cases and 162 clients were controls with controls to cases ratio of 2. A Lottery method was applied to select the controls and cases were selected consecutively. Bivariate, followed by multivariate analyses, were conducted with 95% CI and p-value <0.05 to identify factors associated with successful vaginal birth after cesarean delivery. Result: Parity three and four(AOR = 3.45, 95%CI(1.16, 10.229), labour monitoring with partograph (AOR= 4.77, 95%CI: 1.65,13.88), prior vaginal birth after caesareans (AOR = 5.68, 95%CI:1.44,22.46), occiput-posterior position (AOR = 0.109, 95%CI: (0.02, 0.49), duration of labour after admission less than 8 hours (AOR = 4.57, 95%CI: 1.92,10.85) and artificial rupture of membrane (AOR = 5.02 95%CI: 1.67,15.06) were factors significantly associated with successful vaginal birth after previous cesarean section.  Conclusion: The study shows that parity, duration of labour, previous history of successful vaginal birth after cesarean section, artificial rupture of membrane, and partograph monitoring of labour were associated with successful vaginal birth after previous cesarean section. All Women with a history of cesarean section should be counselled and encouraged to undergo a trial of labour as long as it is not contraindicated. Keywords: Previous cesarean section; vaginal birth after cesareans; Ambo; Ethiopia.