Clinical commentary
For women who have had a previous caesarean section, the choice for method of birth in their next pregnancy is either a trial of vaginal birth after caesarean section (VBAC) or a repeat caesarean section (RCS).
Caesarean section in a first pregnancy makes a subsequent caesarean section more likely, with 86% of pregnant women with a history of caesarean section birth having a subsequent caesarean section, while the remainder have a vaginal birth (AIHW 2021).
Both RCS and VBAC are associated with benefits and harms. Risks of planned VBAC when compared with planned RCS include haemorrhage, need for blood transfusion, uterine rupture, and perinatal death (Guise et al. 2010). About 70% of women who had a previous caesarean section are good candidates for non-instrumental vaginal birth, with 70–87% who attempt succeeding (Frass & Harazi 2011; Potera 2010).