Factors Influencing Pregnant Women's Choice of Vaginal Birth after Cesarian Section (VBAC): A Narrative Review

Abstract

Background & aim: High cesarean section rate are primarily due to the frequent occurrence of repeat cesarean sections. The World Health Organization aims to reduce repeat cesarean sections in low-risk women by promoting vaginal birth after cesarean section (VBAC), as an alternative. The objective of this review was to identify factors associated with the choice of VBAC among pregnant women. Methods: This narrative review was conducted using the scale for narrative review articles (SANRA). To conduct the review, various databases including Scopus, Pub Med, Web of Science, and Embase were searched. The search process was done by relevant keywords including vaginal birth after cesarean section, repeat cesarean section, trial of labor after cesarean section, and their Persian equivalents. The search was not restricted by any time limit and encompassed all relevant documents until June 1, 2023. The retrived studies analysed using a qualitatively synthesis excluding conference papers, short communications, editorials and those articles without full-text. Results: Out of 550 retrived document, 24 eligible studies were included in the review. The decision to pursue VBAC is influenced by five primary areas. These areas encompass factors associated with healthcare organizations, gynecologists, midwives, mothers, and the individuals surrounding them. The final decision can be influenced by various factors, either positively or negatively. Conclusion: The selection of VBAC is influenced by various factors, which should be considered in intervention programs aimed at increasing VBAC and reducing repeat cesarean sections. Copyright © 2023 Mashhad University of Medical Sciences.