Andersen MM, Thisted DLA, Amer-Wahlin I, Krebs L Can intrapartum cardiotocography predict uterine rupture among women with prior caesarean delivery?: a population based case-control study. PLoS One. 2016; 11:(2)e0146347-e0146347

Bayrampour H, Lisonkova S, Tamana S, Wines J, Vedam S, Janssen P. Perinatal outcomes of planned home birth after cesarean and planned hospital vaginal birth after cesarean at term gestation in British Columbia, Canada: A retrospective population-based cohort study. Birth. 2021; 48:(3)301-308

Betran AP, Ye J, Moller A-B, Souza JP, Zhang J. Trends and projections of caesarean section rates: global and regional estimates. BMJ Global Health. 2021; 6:(6)

Perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies: the Birthplace in England national prospective cohort study. BMJ. 2011; 343

Birthrights. Human rights in maternity care. 2017. (accessed 29 January 2021)

Birthrights. Maternal request caesarean. 2018. (accessed 20 January 2021)

Cahill AG, Tuuli M, Odibo AO, Stamilio DM, Macones GA. Vaginal birth after caesarean for women with three or more prior caesareans: assessing safety and success. BJOG. 2010; 117:(4)422-427

Desseauve D, Bonifazi-Grenouilleau M, Fritel X, Lathelize J, Sarreau M, Pierre F. Fetal heart rate abnormalities associated with uterine rupture: a case–control study. Eur J Obstet Gynecol Reprod Biol. 2015; 197:16-21

Dexter S, Windsor S, Watkinson S. Meeting the challenge of maternal choice in mode of delivery with vaginal birth after caesarean section: a medical, legal and ethical commentary. BJOG. 2014; 121:(2)133-140

Dunning T, Martin H, McGrath Y. Vaginal birth after caesarean: how NICE guidelines can inform midwifery practice. Brit J Midwifery. 2019; 27:(11)689-693

Fitzpatrick KE, Kurinczuk JJ, Alfirevic Z, Spark P, Brocklehurst P, Knight M. Uterine rupture by intended mode of delivery in the UK: a national case-control study. PLoS Med. 2012; 9:(3)e1001184-e1001184

Guise J-M, Berlin M, McDonagh M, Osterweil P, Chan B, Helfand M. Safety of vaginal birth after cesarean: a systematic review. Obstet Gynecol. 2004; 103:(3)420-429

Gurol-Urganci I, Cromwell DA, Edozien LC Risk of placenta previa in second birth after first birth cesarean section: a population-based study and meta-analysis. BMC Pregnancy Childbirth. 2011; 11:(1)95-95

Hammad IA, Chauhan SP, Magann EF, Abuhamad AZ. Peripartum complications with cesarean delivery: a review of Maternal-Fetal Medicine Units Network publications. J Matern Fetal Neonatal Med. 2014; 27:463-74

Hehir M, Fitzpatrick M, Cassidy M, Murphy M, O'Herlihy C. Are women having a vaginal birth after a previous caesarean delivery at increased risk of anal sphincter injury?. BJOG. 2014; 121:(12)1515-1520

Hollowell J, Rowe R, Townend J The birthplace national prospective cohort study: perinatal and maternal outcomes by planned place of birth.London: NIHR Service Delivery and Organisation programme; 2015

The safety of maternity services in England.London: Health and Social Care Committee; 2021

Keedle H, Schmied V, Burns E, Dahlen HG. Women's reasons for, and experiences of, choosing a homebirth following a caesarean section. BMC Pregnancy Childbirth. 2015; 15:(1)206-206

Kirkup B. The Report of the Morcombe Bay Investigation.London: The Stationary Office; 2015

Landon MB, Hauth JC, Leveno KJ Maternal and perinatal outcomes associated with a trial of labor after prior cesarean delivery. N Engl J Med. 2004; 351:2581-9

Landon M, Leindecker S, Spong CY The MFMU Cesarean Registry: factors affecting the success of trial of labor after previous cesarean delivery. Am J Obstet Gynecol. 2005; 193:1016-23

McKenna JA, Symon AG. Water VBAC: Exploring a new frontier for women's autonomy. Midwifery. 2014; 30:(1)e20-e25

Montgomery v Lanarkshire Health Board.: UK Supreme Court; 2015

Mozurkewich EL, Hutton EK. Elective repeat cesarean delivery versus trial of labor: A meta-analysis of the literature from 1989 to 1999. Am J Obstet Gynecol. 2000; 183:(5)1187-1197

National Institute for Health and Care Excellence. Inducing Labour. 2008. (accessed 18 October 2021)

National Institute for Health and Care Excellence. Intrapartum care for healthy women and babies. 2017. (accessed 29 January 2021)

National Institute for Health and Care Excellence. Intrapartum care for women with existing medical conditions or obstetric complications and their babies. 2019. (accessed 18 October 2021)

National Institute for Health and Care Excellence. Caesarean Section. 2021a. (accessed 19 April 2021)

National Institute for Health and Care Excellence. Shared decision making. 2021b. (accessed 18 October 2021)

National Maternity and Perinatal Audit: Clinical Report 2019.London: RCOG; 2019

Emerging findings and recommendations from the independent review of maternity services at the Shrewsbury and Telford Hospital NHS Trust. 2020. (accessed 7 February 2021)

Royal College of Obststrics and Gynacologists. Birth after previous caesarean birth. 2015. (accessed 18 October 2021)

Rowe R, Li Y, Knight M, Brocklehurst P, Hollowell J. Maternal and perinatal outcomes in women planning vaginal birth after caesarean (VBAC) at home in England: secondary analysis of the Birthplace national prospective cohort study. BJOG. 2016; 123:(7)1123-1132

Smith GCS. Life-table analysis of the risk of perinatal death at term and post term in singleton pregnancies’. Am J Obstet Gynecol. 2001; 184:(3)489-496

Stock SJ, Ferguson E, Duffy A, Ford I, Chalmers J, Norman JE. Outcomes of induction of labour in women with previous caesarean delivery: a retrospective cohort study using a population database. PLoS One. 2013; 8:(4)e60404-e60404

Tahseen S, Griffith M. Vaginal birth after two caesarean sections (VBAC-2)-a systematic review with meta-analysis of success rate and adverse outcomes of VBAC-2 versus VBAC-1 and repeat (third) caesarean sections. British Journal of Obstetrics and Gyanecology. 2010; 117:(1)5-19

Wallstrom T, Bjorklund J, Frykman J Induction of labor after one previous Cesarean section in women with an unfavorable cervix: A retrospective cohort study. PLoS One. 2018; 13:(7)e0200024-e0200024

Non-clinical interventions to reduce unnecessary caesarean sections.Geneva: World Health Organization; 2018

World Health Organization. Caesarean section rates continue to rise, amid growing inequalities in access. 2021. (accessed 17 June 2021)

Home birth after caesarean. 2021. (accessed 27 July 2021)

Birth after previous caesarean section

02 November 2021
9 min read
Volume 29 · Issue 11


Midwifery and obstetric involvement in supported decision making and subsequent clinical practice around birth after caesarean section has been much debated and negotiated for some time. This article discusses some of the clinical evidence and factors to be taken into account when providing support and information for women and birthing people considering their options for birth after caesarean. The article focuses on the currently published guidelines to support practice and guide discussions with women and birthing people. In the article, the terms ‘planned vaginal birth’ and ‘vaginal birth after caesarean’ are used interchangeably.

Research published by the World Health Organization (WHO, 2021) has shown that caesarean section incidence is globally increasing from 7% in 1990 to a current 21% of all births, with an estimated rise to 29% by 2030 (Betran et al, 2021). In some countries, the incidence of lower (uterine) segment caesarean section already outnumbers the incidence of vaginal birth, with wide variation between countries in incidences, some having rates as high as 43% (Betran et al, 2021). UK statistics presented by the National Maternity and Perinatal Audit Project Team (2019) suggest an overall caesarean section rate of 25.8%, (11.3% elective, 14.5% emergency), with incidence rates for multiparous women and birthing people 15.7% (elective) and 9.4% (emergency). The report indicates that the overall rate of vaginal birth after caesarean is 24.5% (this figure limited to secundiparous women).

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