Asian Journal of Pregnancy and Childbirth

Background: The continuous increase in the rate of repeat caesarean sections after a first prior caesarean delivery is alarming. There is a decrease in the rate of vaginal birth after caesarean delivery (VBAC) and trial of labour after caesarean section (TOLAC) in women with a prior caesarean delivery. However, like other surgical operations, caesarean section puts the woman at risk of various complications and health challenges which can range from immediate to long-term health risks. This can affect her fertility and the outcome of her future pregnancies.

Aim: To determine women’s preference for mode of delivery after a prior caesarean delivery and the reasons for their preferred choices.

Methodology: This was a cross-sectional study of 229 consenting pregnant women with one previous caesarean delivery attending antenatal clinic at the University of Port Harcourt Teaching Hospital (UPTH) from 1^st March to 31^st May, 2023. Structured interviewer administered questionnaires were used to collect information on participant’s prior caesarean related birth experience, complications and current delivery desires. The data was analysed with SPSS version 25.

Results: The modal maternal and gestational age groups were 30-39years (66.5%) and 24-34weeks (48.5%). Approximately 58.9% were in their second pregnancy and 61.6% experienced labour pain in their previous caesarean delivery. Maternal and neonatal complications documented were wound infection and birth asphyxia respectively. Majority of the respondents (89.1%) had satisfactory overall birth experience. Of the 229 respondents, 82.1% preferred vaginal delivery in the index pregnancy due to the cost of caesarean section and innate desire to experience natural birth while 41(17.9%) of them preferred repeat caesarean delivery due to phobia for labour pain.

Conclusion: Majority of the women with prior caesarean delivery attending the antenatal clinic preferred TOLAC in subsequent pregnancies as against a repeat caesarean delivery. Women with a prior caesarean delivery should be adequately counselled during the antenatal period for possible TOLAC in the cases that meet the eligibility criteria in order to reduce the caesarean delivery rate.