Publication:

Study of the causes of non-acceptance of VBAC in patients with previous one LSCS in a tertiary institution

Background Many women who are eligible candidates for a VBAC (Vaginal Birth after Caesarean) in the current pregnancy opt for a repeat LSCS (Lower Segment Caesarean Section) as a mode of delivery. We decided to evaluate the proportion of patients who opt out of a VBAC and to study the causality of this trend.

Methods All patients who presented to the Dept. of OBG in our institution and were eligible to have a VBAC were included in the study till the sample size of 100 cases was met. Consultant opinion was sought prior to deciding the mode of delivery.

Results Incidence of patients of previous one LSCS who were not willing for VBAC was 4%, out of total number of deliveries and 30.7%, out of all cases of patients with previous one LSCS. The reason for not opting for a VBAC in the current pregnancy in the majority of the eligible patients was the desire for a concurrent sterilization procedure. Others cited apprehension of a scar rupture or fear of labor pain or both as their primary reason for opting out of a VBAC.

Conclusions The high incidence of ERC (Elective Repeat Caesarean) as compared to TOLAC (Trial of Labour after Caesarean) has long-term clinical and financial implications. Counseling given to the pregnant woman with an emphasis on the advantages of VBAC in order that she opts for a VBAC with confidence and enthusiasm is the only way forward.