Journal of obstetrics and gynaecology : the journal of the Institute of Obstetrics and Gynaecology
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An audit of 197 patients with one previous caesarean section was undertaken over a 1-year period to determine the rates of vaginal delivery and main indications for repeat caesarean section. Trial of labour was attempted in 51.3% of women, of whom 65.3% had had a successful vaginal delivery. Vaginal birth after caesarean, however, was successful in only 33.5% of women. ⋯ Maternal request was the most common indication for repeat elective caesarean section. The answer to the rising caesarean rates seems to lie in reducing the primary caesarean section rates, rigorous auditing of the unit's caesarean rates and a change in the attitude of doctors, midwives and patients towards vaginal birth after caesarean. The last might prove to be the most difficult target to achieve.