A research paper to be submitted to Hawassa University College of Medicine and Health Science School of Public Health in Partial Fulfillment of the Requirement for Degree of Masters in Public Health in Reproductive Health

Abstract

Background: Vaginal birth after cesarean (VBAC) is giving birth through vagina after giving birth previously by cesarean section. Repeated caesarean deliveries associated with maternal and child complication. It had expanded hospital duration, and high risk of postpartum hemorrhage. However vaginal birth after cesarean is the best choice to reduce repeated CS. But there was insufficiency of evidence to predict determinants of successful vaginal birth after cesarean. So the aim of this study to identify determinants of successful vaginal birth after cesarean section to decreases the overall CS rate and related complication. Objective: To identify determinants of successful vaginal delivery after Caesarean Section at Public hospital in Hawassa city, Sidama Region, Ethiopia, 2023. Methodology: A facility based un-matched case control study was conducted at public hospitals in Hawassa city, Sidama region. A total of 107 consecutive cases and 214 controls were included. Data were collected using pre-tested interviewer administered questionnaire and chart reviewing. Then the data were exported to SPSS for analysis. Descriptive statistics analysis was done. A bi variable regression analysis was done for all independent variables .Variables with p values < 0.25 in bi variable analysis were taken and analyses in multivariable logistic regression .Finally the multivariable logistic regression model were considered statistically significant p values of <0.05 with corresponding 95% CI. Result: In this study 321 mothers were participated from those 107 give birth through birth canal after trial of lobour and 214 mothers end the labour with repeated CS. Mothers who have counseling about trial of labour during Anti natal follow up (AOR2.808; 95%CI1.543-5.112) ,mother who have history of successful vaginal birth after cesarean section(AOR4.170; 95%CI 2.317-7.504), membrane ruptured on admission (AOR 4.891; 95%CI 2.728-8.771) and BISHOPE score >6(AOR 2.661; 95%CI 1.415-4.881) significantly associated with successful VBAC. Conclusion Successful VBAC is reduced repeated cesarean delivery and related complication. So in our study counseling about TOLAC during ANC follow up, History of successful VBAC, Membrane ruptured on admission and BISHOPE score >6 were determinants of successful VBAC