title: Vaginal birth after caesarean section: a cohort study investigating factors associated with its uptake and success.
abstract: OBJECTIVE
  To investigate the demographic and obstetric factors associated with the uptake and success rate of vaginal birth after caesarean section (VBAC).
  
  
  METHODS
  Cohort study using data from Hospital Episode Statistics.
  
  
  METHODS
  English National Health Service.
  
  
  METHODS
  Women whose first birth resulted in a live singleton delivery by caesarean section between 1 April 2004 and 31 March 2011, and who had a second birth before 31 March 2012.
  
  
  METHODS
  Logistic regression to estimate adjusted odds ratios (OR).
  
  
  METHODS
  Attempted and successful VBAC.
  
  
  RESULTS
  Among the 143,970 women in the cohort, 75,086 (52.2%) attempted a VBAC for their second birth. Younger women, those of non-white ethnicity and those living in a more deprived area had higher rates of attempted VBAC. Overall, 47,602 women (63.4%) who attempted a VBAC had a successful vaginal birth. Younger women and women of white ethnicity had higher success rates. Black women had a particularly low success rate (OR, 0.54; 95% confidence interval [CI], 0.50-0.57). Women who had an emergency caesarean section in their first birth also had a lower VBAC success rate, particularly those with a history of failed induction of labour (OR, 0.59; 95% CI, 0.53-0.67).
  
  
  CONCLUSIONS
  In this national cohort, just over one-half of women with a primary caesarean section who were eligible for a trial of labour attempted a VBAC for their second birth. Of these, almost two-thirds successfully achieved a vaginal delivery.
authors.affiliation: Office for Research and Clinical Audit, Lindsay Stewart R&D Centre, Royal College of Obstetricians and Gynaecologists, London, UK; Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: H E
authors.initials: HE
authors.lastname: Knight
authors.forename: I
authors.initials: I
authors.lastname: Gurol-Urganci
authors.forename: J H
authors.initials: JH
authors.lastname: van der Meulen
authors.forename: T A
authors.initials: TA
authors.lastname: Mahmood
authors.forename: D H
authors.initials: DH
authors.lastname: Richmond
authors.forename: A
authors.initials: A
authors.lastname: Dougall
authors.forename: D A
authors.initials: DA
authors.lastname: Cromwell
mesh_terms: D000328:Adult; D000367:Age Factors; D001721:Birth Intervals; D001724:Birth Weight; D044383:Black People / Q000706:statistics & numerical data; D015331:Cohort Studies; D016640:Diabetes, Gestational / Q000453:epidemiology; D004630:Emergencies; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D011247:Pregnancy; D014219:Trial of Labor; D006113:United Kingdom; D016064:Vaginal Birth after Cesarean / Q000706:statistics & numerical data*; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Administrative data; England; trial of labour; vaginal birth after caesarean