IMPACT OF BIRTH EXPERIENCE IN PLAN OF SUBSEQUENT MODE OF DELIVERY

Abstract

Background: While   Trial of Labor After Cesarean (TOLAC) or Vaginal Birth After Cesarean (VBAC) is safe and recommended for eligible women, its clinical uptake remains low. This study evaluated   impact of   woman’s subjective perception of her previous childbirth experience on her planned mode of subsequent delivery.

Methods: This cross-sectional study was conducted at   Department of Obstetrics and Gynecology Feb 2024 to May 2025.   total of 360 pregnant prior childbirth were recruited using non-probability consecutive sampling..

Results: Out of 360 participants, 248 (68.9%) planned   TOLAC/VBAC, while 112 (31.1%) opted for   Elective Cesarean Section (ERCS). Bivariate analysis revealed   highly significant association between past birth perception and current choice ( p < 0.001 ). Among women with   positive/neutral past experience, 94.6% planned   TOLAC/VBAC. Conversely, 81.8% of women reporting   negative/traumatic past birth requested   ERCS. Multivariable logistic regression confirmed that   negative/traumatic birth memory was   strongest independent predictor of choosing surgery (Adjusted Odds Ratio = 82.15; 95% CI: 39.50–170.81; p < 0.001), overriding maternal age and educational background.

Conclusion:   mother’s subjective memory of past birth trauma is   powerful driver of subsequent elective surgical delivery. Antenatal counseling must incorporate trauma-informed psychological screening alongside clinical risk assessments to safely reduce repeat cesarean rates.