Abstract

The general objective of the study was to investigate the factors influencing the success of VBAC among women
with one previous scar at HRRH. The specific objectives of the study were; to determine the rate of VBAC among
women with one previous scar at HRRH, to determine obstetric factors influencing success of VBAC among women
with one previous scar and to assess the socio-demographic factors influencing success of VBAC among women with
one previous scar. This study was a hospital based cross-sectional investigation. All pregnant women delivering at
HRRH who have delivered by caesarean section before with one previous scar were included in the study data once
they provided their consent. Analysed data was presented in tables and figures showing frequencies and proportions.
Majority of the women (81.7%) had attended ANC, although only 16.7% had attended the minimum recommended
amount of 4 times. 70% were at 37-42 weeks of gestation at the time of labour. In the conclusions chapter of this
investigation, it was revealed that successful vaginal delivery after one previous caesarean scar was associated with
past obstetrics performance, and to a larger extent, the current labour processes. The main determinants included
history of stillbirth, history of successful VBAC in the past, rupture of membrane, absence of meconium, cervical
stage of labour at admission, position of the presenting part, duration of labour, and knowledge of the previous
indication for the past caesarean section. The study concluded that Routine amniotomy should be discouraged to
decrease incidence of prolonged rupture of membranes. The review at two weeks post-caesarean delivery should be
emphasized because most SSI developed after discharge and within the first two weeks after surgery.