Recently, a study from WHO has shown an increase in the number of Cesarean section globally4. It is accounting for more  than 1 in 5 (21%) of all childbirth, this projection is expecting to continue to rise to nearly a third (29%) of all births by  20304,5. The most common reason is Repeated C-Section, although evidence shows the chance to  have a vaginal  birth  after lower segment C-Section with uneventful pregnancy is 60-75%. VBAC rates vary widely in different healthcare  settings and countries 1-3.

Al Wakra Hospital initiated to establish VBAC clinic  since July 2020. This clinic  aim is  to provide women and her family  full access to all information in VBAC and Elective Repeated Cesarean Section (ERCS) benefits, challenges, and  disadvantages. Taking obstetric shared- care model, a midwife specialist and Obstetric team collaborate to support  previous scars women to decide which options are suitable for her as well as respect her own preferences.

All the pregnant women are initially seen and counselled by the specialist midwife either individually, or with their  husbands or selected family members present over 30 - 45minute sessions. After discussing the options, a preliminary  informed decision is recorded by the midwife and passed onto her obstetric team for further discussion and planning. In  2019 data shows the percentage of VBACs in AWH was 19.0%, this number had increased to 20.8% in 2021. However,  only 32.8% of women with a previous CS referred to the VBAC clinic. This report identifies success rates after the VBAC  clinic was established and will give an account of measures introduced to increase the clinic uptake.

METHOD:

Data was collected retrospectively from womens’ electronic  medical records and VBAC clinic  logbooks between July  2020 and December 2022 at Al Wakra Hospital. This included the numbers of women referred to the service, those  accepting a trial of labour and mode of delivery after acceptance in those with spontaneous labour onset, number of  emergency CS after trial of labour, and numbers of elective repeat CS (ERCS) where labour did  not  ensue  spontaneously.

During the VBAC clinic risk assessment process, counseling check lists are documented in each patients’ electronic  medical record.

CONCLUSION :