Thesis (M.Sc.) - Cairo University - Faculty of Nursing - Department of Maternal and Newborn Health Nursing

Repeated cesarean section (CS) is the most significant factor contributing to overall increased CS rates.The primary indicator of repeated CS is a prior CS. Vaginal birth after cesarean (VBAC) is atrial to reduce CS rates. The aim of the study was to examine the effect of counseling on the incidence, maternal & neonatal outcomes of VBAC. Design: Quasi experimental one group post-test only design was adopted for this study. Setting: The study was conducted at antenatal clinic and casualty department at Manial University Hospital affiliated to Cairo University. Sample: A purposive sample of 90 pregnant women who were had a previous one cesarean section. Tools: Structured Interviewing Tool, Labor Progress Record (Partograph) and Neonatal Apgar Score were used to collect the data. Results: (79)87.8% of women agreed to have VBAC after counseling compared to only (11) 12.2 % refused to have VBAC and choose CS.The Trial of Labor after Cesarean section (TOLAC) rate was 40.5%. The rate of VBAC was 31.6%. Success rate of TOLAC was 78.1% while failed TOLAC was 21.9%. All women who delivered VBAC had normal progress of labor and their babies had normal Apgar score (8-10). No cases underwent VBAC had any morbidity or mortality. Conclusion: Successful VBAC is associated with better feto-maternal and neonatal outcomes so most women with one previous cesarean delivery with a low-transverse incision should be counseled and encouraged to undergo a trial of labor in her recurrent pregnancy. Recommendations; Counseling about VBAC should be part of the routine care of all pregnant women who delivered previously by CS and considered a good candidate for VBAC

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