Safety and success of Vaginal Birth after Cesarean Section (VBAC) in low socio-economic countries.

Abstract

Objective: To assess the safety and success rate of VBAC in women from low socio-economic backgrounds. Study Design: Prospective Observational Design. Setting: Gynecology and Obstetrics Unit of Hayatabad Medical, Complex. Period: October 2024 to March 2025. Methods: A total of 149 women with a history of one previous cesarean section were observed. A non-probability purposive sampling technique was used to recruit participants for this study. Demographic data, gestational age, and delivery outcomes were analyzed. The primary outcome was the success rate of VBAC, while secondary outcomes included fetal health indicators and complications. Results: The majority of participants were aged between 20–30 years (n=109, 73.2%), with most at a gestational age of 37–39 weeks (n=107, 71.8%). Out of 149 women, 93 (62.4%) achieved a successful VBAC. Fetal outcomes were generally favorable: 82 newborns (88%) had uneventful postnatal periods. Adverse outcomes included 2 cases of low birth weight, 3 cases each of APGAR scores <7 at 1 and 5 minutes, and 3 intrauterine deaths. Conclusion: VBAC can be a safe and effective option in low socio-economic settings, particularly among well-selected candidates. Despite some adverse fetal outcomes, the majority of births were successful and uneventful, suggesting the feasibility of promoting VBAC to reduce surgical burden in resource-limited healthcare systems.