First Vaginal Birth after Cesarean: a retrospective cohort study

<b>Objective:</b> The main aim of this study was to explore the course of labor and extent of perineal trauma at the first vaginal birth after cesarean section (fVBAC) in comparison to primiparous vaginal birth (PVB) in women without epidural analgesia. <b>Study design:</b> All fVBACs without epidural analgesia and the subsequent PVBs (controls) between 2012 - 2016 were included in this retrospective cohort study. Data were collected from health records and included maternal characteristics and labor details in both groups as well as cervical dilation at the time of previous cesarean in fVBAC group. <b>Results:</b> The study comprised 510 women; 255 fVBACs and 255 controls. The majority of fVBACs were after a pre-labor cesarean section – 177 (69.4%). There was a statistically significant difference in the recorded duration of first stage between the fVBACs and controls (289 vs. 347min respectively, p <b>Conclusion:</b> Compared to primiparous women having a vaginal birth, women having their first vaginal birth after a cesarean section have a shorter 1^st stage of labor, a higher risk of sustaining cervical lacerations and perineal trauma. However, the risk of anal sphincter injury does not seem to be increased.