Strengths and limitations
The main strength of our study is the nationwide population-based design and robust data extraction of almost all births in the Netherlands of the past twenty years.
Limitations are indwelled in the retrospective nature of a registry-set and some under- and misreporting might have occurred. The registry did not include the option to analyse women with one previous caesarean section who also had a previous vaginal birth. Our study design does not allow for conclusions of causality particularly since indications for caesarean sections are not reported.