RESULTS
Our study population consisted of 143,308 women with one previous caesarean section who gave birth to a singleton in cephalic presentation at term over the 20-year study period. Baseline characteristics are shown in Table 1 and compare women with a planned caesarean section to those with an intended VBAC.
The caesarean section rate (both planned and unplanned) among women with one previous caesarean section was 52.6% (n= 75,357, 2000-2019) and increased by 18.5% in 20 years, from 45.1% in 2000 to 63.6% in 2019. Women intended VBAC in 68.8% (n= 98,651, 2000-2019). Up to 2008 the proportion of women intending VBAC was relatively stable, but it decreased markedly from 2009 onwards (Figure 1). An increasing proportion of women gave birth by planned caesarean section in the same time frame. The average VBAC success rate was 68.9% (n= 67,951, 2000-2019). This rate dropped from 71.0% in 2000 to 65.3% in 2019.
Adverse perinatal outcomes were higher in women intending VBAC compared to those with a planned caesarean section (Table 1 and Figure 3). However, perinatal mortality decreased between 2000 and 2008, but stabilized from 2009 onwards (Figure 2).