FACTORS AFFECTING THE SUCCESS OF VBAC (VAGINAL BIRTH AFTER CESAREAN) IN MOTHERS WITH A HISTORY OF CESAREAN SECTION: A LITERATURE REVIEW

Abstract

Background: Vaginal Birth After Cesarean (VBAC) is a recommended alternative to cesarean delivery for women with a history of cesarean section (CS) in order to reduce the globally rising rate of repeat CS. The VBAC success rate ranges from 60–80%, but is strongly influenced by various maternal and clinical factors. Objective: The objective of this literature review is to identify the determinants that influence VBAC success based on the latest primary literature. Methods: The method involved searching for articles in the PubMed, Google Scholar, Scopus, and ScienceDirect databases, as well as in Sinta-accredited national journals, using the keywords “vaginal birth after cesarean,” “VBAC success factors,” “TOLAC,” and “VBAC success factors.” Articles meeting the inclusion criteria were primary observational studies published between 2021 and 2026. A total of 10 articles were extracted using the PRISMA flowchart and their quality was assessed using the JBI Critical Appraisal Checklist. Results: The review results showed that factors consistently predicting VBAC success included: maternal age (<35 years), a history of previous vaginal delivery (particularly a history of VBAC), cervical dilation upon hospital admission (≥4 cm), Body Mass Index (BMI <30 kg/m²), pregnancy interval (≥18–24 months), fetal weight (<3,500 grams), a non-recurrent indication for the previous cesarean section, and spontaneous onset of labor. Conclusion: Understanding these factors is crucial for healthcare providers in safely screening candidates for a Trial of Labor After Cesarean (TOLAC) and providing evidence-based counseling.