Prevalence and Determinants of Preferred Mode of Delivery among Gravidas with One Previous Cesarean Section who have ANC at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopa, 2022

Abstract

Abstract Background: Vaginal births after cesarean or elective repeat cesarean section (CS) are the options of delivery after one previous scar. However, there is no evidence regarding the preferred mode of delivery in Ethiopia. Thus, this study assessed the prevalence and determinants of preferred mode of delivery after one previous CS in the antenatal clinic (ANC) at the University of Gondar Comprehensive Specialized hospital (UoGCSH). Methods: An institutional-based cross-sectional study was conducted in 235 mothers with one previous CS at UoGCSH from March to August 2022. A consecutive sampling technique was used to approach the participants and participants were interviewed using a structured questionnaire. The collected data was entered, cleaned and edited using EPI-data 4.6 and exported to SPSS version 26 for analysis. Descriptive statistics were used to present demographic and clinical variables. A binary logistic regression was performed to assess determinants of preferred mode of delivery. A p-value < 0.05 at 95% CI of adjusted odds ratio was considered statistically significant. Results: 235 gravidas were enrolled in this study with a mean age of 30.6(�2) years. Majorities (94.5%) were married. More than half of (55.5%) the participants delivered once. The mean gestational age of participants was 33.05(�9) weeks. Majority, 71.5% (95% CI: 64.7, 77.1) of participants preferred Trial of Labor After Cesarean (TOLAC) to be their mode of delivery. Those who were married (AOR = 4.47, 95% CI: 1.19- 16.85), who had diploma educational level (AOR = 3.77, 95% CI: 1.84 -12.36), previous post cesarean complications (AOR = 3.25, 95% CI: 1.08- 9.74) and who knew about the success of TOLAC (AOR = 13.56, 95% CI: 4.52-37.19) were found to prefer TOLAC compared with their counterparts. Conclusion and recommendation: This study concluded that around three-fourths of gravidas preferred to have TOLAC after one cesarean section. Previous maternal post cesarean experience and information gained during ante natal care regarding the pros and cons of preferred mode of delivery could impact their choice. Provision of adequate information and counseling of mothers so that they can have the ability of informed decision making. Keywords: Cesarean scar; Gravidas; Mode of delivery; Prevalence; University of Gondar comprehensive specialized hospital