Investigating the Success Rate of Vaginal Delivery After Cesarean Section and Its Associated Factors in Afghan Women: Insights from a Maternity Hospital in Kabul

Parvin Golzareh; Halima Baha; Fahima Aram; Muhammad Haroon Stanikzai; Razia Rabizada; Massoma Jafari

doi:10.2147/IJWH.S517179

Investigating the Success Rate of Vaginal Delivery After Cesarean Section and Its Associated Factors in Afghan Women: Insights from a Maternity Hospital in Kabul

Int J Womens Health. 2025 Jun 6:17:1701-1710. doi: 10.2147/IJWH.S517179. eCollection 2025.

Authors

Parvin Golzareh¹, Halima Baha², Fahima Aram³, Muhammad Haroon Stanikzai⁴, Razia Rabizada⁵, Massoma Jafari⁶

Affiliations

¹ Department of Advanced Midwifery Skills, School of Midwifery, Kabul University of Medical Sciences "Abu Ali Ibn Sina", Kabul, Afghanistan.
² Department of Normal Midwifery, School of Midwifery, Kabul University of Medical Sciences "Abu Ali Ibn Sina", Kabul, Afghanistan.
³ Department of Gynecology, School of Midwifery, Kabul University of Medical Sciences "Abu Ali Ibn Sina", Kabul, Afghanistan.
⁴ Department of Public Health, Faculty of Medicine, Kandahar University, Kandahar, Afghanistan.
⁵ Department of Oral Health, School of Stomatology, Kabul University of Medical Sciences "Abu Ali Ibn Sina", Kabul, Afghanistan.
⁶ Department of Health Profession Education Research, University of Toronto, Ontario, Canada.

Abstract

Background: Vaginal Birth After Cesarean delivery (VBAC) is widely regarded as one of the most effective methods to reduce unnecessary Cesarean section and their complications. Despite its proven benefits, data on the success rate of VBAC and the associated factors remain scarce in Afghanistan. This study aimed to address this gap by determining the VBAC success rate and identifying its associated factors in a maternity hospital in Kabul, Afghanistan.

Methods: This cross-sectional study was conducted at Malalai Obstetrics and Gynecology Hospital in Kabul, Afghanistan. The study sample included women with a history of previous cesarean section who visited the hospital between March 21 and September 22, 2023. Demographic and clinical information were collected from client files. Descriptive statistics were used to summarize the demographic and clinical characteristics of the study sample. The association between VBAC and various categorical variables were examined using chi-square tests, with a significance level set at p < 0.05. Logistic regression analysis was performed to identify independent predictors of VBAC, with VBAC as the outcome variable and multiple predictors included in the model.

Results: Among the 567 women included in the study, 449 (79.2%) had a successful VBAC. Factors associated with successful VBAC and their adjusted odds ratio (95% CI) were lower gestational age: 1.25 (1.05-1.48), absence of gestational hypertension: 2.71 (1.26-5.85), cervical dilation of > 4 cm on admission: 2.77 (1.38-5.55), effacement of ≥ 50% on admission: 2.13 (1.04-4.35), and absence of fetal distress: 7.35 (4.29-12.6).

Conclusion: The rate of successful VBAC observed in this study is at a high level (79.2%). This study is the first study to determine the VBAC success rate and its associated factors in Afghanistan. Further research is needed to validate these findings and explore additional factors influencing VBAC success.

Keywords: Afghanistan; dilatation; effacement; fetal distress; gestational age; vaginal delivery after cesarean.