Back to "once a caesarean: always a caesarean"? A trend analysis in Switzerland.

Christmann-Schmid, Corina; Raio, Luigi; Scheibner, Katrin; Müller, Martin; Surbek, Daniel (2016). Back to "once a caesarean: always a caesarean"? A trend analysis in Switzerland. Archives of gynecology and obstetrics, 294(5), pp. 905-910. Springer 10.1007/s00404-016-4055-4

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PURPOSE Caesarean sections (CS) have significantly increased worldwide and a previous CS is nowadays an important and increasingly reported indication to perform a repeat CS. There is a paucity of information in Switzerland on the incidence of repeat CS after previous CS and relationship between the rates of vaginal birth after CS (VBAC). The aim of this study was to analyse the actual trend in VBAC in Switzerland. METHODS We performed a retrospective cohort study to analyse the proportion of VBAC among all pregnant women with previous sections which give birth during two time periods (group 1:1998/1999 vs. group 2:2004/2005) in our tertiary care referral hospital and in the annual statistics of Swiss Women's Hospitals (ASF-Statistics). In addition, the proportion of induction of labour after a previous caesarean and its success was analysed. RESULTS In both cohorts studied, we found a significant decrease of vaginal births (p < 0.05) and a significant increase of primary elective repeat caesarean section (p < 0.05) from the first to the second time period, while there was a decrease of secondary repeat caesarean sections. The prevalence of labour induction did not decrease. CONCLUSION Our study shows that vaginal birth after a prior caesarean section has decreased over time in Switzerland. There was no significant change in labour induction during the study period. While this trend might reflect an increasing demand for safety in pregnancy and childbirth, it concomitantly increases maternal risks of further pregnancies, and women need to be appropriately informed about long-term risks.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Gynaecology

UniBE Contributor:

Raio, Luigi; Müller, Martin and Surbek, Daniel


600 Technology > 610 Medicine & health








Monika Zehr

Date Deposited:

26 Apr 2017 08:24

Last Modified:

26 Apr 2017 08:24

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

Induction of labour; Maternal risk; Repeat caesarean section; Vaginal birth after caesarean section; Vaginal delivery




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