Acceptance of trial of labor after cesarean (Tolac) among obstetricians in the Western Region of Saudi Arabia: A cross-sectional study

Abstract

Background: Babies to women eligible for trial of labor after a cesarean (TOLAC) are sometimes delivered by cesarean section (CS). To obtain clinicians’ attitudes and beliefs about TOLAC, this study was designed to investigate the views of clinicians when advising TOLAC-eligible pregnant women about TOLAC, and to explore their reasons in favor of or against TOLAC. Methods: Interviews were carried out individually (face-to-face) with clinicians using a specially designed questionnaire to collect data from obstetricians in the Western Region of Saudi. Regression analysis was used as appropriate. Results: Among the 183 obstetricians included in the current study, approximately 79.2% were against offering TOLAC. However, most of the physicians (89.1%) were in favor of offering TOLAC to patients who had had a successful vaginal birth after CS. significant associations were found between physicians’ opposition to TOLAC and medical and most non-medical factors. Conclusion: Clinicians should recognize that the critical role they play in the delivery decision-making process and in boosting women’s confidence in TOLAC may be key to increasing the rate of TOLAC.

Keywords

• Trial of labor after cesarean section
• Vaginal birth
• Acceptance
• Obstetricians
• Cesarean section
• Saudi physicians