Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2024 Jul 2;16(4):371-379.
doi: 10.1093/inthealth/ihad048.

Trend, prevalence and predictors of successful vaginal birth after caesarean section in Ethiopia: a systematic review and meta-analysis

Bikila Balis  1 , Habtamu Bekele  1 , Aboma Diriba Hunde  2 , Lemesa Abdisa  1 , Magarsa Lami  1
Affiliations
Meta-Analysis

Trend, prevalence and predictors of successful vaginal birth after caesarean section in Ethiopia: a systematic review and meta-analysis

Bikila Balis et al. Int Health. .

Abstract

Background: Vaginal birth after caesarean section (VBAC) is an alternative to a caesarean section (CS) in the absence of repeat or new indications for primary CS. There is a knowledge gap regarding the trend and successful VBAC in Ethiopia. Therefore this systematic review and meta-analysis aimed to assess the trend, pooled prevalence of successful VBAC and its predictors in Ethiopia.

Methods: Electronic databases (SCOPUS, CINAHL, Embase, PubMed and Web of Science), Google Scholar and lists of references were used to search works of literature in Ethiopia. Stata version 14 was used for analysis and the odds ratios of the outcome variable were determined using the random effects model. Heterogeneity among the studies was assessed by computing values for I2 and p-values. Also, sensitivity analyses and funnel plots were done to assess the stability of pooled values to outliers and publication bias, respectively.

Results: A total of 12 studies with a sample size of 2080 were included in this study. The overall success rate of VBAC was 52% (95% confidence interval 42 to 65). Cervical dilatation ≥4 cm at admission, having a prior successful vaginal delivery and VBAC were the predictors of successful VBAC.

Conclusions: Meta-analyses and sensitivity analyses showed the stability of the pooled odds ratios and the funnel plots did not show publication bias. The pooled prevalence of successful VBAC was relatively low compared with existing evidence. However, the rate was increasing over the last 3 decades, which implies it needs more strengthening and focus to decrease maternal morbidity and mortality by CS complications. Promoting VBAC by emphasizing factors favourable for its success during counselling mothers who previously delivered by CS to enhance the prevalence of VBAC.

Keywords: Ethiopia; meta-analysis; predictors; systematic review; trail of labour; vaginal birth after caesarean section.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this article.

Figures

Figure 1.
Figure 1.
PRISMA statement presentation for systematic review and meta-analysis of successful vaginal birth after cesarean section in Ethiopia, 2023. Reports excluded: reason 1, outcome of interest not reported (n=15); reason 2, different population (n=7). Studies assessed for eligibility (n=28). New studies included in review (n=6). Total studies included in review (n=12). *Consider, if feasible to do so, reporting the number of records identified from each database or register searched (rather than the total number across all databases/registers).**If automation tools were used, indicate how many records were excluded by a human and how many were excluded by automation tools.
Figure 2.
Figure 2.
The trend of successful VBAC in Ethiopia, 2023.
Figure 3.
Figure 3.
Forest plot of the pooled prevalence of successful VBAC in Ethiopia, 2023.
Figure 4.
Figure 4.
Forest plot of the pooled prevalence of successful VBAC in Ethiopia, 2023.
Figure 5.
Figure 5.
Forest plot of the subgroup analysis based on the region of successful VBAC in Ethiopia, 2023.
Figure 6.
Figure 6.
Forest plot of the subgroup analysis based on publication year of successful VBAC in Ethiopia, 2023.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Betran AP, Ye J, Moller A-B et al. Trends and projections of caesarean section rates: global and regional estimates. BMJ Glob Health. 2021;6(6):e005671. - PMC - PubMed
    1. World Health Organization . Caesarean section rates continue to rise, amid growing inequalities in access. Available from: https://www.who.int/news/item/16-06-2021-caesarean-section-rates-continu... [accessed 25 December 2021].
    1. Central Statistical Agency [Ethiopia] , ICF . Ethiopia Demographic and Health Survey 2016. Addis Ababa, Ethiopia and Rockville, MD: Central Statistical Agency and ICF; 2016. Available from: https://dhsprogram.com/pubs/pdf/FR328/FR328.pdf.
    1. Gedefaw G, Demis A, Alemnew B et al. Prevalence, indications, and outcomes of caesarean section deliveries in Ethiopia: a systematic review and meta-analysis. Patient Saf Surg. 2020;14:11. - PMC - PubMed
    1. Umar BU, Haque M. Growing concern over rising caesarean section rates: is it a problem for low-and middle-income countries only? Adv Hum Biol. 2022;12(2):93.