Vaginal Birth After Caesarean Section – Effect on Maternal Psychosocial Function

Overview

The incidence of caesarean section has reached 15-20% in most developed countries. Encouraging vaginal birth after caesareans section (VBAC) has been considered a key component of a strategy to reduce the caesarean section rate. Most medical literature has focused on the efficacy of VBAC in reducing the caesarean section rate and the physical safety of successful VBAC. However, 30%-40% of these women fail to achieve a vaginal delivery. Little is known about how the uncertainty of labour outcome and a failed VBAC impact on the psychosocial function of these women. What we do know is that antenatal depression and unplanned caesarean section are major risk factors for postpartum depression, which in turn is the major cause of maternal mortality in many developed countries including Hong Kong. We propose to study a cohort of women with a prior caesarean section and presenting with a subsequent pregnancy for care. After consent and recruitment, these subjects will be randomly assigned to have a repeat caesarean section or VBAC. The medical outcomes, overall satisfaction of the subjects with the care they received, and the short-term psychosocial function of these subjects will be studied. The result of this study will provide important information that would be useful in assisting women to decide the mode of delivery after a prior caesarean section. The Hypothesis is that there is a significant difference in psychosocial function between these 2 groups of patients.

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Single Group Assignment
    • Primary Purpose: Treatment
    • Masking: None (Open Label)

Interventions

  • Procedure: elective cesarean section

Clinical Trial Outcome Measures

Primary Measures

  • General Health Questionnaire (GHQ)

Secondary Measures

  • State-Trait Anxiety Inventory
  • Beck Depression Inventory
  • Edinburgh Postnatal Depression Scale
  • Client Satisfaction Questionnaire
  • MRC Social Performance Schedule
  • WHO Quality of Life questionnaire

Participating in This Clinical Trial

Inclusion Criteria

  • women who agree for vaginal birth after prior cesarean section and who had no previous history of vaginal delivery Exclusion Criteria:

  • Inability or unwillingness to give informed consent. Multiple pregnancy, more than one previous caesarean section, and a previous classical caesarean section, presence of other contra-indications to vaginal birth

Gender Eligibility: Female

Minimum Age: 0 Years

Maximum Age: N/A

Investigator Details

  • Lead Sponsor
    • Chinese University of Hong Kong
  • Overall Official(s)
    • Tze Kin LAU, MD, Principal Investigator, Chinese University of Hong Kong

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