Trends in Attempted and Successful Trial of Labor After Cesarean Delivery in the United States From 2010 to 2020

The vaginal birth after cesarean (VBAC) delivery rate was last reported as 13.8% in 2019. However, contemporary trends in attempted and successful trial of labor after cesarean (TOLAC) delivery among individuals with prior cesarean delivery have not been evaluated. We performed a repeated cross-sectional analysis of singleton, cephalic, term deliveries in individuals with a history of one or two cesarean deliveries in the National Vital Statistics System from 2010 to 2020. Temporal trends in attempted and successful TOLAC, as well as VBAC, were characterized using joinpoint regression. Overall, 4,277,800 deliveries were included. Attempted TOLAC increased from 15.3% in 2010 to 21.7% in 2020, with an annual percent increase (relative) of 4.25% (95% CI 2.9-5.6%). Successful TOLAC increased from 69.8% to 74.7%, with an annual percent change (relative) of 0.91% (95% CI 0.7-1.2%). The VBAC rate similarly increased such that, by 2020, it was 16.2%.

Automated summary

Based on data analysis from 2010 to 2020, the rate of attempted vaginal birth after cesarean (VBAC) increased from 15.3% in 2010 to 21.7% in 2020. The rate of successful trial of labor after cesarean (TOLAC) also increased from 69.8% to 74.7% during this period. By 2020, the VBAC rate reached 16.2%.