Strengths and limitations of this study

  • The study uses a detailed sub-national electronic medical record system (BESTCare) that keeps digitised, complete and rigorously validated individual records.

  • The study will evaluate various short-term and long-term clinical, psychological and cognitive health outcomes to offer a comprehensive view of vaginal birth after caesarean section.

  • Procedural or diagnostic misclassification can happen because of differences in physician reviews and clinical documentation processes, which may result in incomplete or missing registry data.

  • The gestational age definition in this study does not completely match the updated standards in use during the study period, potentially influencing the definitions of related obstetric terms.

    • Introduction

    Globally, rates of caesarean section (CS) have risen significantly over past decades. An estimated 21% of all births were delivered via CS in 2018, with forecasts predicting that nearly one-third (29%) of all births will occur…