Impact of Interpregnancy Interval on Success of Vaginal Birth after Cesarean Section

Abstract

Introduction: The inter-pregnancy interval may play a role in the success of VBAC due to its effect on the healing of the uterine scar, the mother's recovery, and the outcome of the second labor. The safety and success of TOL may then be enhanced with appropriate birth spacing.

Objective: To assess the effect of IPI on VBAC following a previous cesarean delivery.

Materials and Methods: This was a prospective cohort study carried out at Benazir Bhutto Shaheed Teaching Hospital, Women and Children Hospital, Abbottabad, from November 2025 to April 2026. There were 240 eligible women who had had one cesarean section who were included in the study. The outcomes of delivery were compared among the participants according to the interpregnancy interval.

Results: Of all the women who attempted VBAC, 72.5% were successful. The success rates were 55.0%, 72.5% and 83.0% for women with intervals of <18 months, 18–23 months and ≥24 months, respectively. The length of interpregnancy interval was significantly associated with successful VBAC.

Conclusions: The longer the time between pregnancies, the higher the likelihood of having a successful VBAC. Birth spacing should be taken into account when counselling and selecting for TOLAC.