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Abstract

Objectives: To analyze the acceptance of the trial of vaginal delivery after cesarean birth, to identify associated factors, and to evaluate obstetricians’ satisfaction with the trial.Methods: This cross-sectional, questionnaire-based online survey was conducted from December 2022 to September 2023 among obstetricians in the governmental hospitals of the eastern region, retrieving sociodemographic information, challenges in favoring trial of labor after cesarean (TOLAC), practice guidelines, outcomes of the trial, and their global satisfaction. Both Saudi and non-Saudi obstetricians (residents and above) working in governmental hospitals in the Eastern Province of Saudi Arabia, both genders, were included in this study. The study objectives were explained, and participants’ anonymity was ensured. The data was evaluated then analyzed with statistical testing.Results: Among the 134 included obstetricians, 78.4% favored trial of labor especially those with more than 10 years of experience (aOR=5.80, 95% CI: 1.52-22.14, p=0.01), and 77.6% intended to recommend that pregnant women with a history of a cesarean should undergo a labor trial if they meet the criteria (p=.001), choose it for themself (p=.001) and reflected satisfaction with the trial(p=.001). However, 80.6% were concerned about medical litigations due to grave unexpected outcomes. Generally, 50% had a good satisfaction level with the trial after cesarean birth.Conclusion: Most of the obstetricians had a positive attitude towards trial of labor especially the experienced obstetricians and the fresh residents, with a majority were in favor of taking chances for vaginal delivery after a surgical birth. Those who supported this trial of labor were highly satisfied with the procedure and would consistently advocate for pregnant women with prior surgical birth to avail a vaginal delivery chance if found eligible candidate to it. There is a need to follow this practice and improve obstetricians’ attitudes towards it at all stages of training.