ArticlePLOS global public health2024
"I can't make it safe, so I don't do it": Exploring obstetricians' views on barriers and enablers to promoting vaginal birth after caesarean section in Bangladesh.
Article in PLOS global public health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- Estimating the prevalence of vaginal birth after cesarean section and repeat cesarean section: An analysis of nationally representative household surveys in 59 low- and middle-income countries.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
- Factors behind high caesarean section in Bangladesh: insight from a systematic literature review and meta-synthesis.BMJ public health · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The rise in the number of facility-based births in Bangladesh has been accompanied by a caesarean section (CS) epidemic. The current CS rate is 45% and while many are performed when medically unnecessary, there is still maternal mortality due to lack of access to CS. A significant contributor to the rising CS rates in Bangladesh is repeat CS. Evidence from high-income settings has shown that vaginal birth after caesarean section (VBAC) is safe and should be recommended for women with one previous CS, however, its practice in Bangladesh is low. VBAC has the potential to help reduce unnecessary CS in Bangladesh. As obstetricians play a significant role in birth decision-making, their opinions, and perspectives on barriers to VBAC need to be explored. This study will address a gap in the literature exploring barriers and enablers to promoting VBAC from the level of the obstetric decision-maker. This qualitative study was conducted in the Dhaka Division of Bangladesh in July 2023. Criterion sampling was used to select obstetricians for in-depth semi-structured interviews. Seven interviews were conducted in a private hospital in Dhaka city and five interviews were conducted in a non-governmental organisation (NGO) hospital outside Dhaka city. Ethical approval was received from the relevant organisations in both Liverpool and Bangladesh. The thematic analysis gave rise to three main themes: "policy awareness and national situation", "reasons for practice decisions" and "ways to improve service delivery". Despite good awareness of VBAC policies and appreciation of its benefits, obstetricians expressed a preference for repeat CS. From the perspective of obstetricians, the main barriers to VBAC practice are related to the structure and function of the health system. To create an environment that will enable safe practice of VBAC, health system improvement and community awareness of the benefits of normal vaginal birth are required.
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.