# Delivery mode preferences and trial of labor after a first cesarean delivery

> **NIH NIH R03** · UNIVERSITY OF MASSACHUSETTS AMHERST · 2020 · $83,066

## Abstract

PROJECT ABSTRACT
Most pregnant women with one prior cesarean birth are appropriate candidates for trial of labor after cesarean
(TOLAC), yet only about 20% of U.S. women with a prior cesarean have a TOLAC. Repeat cesarean is by far
the most common indication for cesarean delivery; therefore, increasing access to TOLAC is an important
mechanism for reducing the rate of cesarean delivery. However, little is known about how specific experiences
in the first pregnancy, birth, and postpartum period – particularly those measured prospectively – impact the
development of delivery mode preferences for a subsequent birth, and how these preferences translate into
delivery mode decisions. There is a critical need to better understand the experiences shaping women's
delivery mode preferences in order to guide future research testing approaches to support shared decision
making in this population. This study will use data from a large-scale, prospective cohort to address the
following specific aims: 1) To determine how experiences in the first pregnancy, birth and postpartum period
shape women's preferences for delivery mode after a first birth by cesarean, reported during the next
pregnancy; and 2) To examine the relationship between delivery mode preferences and subsequent trial of
labor and VBAC among women who had a second birth during the study follow-up period. The results of this
study will provide information directly relevant to clinicians who are seeking to understand women's mode of
delivery preference after first delivery by cesarean (VBAC or repeat cesarean) and to work toward decisions
with their patients about whether or not to have a trial of labor, taking into account both preference and risks.
This research will add to the evidence base for future studies developing interventions to support shared
decision making regarding trial of labor after cesarean.

## Key facts

- **NIH application ID:** 9896382
- **Project number:** 1R03HD098392-01A1
- **Recipient organization:** UNIVERSITY OF MASSACHUSETTS AMHERST
- **Principal Investigator:** Laura B Attanasio
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $83,066
- **Award type:** 1
- **Project period:** 2020-05-01 → 2022-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9896382

## Citation

> US National Institutes of Health, RePORTER application 9896382, Delivery mode preferences and trial of labor after a first cesarean delivery (1R03HD098392-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/9896382. Licensed CC0.

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