Predictors of Repeat Cesarean Delivery Versus VBAC in a National Sample of U.S. Births
Faculty Mentor
Logan Cowan
Location
Russell Union Ballroom
Type of Research
On-going
Session Format
Poster Presentation
College
Jiann-Ping Hsu College of Public Health
Department
Department of Biostatistics, Epidemiology & Environmental Health Sciences
Abstract
Introduction
Cesarean deliveries account for nearly one-third of all births in the United States, despite the world health organization recommendation of 10–15%. The sustained rise in cesarean rates has raised public health concerns due to increased maternal morbidity, prolonged recovery, and higher healthcare costs. Vaginal birth after cesarean (VBAC) is a safe and evidence-based alternative for individuals with a prior cesarean delivery; however, its utilization remains limited, due to patient, provider, sociodemographic and system-level barriers among others. This study aims to examine demographic, clinical, and structural determinants of having a repeated cesarean (RC) to inform equitable obstetric care and expand opportunities for safe, effective delivery in the United States.
Methods
We performed a cross-sectional study using 2024 birth certificate data from the National Vital Statistics System. We used logistic regression to assess the association between maternal, paternal, and infant characteristics and RC.
Results
Among maternal characteristics, increased age, foreign nativity, foreign residence, higher education, being on WIC, having private insurance, smoking, higher BMI category, and higher weight gain during pregnancy were associated with higher odds of RC while being married, self paying for the delivery, having fewer prenatal visits, and having a shorter interval since last delivery/pregnancy were associated with lower RC odds. Among paternal characteristics, increased age was associated with higher RC odds while higher education was associated with lower CR odds. Among infant characteristics, male babies and non-cephalic presenters had higher odds of RC.
Discussion
Repeat cesarean was influenced by a combination of clinical, demographic, and structural indicators. Efforts to broaden access to VBAC, both through improved counseling and system-level reforms, could help prevent unnecessary surgical births and improve both maternal and infant outcomes across the United States.
Program Description
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Start Date
4-23-2026 2:00 PM
End Date
4-23-2026 4:00 PM
Recommended Citation
Seybold, Dorothy; Andrew, Caroline; Oguoma-Richards, David; Brown, Sierra; Daniels, Dominique; Reyes, Naomi; and Cowan, Logan, "Predictors of Repeat Cesarean Delivery Versus VBAC in a National Sample of U.S. Births" (2026). GS4 Student Scholars Symposium. 173.
https://digitalcommons.georgiasouthern.edu/research_symposium/2026/2026/173
Predictors of Repeat Cesarean Delivery Versus VBAC in a National Sample of U.S. Births
Russell Union Ballroom
Introduction
Cesarean deliveries account for nearly one-third of all births in the United States, despite the world health organization recommendation of 10–15%. The sustained rise in cesarean rates has raised public health concerns due to increased maternal morbidity, prolonged recovery, and higher healthcare costs. Vaginal birth after cesarean (VBAC) is a safe and evidence-based alternative for individuals with a prior cesarean delivery; however, its utilization remains limited, due to patient, provider, sociodemographic and system-level barriers among others. This study aims to examine demographic, clinical, and structural determinants of having a repeated cesarean (RC) to inform equitable obstetric care and expand opportunities for safe, effective delivery in the United States.
Methods
We performed a cross-sectional study using 2024 birth certificate data from the National Vital Statistics System. We used logistic regression to assess the association between maternal, paternal, and infant characteristics and RC.
Results
Among maternal characteristics, increased age, foreign nativity, foreign residence, higher education, being on WIC, having private insurance, smoking, higher BMI category, and higher weight gain during pregnancy were associated with higher odds of RC while being married, self paying for the delivery, having fewer prenatal visits, and having a shorter interval since last delivery/pregnancy were associated with lower RC odds. Among paternal characteristics, increased age was associated with higher RC odds while higher education was associated with lower CR odds. Among infant characteristics, male babies and non-cephalic presenters had higher odds of RC.
Discussion
Repeat cesarean was influenced by a combination of clinical, demographic, and structural indicators. Efforts to broaden access to VBAC, both through improved counseling and system-level reforms, could help prevent unnecessary surgical births and improve both maternal and infant outcomes across the United States.
