Trial of scar or elective repeat caesarean section at maternal request?

In a study between 1 January 1996 and 31 December 1998 at Watford General Hospital, we identified all women who booked having had a previous caesarean section. Data on age, social class and previous obstetric history was extracted from the notes, as was mode of delivery. Of the 718 patients identified, 497 were considered suitable for trial of scar. Of these 221 (44.5%) requested repeat caesarean section. Age, social class and indication for previous caesarean section could not predict those who accepted trial of scar. Of the 60 women who had had a previous successful trial of scar 59 (98.3%) underwent trial of scar and of the 48 who had had a vaginal delivery prior to caesarean section 37 (77.1%) underwent trial of scar (P < 0.01). Maternal request for caesarean section, without obstetric contraindication to trial of scar, accounted for 24.9% of all the elective caesarean sections undertaken in our unit.