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Objective To identify socio-cultural and clinician determinants in the decision-making process in the choice for trial of labor after cesarean (TOLAC) or elective repeat cesarean section (ERCS) in delivering women. Methods A tailored questionnaire focused on epidemiological, socio-cultural and obstetric data was administered to 133 patients; of these, 95 were admitted for assistance at birth at Fondazione Policlinico Universitario “A. Gemelli” (FPG) IRCCS, Rome, and 38 at S. Chiara Hospital (SCH), Trento, Italy. Descriptive analysis and logistic regression modeling were performed. Results Vaginal birth after cesarean (VBAC) rates were higher at SCH than at FPG (68.4% vs. 23.2%; P < 0.05). Maternal age in the TOLAC/VBAC group was significantly higher at SCH than at FPG (37.1 vs. 34.9 years, P < 0.05). High levels of education and no-working condition corresponded to a lower rate of VBAC. Proposal on delivery mode after a previous CS was missed in the majority of cases. Participation in prenatal course was significantly less among women in the ERCS groups. Using logistic regression, the following determinants were found to be statistically significant in the decision-making process: maternal age [odds ratio (OR) = 0.968 (95% confidence interval [CI] 0.941–0.999); P = 0.019], education level [OR = 0.618 (95% CI 0.419–0.995); P = 0.043], information received after the previous CS [OR = 0.401 (95% CI 0.195–1.252); P = 0.029], participation in antenatal courses [OR = 0.534 (95% CI 0.407–1.223); P = 0.045] and self-determination in attempting TOLAC [OR = 0.756 (95% CI 0.522–1.077); P = 0.037]. Conclusion In the attempt to promote person-centered care, increases in TOLAC/VBAC rates could be achieved by focusing on individual maternal needs. An ad hoc strategy for making birth safer should begin from accurate information at the time of the previous CS.

Introduction:Coping strategies performed in labour or taught in pregnancy reduce women's pain and anxiety, enhancing women' self-efficacy. To identify which are the most appropriate coping strategies health care providers should implement to help women cope with a prolonged latent phase of labour. Materials and Methods:A systematic review was carried out during December 2018 on MEDLINE -Pubmed, CINAHL, Web of Science PsycINFO, and Scopus. All of the RCTs assessing the effects of coping strategies during the latent phase of labour on primiparous or nulliparous women aged 16 or above were included. We independently reviewed the selected studies and extracted data using predefined criteria including samples, interventions, timings and outcomes.Results: 3591 studies were identified, of which 8 met the inclusion criteria. Two main groups of coping strategies were found: Coping Strategies Performed in Labour (CSPL) or Coping Strategies Taught in Pregnancy (CSTP). The CSPL included manual or relaxation techniques delivered during labour, which were associated with a decrease of pain intensity and anxiety levels. The CSTP included educational interventions provided during the third trimester of pregnancy, which were aimed to improve women's selfefficacy and knowledge about labour. Efficacy of educational interventions wasn't consistent among all studies, but self-efficacy was higher in women educated on relaxation techniques, while pain was lower in women educated on both manual and relaxation techniques.Discussion: More high-quality research is needed regarding which groups of coping strategies is more effective, paying attention on the measurement tools, outcomes and health care providers involved.