Search Strategy and Inclusion Criteria
We searched PubMed, MEDLINE, CAB, EMBASE, African Index Medicus, and CINAHL databases from inception (1966) until July 28th, 2020, to identify all studies in women with a prior CS conducted in SSA. We also reviewed reference lists of included articles and available systematic reviews to identify additional articles. Specific search terms included vaginal birth after caesarean, trial of labour after caesarean, caesarean section/delivery, abdominal delivery, and trial of labour. Unpublished studies were not included in this search. Full details of the search strategy are available in Table S1.
We included studies from full-text published studies in either English or French. Studies had to report information on participants with at least one prior CS presenting for delivery in a subsequent pregnancy. We included articles reporting planned and actual mode of delivery and delivery outcomes, including maternal, fetal and neonatal outcomes. We included studies with a range of study designs, including randomised controlled trials, cohort studies, case-control studies, cross-sectional studies and case series and be conducted in a range of clinical settings. We excluded articles with a study setting outside of SSA and those focusing on a narrower subset of women within the desired population, e.g., only women with multiple gestations or with a hypertensive disorder of pregnancy.