Abstract: 【Abstract】  Objective：To discuss the mode of delivery for the pregnant women after prior cesarean when spontaneous labor. Methods：A retrospective study was conducted, which included 230 pregnant women attending Suzhou Municipal Hospital from Jan. 2015 to Apr. 2016. All women had a previous cesarean and a singleton pregnancy with cephalic presentation, also spontaneous labor when admitted. The cases were divided into two groups according to the women′s preferences, trial of labor after cesarean (TOLAC) group and refused TOLAC group. The TOLAC group were further divided into successful TOLAC and failed TOLAC groups. The demographic characteristics, relevant factors about prior cesarean, pregnancy outcomes and socioeconomic performance were evaluated. Results：In all 230 pregnant women, 98 women eligible for TOLAC. TOLAC led to vaginal birth in 87 women (88.78%), 11 women failed due to fetal distress or a non-progress of labor. The BMI in failed TOLAC group was significantly higher than the other two groups (both P＜0.05). In total, 2 women who eligible for TOLAC [2.04% (2/98)] and 2 women refused TOLAC [1.52% (2/132)] had uterus scar rupture, there was no significant difference in two groups (χ2=0.091, P=0.767). The mean intrapartum blood loss in successful TOLAC group was significantly lower than the other two groups (both P＜0.05); when failed TOLAC group compared with refused TOLAC group, there was no significant difference (P=0.434). The proportion who required bold transfusion in successful TOLAC group was significantly lower than failed TOLAC group (P＜0.05), however there were no significant differences in the proportion in failed TOLAC group and refused TOLAC group (P=0.092). The proportion of neonates who had to be admitted to intensive care did not differ significantly by mode of delivery. Conclusions：Based on sufficient evaluate, under strict supervision and administration, TOLAC is a reasonable option, particularly when spontaneous onset of labor. Vaginal birth will be much safer and more reliable than emergency cesarean.

Key words: 【Keywords】 , Cesarean section, Vaginal birth after cesarean, Natural childbirth, Parturition, Pregnancy outcome