Two Previous Cesarean and Vaginal Birth Before and After Starting Training and Protocols

Women attending birth in Santo Spirito Hospital with 2 previous CS were collected. Exclusion Criteria: * Patients with clinical indication to CS * a previous CS less than 18 month before * breech presentations * triplets * premature labor before 34 completed weeks' gestation The first period was starting January 1st 2016 to December 31st 2020. The second period was starting January 1st 2021 to December 31st 2025 Primary outcomes: * incidence of trial of labor acceptance * incidence of vaginal birth Secondary outcomes: * maternal adverse outcomes (PPH, blood transfusion, vaginal tears, hysterectomy, maternal death) * fetal adverse outcomes (fetal death, NICU stay, APGAR score less than 7 at 5')