Trial of labour is a safe option for most women after one previous caesarean delivery. However, the proportion of women attempting trial of labour after previous caesarean delivery (TOLAC) has been declining in many countries. In addition, women with prior caesarean delivery appear to know little regarding their mode of delivery and healthcare providers’ recommendations. The doctors’ preferences exert a strong influence on patient’s decision whether or not to pursue TOLAC.

Since March 2000, the Population Council and the University of Nairobi have been assisting the Kenya Ministry of Health to implement Safe Motherhood activities in Western Kenya. The purpose of this project was to increase utilization of quality maternal services in the selected districts and, in an effort to improve pregnancy outcomes, focused on improving quality of antenatal care, essential obstetric care, clean and safe delivery, postpartum care, postabortion care, and management issues at all levels.

Health professionals have a critical role to play in the prevention and management of FGM. However, several KAP (Knowledge, Attitudes and Practices) studies conducted in high and low-income countries have shown a lack of knowledge on WHO classification, diagnosis and management of FGM. Although several countries have developed FGM guidelines for professionals and have voted specific laws against the practice, the studies showed that these measures are not sufficient and that educational activities are needed to implement existing guidelines.