Luchristt D, Brown O, Pidaparti M, et al. - Researchers conducted a secondary subgroup analysis of the Maternal-Fetal Medicine Units Network Trial of Labor After Cesarean Delivery prospective cohort in order to develop and validate a predictive model facilitating estimation of the risk of obstetrical anal sphincter injuries in the setting of vaginal birth after cesarean delivery population, for improving antenatal counseling of patients with respect to risks of trial of labor after cesarean delivery. From the Maternal-Fetal Medicine Units Network Trial of Labor After Cesarean Delivery cohort, they included 10,697 women meeting the inclusion criteria; of these, 669 women (6.3%) experienced obstetrical anal sphincter injuries. The model was developed including following factors which were noted to be independently linked with obstetrical anal sphincter injuries: use of forceps and vacuum assistance, along with increasing maternal age, body mass index, previous vaginal delivery, and tobacco use during pregnancy. This model yielded a robust, validated estimate of the probability of obstetrical anal sphincter injuries during vaginal birth after cesarean delivery and can be utilized to counsel patients with respect to the risks of trial of labor after cesarean delivery compared with risks of elective repeat cesarean delivery.