To explore the status quo and the influencing factors of the cesarean section of women with the first pregnancy, and to establish the prediction model for the cesarean section of the women. Methods: The clinical data of 1650 full-term women with the first pregnancy and the singleton who had undergone the vaginal trial labor from January 2021 to January 2024 were collected retrospectively. Among them, 200 women in study group were transferred to the cesarean section, and in the other 200 women with the successful vaginal delivery were randomly selected in control group. The related data of the women were analyzed and compared between the two groups. Univariate and multivariate logistic regression analysis were used to analyze the related factors affecting the transfer to the cesarean section of the women. Receiver operating characteristic (ROC) curve was used to analyze the value of the risk prediction model constructed based on these independent influencing factors of the women for their transfer to the cesarean section. Results: Among the 1650 women with the vaginal trial labor, there were 200 (12.1%) cases with the transferred to the cesarean section. In the study group, the proportion of the transferred to the cesarean section of the women due to the relative cephalopelinal disproportion was 69.0%, and which was the highest. The maternal age, the prenatal body mass index (BMI), the proportion of the premature rupture of membranes, the classification of the amniotic fluid, the proportion of the induced labor and the neonatal weight and length of the women in the study group were significantly higher than those of the women in the control group, and the cervical Bishop score of the women in the study group was significantly lower than that of the women in the control group (P<0.05). Logistic regression analysis showed that the higher Bishop score of the women was a related factor to reduce their transferred to the cesarean section, while the advanced age, the higher prepregnant BMI, and the higher neonatal weight of the women were the risk factors of their transferred to the cesarean section (all P<0.05). The area under the curve of the risk model based on these independent influencing factors for predicting the transferred to the cesarean section of the women was 0.821 (95%CI 0.780-0.857), with the sensitivity of 77.0% and the specificity of 74.5%. Conclusion: The advanced age, the high prepregnant BMI, the low cervical maturity and the high neonatal weight of the women may affect their transferred to the cesarean section during the vaginal trial delivery, and the risk prediction model established based on which of the women with the first pregnancy has certain value for predicting the transferred to the cesarean section, and the risk prediction model can guide the clinical delivery intervention.