Vaginal Birth After Cesarean (VBAC) in Morocco: Women’s Experiences and Obstetric Outcomes – A Community-Based Cross-Sectional Study

¹ Higher Institute of Nursing and Health Technology Professions – Kenitra, Morocco
² Laboratory of Natural Resources and Sustainable Development, Department of Biology, Faculty of Sciences, Ibn Tofail University, B.P. 133, 14000, Kenitra, Morocco

^* Corresponding Author: Ghizlane Bouazza Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

Abstract

Objective: To explore the experiences of Moroccan women with a scarred uterus who delivered vaginally, and to describe self-reported maternal and neonatal outcomes as well as associated factors.

Methods: A community-based cross-sectional study was conducted among 150 women in the Rabat–Salé–Kénitra region. Data were collected at the women’s homes using a self-administered questionnaire covering sociodemographic characteristics, obstetric history, complications, neonatal outcomes, and subjective experience. Descriptive statistics (means, frequencies, 95% CI), bivariate comparisons (χ^², Mann–Whitney), and logistic regression were performed.

Results: The mean age was 28.6 ± 4.7 years (median 29; IQR 26–31). The VBAC success rate was 82.7% [95% CI: 76.1–88.0]. Reported maternal complications included postpartum hemorrhage (6.0%), uterine rupture (1.3%), postpartum infection (2.0%), and uterine revision (4.7%). Fetal heart rate anomalies occurred in 9.3%. Neonatal outcomes included Apgar <7 at 5 minutes (7.3%) and neonatal transfer (8.7%). Maternal satisfaction was high (74.0%), although 38.7% reported fear or anxiety. Multiparity, interpregnancy interval ≥24 months, and spontaneous labor were significantly associated with VBAC success (p < 0.05).

Conclusion: VBAC is feasible and relatively safe in the Moroccan context, as reported by women in the community. Maternal experience emphasizes the need for clear information and psychological support.