Exploring Vaginal Birth After Cesarean: Success Rates and Cultural Decisions in the United Arab Emirates.

OBJECTIVE: This study explores the success rates and cultural influences on the decision-making process for vaginal birth after cesarean (VBAC) in the United Arab Emirates (UAE).

METHODOLOGY: An observational cohort study was conducted at a hospital in the UAE accredited by Joint Commission International, enrolling 263 women eligible for VBAC from March 1, 2018, to February 28, 2019. The study focused on maternal-fetal outcomes, the proportions of women opting for trial of labor after cesarean (TOLAC) versus elective repeat cesarean section (ERCS), and the impact of cultural backgrounds on these decisions.

RESULTS: The study found significant cultural variations in VBAC acceptance and success rates. Among local Emirati/Omani women, 86% (152 out of 177) opted for TOLAC, with an 83% success rate (126 out of 152). In contrast, lower TOLAC uptake and success rates were observed among other nationalities, such as Egyptian and other Arab women. The study also noted higher VBAC success rates in women with prior vaginal deliveries and those who experienced spontaneous labor. NICU admissions and maternal readmissions were lower in the TOLAC group (1% NICU admissions and 2% maternal readmissions) compared to the ERCS group (8.2% NICU admissions).

CONCLUSION: The study underscores the influence of cultural factors in VBAC decision-making and outcomes, highlighting the need for culturally tailored counseling and care. It also confirms the safety and efficacy of VBAC in appropriately selected cases, advocating for more research into counseling practices and long-term outcomes in culturally diverse populations. Impact statement: This research adds to the understanding of how cultural and ethnic backgrounds influence VBAC decisions and outcomes, offering critical insights for clinical practice, especially in multicultural societies like the UAE. It emphasizes the role of tailored counseling and suggests avenues for future research in this domain.