The Effect of a Multicomponent Prenatal Intervention on Maternal Satisfaction Following Vaginal Birth After Cesarean: A Randomized Controlled Trial

Abstract

Background: Cesarean section remains a major contributor to maternal and neonatal complications, with repeat cesarean sections being a primary factor. Vaginal birth after cesarean (VBAC) offers a potential alternative, and its success and maternal satisfaction depend on structured, multicomponent interventions. Objectives: The present study aimed to determine the effect of a multicomponent prenatal intervention on maternal satisfaction following VBAC. Methods: A randomized controlled trial was conducted at Amin Hospital, Isfahan, Iran (March 2024 - March 2025). Eligible women with one prior cesarean and a gestational age < 24 weeks were randomly assigned to repeat cesarean section (control, n = 50) or VBAC (intervention, n = 50) groups via permuted block randomization. The intervention included eight individual/group counseling sessions, at least eight prenatal visits, one acupressure session, and delivery at a specialized center. Data were collected via a demographic questionnaire and the Birth Satisfaction Scale (BSS). The data were analyzed via descriptive statistics (means, standard deviations, frequencies, and percentages) and inferential statistics (independent t-tests and chi-square tests). Results: The VBAC success was achieved in 52% of the intervention group (26/50), with no VBACs in the control group (P < 0.001). Overall maternal satisfaction scores did not differ significantly between groups (control: 157.68 ± 20.45 vs. intervention: 163.15 ± 22.45), but significant improvements were noted in postpartum care (P = 0.003) and participation in childbirth (P = 0.018). Conclusions: Although overall maternal satisfaction did not differ significantly between groups, the multicomponent VBAC-focused intervention increased VBAC success and increased satisfaction with specific aspects of care.