If you had a Caesarean section (C-section) before, it does not mean that you will have to deliver again the same way. Many women can have vaginal deliveries after having a C-section in the past. This is called a vaginal birth after cesarean (VBAC).
Why Should I Think about a VBAC?
Most women who try VBAC are able to deliver vaginally. If you can have a VBAC, there are many good reasons to try it rather than have a C-section. Some are:·
Shorter stay in the hospital
Lower risk for getting infections
Less chance you would need a blood transfusion
It may help you avoid future C-sections. This is a good thing for women who want to have more children.
What Are the Risks?
The most serious risk with VBAC is rupture (break) of the uterus. Blood loss from a rupture can be a risk for the mom and can cause damage to the baby.
Women who try VBAC and do not succeed are also more likely to need a blood transfusion. There is also a greater risk of getting an infection in the uterus.
Who Can Have a VBAC?
The chance of a rupture depends on how many and what kind of C-section you had before. You may be able to have a VBAC if you have had no more than one C-section deliveries in the past. But that is not all.
The cut on your uterus from prior C-section should be what is called low-transverse. Your health care provider may ask for the report from your past C-section.
There should be no past history of ruptures of your uterus or scars from other surgeries.
Your doctor will want to make sure your pelvis is large enough for a vaginal birth and monitor to see if you have a big baby. It may not be safe for the baby to pass through the pelvis.
Since problems can occur quickly, where you plan to have your delivery is also a factor.
You will need to be somewhere where you can be monitored through your entire labor.
The doctor and the correct medical team must be nearby to do an emergency C-section if things do not go as planned.
Smaller hospitals may not have the right team. You may need to go to a bigger hospital to deliver.
Who Decides if I Should Try for a VBAC?
You and your doctor will decide if a VBAC is right for you. Talk with your health care provider about the risks and benefits for you and your baby.
Every woman’s risk is different, so ask what factors matter most for you. The more you know about VBAC, the easier it will be to decide if it is right for you.
If your doctor says that you can have a VBAC, chances are good that you can have one with success. Around 3 out of 4 women who try VBAC are able to deliver vaginally.
Keep in mind, you can try for a VBAC, but you may need a C-section anyway.
Berghella V, Landon MB. In: Gabbe SG, Niebyl JR, Simpson JL, et al, eds. Obstetrics: Normal and Problem Pregnancies. 6th ed. Philadelphia, Pa: Saunders Elsevier; 2012:chap 20.
Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.