This handout explains the option of choosing a vaginal birth after cesarean (VBAC). This helps our patients decide if they want to attempt a vaginal birth or to have a repeat C section.
Is it possible to have a vaginal birth if you have had a C section?
Yes, even if you have had one or two C sections in the past, you may be able to have a VBAC in the future. The success rates of women trying VBAC range between 60 and 80%.
Why choose to VBAC?
Shorter recovery time
Less chance of infection
Less blood loss
Less complications with future pregnancies
Less risk for future deliveries
Why choose a repeat C section?
Avoid the risk of uterine rupture (separation of uterine scar), which may injure the infant or result in hysterectomy (removal of the uterus)
Avoid the chance that you will go through most of labor, and still need a C section
Ease of having a scheduled birth
Who can have a VBAC?
Women who have had one or two C sections.
C section incision on the uterus must have been “low transverse” rather than vertical. Skin incision may be different than the incision on the uterus. We will need to get the report of your prior C section to confirm this.
Some reasons women may not be able to try VBAC include:
If your baby is not head down
If the placenta is covering the cervix (placenta previa)
If you have had more than two C sections
Prior uterine rupture
If your former doctor advised against having a future VBAC
What are the risks of trying VBAC?
Emergency C section
Risks to your health
Risks to baby’s health
There is more risk if C section needs to be done after an attempt at labor compared to having a planned repeat C section
How can these risks be decreased?
Continuous fetal monitoring, to assure baby’s health through labor.
Lab work (to include blood count and blood typing)
Intravenous line (IV) while in labor
Using certain medicines known as prostaglandins to soften and ripen the cervix as the due date gets closer
Delivery in a hospital and with a doctor able to recognize and manage problems
Avoid prolonged labor, and proceed to repeat C section if problems arise
What can increase my chances of having a successful VBAC?
Labor that starts on its own
Labor before the due date
A history of a successful vaginal delivery in the past
Good prenatal care, that includes a healthy diet and exercise
All types of deliveries, vaginal and cesarean, are subject to risks. Keep in mind that most women and their babies have happy and healthy outcomes.
Discuss these issues, your concerns, and your obstetric history with our Ob/Gyn doctors to set a plan that you are both at ease with and agree to follow.