Vaginal Birth After Cesarean (VBAC)

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Overview

What is a vaginal birth after cesarean (VBAC)?

If you have had a cesarean delivery (also called a C-section) before, you may be able to deliver your next baby vaginally. This is called vaginal birth after cesarean, or VBAC.

Most women, whether they deliver vaginally or by C-section, don't have serious problems from childbirth. See pictures of a vaginal birth or a cesarean delivery .

If you and your doctor agree to try a VBAC, you will have what is called a "trial of labor." This means that you plan to go into labor with the goal to deliver vaginally. But as in any labor, it is hard to know if a VBAC will work. You still may need a C-section. As many as 4 out of 10 women who have a trial of labor need to have a C-section.¹

Is a VBAC trial of labor safe to try?

If you have had only one cesarean delivery, VBAC may be a safe option for you. You and your doctor may think about a VBAC trial of labor if:

• You have only one low, side-to-side scar from a C-section.
• You have had 2 cesareans before, but you have also had a vaginal delivery.
• The hospital has the staff and tools to do a quick C-section in case you need one.
• You don't have a reason for a cesarean in this pregnancy, such as a placenta previa.

VBAC is considered safe if you are older than 35, you have a large fetus, or your pregnancy goes beyond 40 weeks. But these things do lower your chance of being able to deliver vaginally.

VBAC is not considered safe if you have:

• Two C-section scars and have not delivered vaginally before.
• Three or more C-section scars.
• Any scarring above the lower, thinner part of your uterus.

What are the benefits of a VBAC?

The benefits of a VBAC compared to a C-section include:

• Avoiding another scar on your uterus. This is important if you are planning on a future pregnancy—the more scars on the uterus, the greater the chance of problems with a later pregnancy.
• Less pain after delivery.
• Fewer days in the hospital and a shorter recovery at home.
• A lower risk of infection.
• A more active role for you and your birthing partner in the birth of your child.

What are the risks of VBAC?

The most serious risk of a VBAC is that a C-section scar could come open during . This is very rare, but when it does happen, it can be very serious for both the mother and the baby. The risk that a scar will tear open is very low during VBAC when you have just one low cesarean scar and your labor is not started with medicine. This risk is why VBAC is only offered by hospitals that can do a rapid emergency C-section.

If you have a trial of labor and need to have a C-section, your risk of infection is slightly higher than if you just had a C-section.

Frequently Asked Questions

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Last updated:	April 20, 2007
Author:	Kathe Gallagher, MSW
Reviewed By:	Joy Melnikow, MD, MPH - Family Medicine, Kirtly Jones, MD - Obstetrics and Gynecology
Editors:	Kathleen M. Ariss, MS, Pat Truman