VBAC: All About Vaginal Birth After a Cesarean Delivery

You might think that if you’ve previously had a cesarean section that you cannot give birth vaginally. This is not necessarily the case. The vaginal delivery of a baby after a cesarean section is often referred to as VBAC, which stands for vaginal birth after a cesarean section. Read on to find out more about VBAC and whether this might be appropriate for you.

What Is VBAC?

VBAC is short for vaginal birth after cesarean delivery. Between 60 and 80 percent of women who have had a previous delivery via cesarean section are able to give birth vaginally.

You may be wondering whether you could try for a vaginal delivery this time around. Vaginal delivery may or may not be recommended by your healthcare provider for a number of reasons, and sometimes a planned vaginal delivery can turn into an emergency cesarean section due to how the labor is progressing.

Every pregnancy is unique, and your personal situation and medical history needs to be considered holistically. Whether or not you can safely choose a vaginal delivery after a cesarean section can be a complicated question, but your healthcare provider will be able to make a recommendation as well as explain the risks and benefits of each type of delivery.

Are You a Good Candidate for a VBAC?

It’s important to let your healthcare provider know early on if you’re interested in having a VBAC. That way, your provider can explain the pros and cons, and you can work together to decide on the best course of action for both you and your baby.

Your healthcare provider will consider the following factors when determining whether to recommend a VBAC:

• Your uterine incision. Your healthcare provider takes into account the type of incision that was made during your previous cesarean section. Certain types of uterine incisions can increase your risk of uterine rupture. A low transverse (horizontal) incision is the least risky, and is the most commonly used incision for a cesarean delivery. A VBAC is not recommended if you’ve had a high vertical incision, which has the highest risk of rupturing.

• Your previous deliveries. You’re likely to have more success with a VBAC this time around if you’ve already had a VBAC. However, you may still be a good candidate for a VBAC even if all of your previous deliveries were by cesarean.

• Your future deliveries. Multiple cesarean deliveries can increase your risks, and this is something to keep in mind if you plan to have more children. Have a discussion about family planning with your healthcare provider so that this can also be factored into the decision-making process.

• Medical conditions or problems with the pregnancy. A vaginal delivery carries more risk if you have certain medical conditions during your pregnancy, such as preeclampsia, or if there is a problem with the placenta, such as placenta previa, or with the baby.

• Where you plan to give birth. The hospital or medical center where you plan to give birth is another key factor. For example, your provider will consider whether the facility is prepared to address any medical emergencies that may happen during your VBAC.

What Are the Benefits of a VBAC?

Here are some of the benefits of having a VBAC as opposed to a cesarean birth:

• Abdominal surgery is avoided

• There may be less blood loss

• VBAC has a lower risk of infection and carries a lower risk of blood clots

• Vaginal deliveries have a shorter postpartum recovery time

• Having a VBAC can help lower the risk of complications associated with multiple cesarean deliveries such as injury to the bladder or bowels, the need for a hysterectomy, or placental problems.

How Do You Prepare for a VBAC?

If your previous delivery was via a cesarean section, and you’re pregnant again, you might consider bringing up the subject of a VBAC with your healthcare provider at your first prenatal checkup. This is a great opportunity to discuss any concerns you may have.

If your provider is not the same one as you had at your previous delivery, make sure that your new provider has your complete medical history, which would include all the details of your previous cesarean section and any other procedures you may have had. All this information helps your provider assess whether a VBAC is appropriate.

What Are the Risks of a VBAC?

VBAC is not a good choice for everyone or for every situation. There are certain risks involved, including:

• Infection

• Injury

• Blood loss

• Rupturing of the cesarean scar on the uterus

• Rupturing of the uterus.

Even if you plan to have a VBAC, things can happen at the last minute during labor or delivery, so there’s always a chance that plans may change. Your healthcare provider can go over all the details and risks with you, and will ensure that you and your baby have the best possible care.

What Can You Anticipate During a VBAC?

During VBAC, your healthcare provider and your entire medical team will follow the same process that is called for in a vaginal delivery. They will continuously monitor you and your baby, which will include monitoring your baby’s heart rate. The provider will also prepare for a cesarean section in case it’s needed.

The Bottom Line

A VBAC can be a good option for some women who have previously had a cesarean section. However, only your healthcare provider knows your full medical history as well as how your current pregnancy is progressing. That’s why it’s important to discuss your preferences with your provider, and to learn about the safest options for you and your baby.

Remember that labor and delivery can be unpredictable, so you'll need to keep an open mind and be flexible. Even with a planned VBAC it may be the case that a cesarean section is needed in the end based on how your labor is progressing.

Whether you’re able to have a VBAC, or you end up having a cesarean delivery again, you’ll still have a beautiful baby in your arms.