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Vaginal birth after C-section

Definition

If you had a cesarean birth (C-section) before, it does not mean that you will have to deliver the same way again. 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. There are many good reasons to try a VBAC rather than have a C-section. Some are:

• Shorter stay in the hospital

• Faster recovery

• No surgery

• Lower risk for infections

• Less chance you will need a blood transfusion

• You may avoid future C-sections -- a good thing for women who want to have more children

What are the Risks?

The most serious risk with VBAC is a rupture (break) of the uterus. Blood loss from a rupture can be a risk for the mom and can injure 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 C-sections and what kind you had before. You may be able to have a VBAC if you had only one C-section delivery in the past.

• The cut on your uterus from a past C-section should be what is called low-transverse. Your health care provider may ask for the report from your past C-section to determine this.

• You should have no past history of ruptures of your uterus or scars on your uterus from other surgeries.

Your provider will want to make sure your pelvis is large enough for a vaginal birth and will monitor you to see if you have a big baby. It may not be safe for your baby to pass through your pelvis.

Because 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.

• A medical team including anesthesia, obstetrics and operating room personnel 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 provider will decide if a VBAC is right for you. Talk with your 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 provider says that you can have a VBAC, the chances are good that you can have one with success. Most women who try VBAC are able to deliver vaginally.

Keep in mind, you can try for a VBAC, but you may still need a C-section.

References

Chestnut DH. Trial of labor and vaginal birth after cesarean delivery. In: Chestnut DH, Wong CA, Tsen LC, et al, eds. Chestnut's Obstetric Anesthesia: Principles and Practice. 6th ed. Philadelphia, PA: Elsevier; 2020:chap 19.

Landon MB, Grobman WA. Vaginal birth after cesarean delivery. In: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Gabbe's Obstetrics: Normal and Problem Pregnancies. 8th ed. Philadelphia, PA: Elsevier; 2021:chap 20.

Review Date: 11/8/2024

Reviewed By: LaQuita Martinez, MD, Department of Obstetrics and Gynecology, Emory Johns Creek Hospital, Alpharetta, GA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.