If you have had a cesarean delivery you may be able to deliver your baby vaginally (VBAC).
If you are a candidate for VBAC we will await spontaneous labor and then undergo a trial of labor. We are not able to start your labor (induce) because the risks are too high for you and your baby, but we may add to your labor progress (augment). But as in any labor, it is difficult to know if a VBAC will work for you and you may still need a C-section.
We will work with you in determining if you are a good candidate for VBAC. Some of the factors that help in predicting a successful VBAC are:
- Prior vaginal birth, before or after your previous cesarean section.
- No history of diabetes or hypertension.
- Good pelvic anatomy, determined on exam.
- Prior cesarean was for reasons other than failure to progress.
- Physically active.
- No prior Classical Scar on your uterus.
Factors that make your chances of VBAC less likely are:
- No prior vaginal delivery.
- 2 or more cesarean sections.
- Prior cesarean for failure to progress or “baby too big”.
- Poor pelvic anatomy for delivery.
- Diabetes, hypertension or health concerns for pushing or awaiting spontaneous labor.
Is VBAC safe?
Having a vaginal birth after having a C-section can be a safe choice for you, especially if you are a good candidate.
A woman who chooses VBAC is closely monitored. As with any labor, if the mother or baby shows signs of distress, an emergency cesarean section is done.
What are the benefits of a VBAC?
The benefits of a VBAC compared to a C-section include:
- Less pain after delivery.
- Fewer days in the hospital and a shorter recovery at home.
- A lower risk of infection.
- A lower risk of bleeding.
What are the risks of VBAC?
The most serious risk of a VBAC is that your prior C-section scar could come open during labor. This occurs in about 1% of the time and 2% after 2 prior cesareans. If the scar opens the blood flow to your baby is shunted away, increasing your baby’s risk of brain, neurologic injury and death, and your risk of hemorrhaging. This risk is why VBAC is often only offered by hospitals that can do a rapid emergency C-section, and is not recommended to be done in the setting of a home birth. If you labor and need a cesarean section that increases your risk of bleeding and infection.