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Vaginal Birth after a Previous C-Section

What is a vaginal birth after a previous C-Section?

If you previously gave birth to a child by C-section (cesarean section), you may be able to deliver your next child vaginally. This is called a vaginal birth after a cesarean, or VBAC. Your healthcare provider may encourage you to try a vaginal birth with a next pregnancy, since a VBAC is often considered safe for you and the baby. However, sometimes it is better to deliver your next baby with another cesarean birth.

What is a trial of labor?

Your healthcare provider may recommend a trial of labor. This means that when your labor begins or when your bag of water breaks, you will be asked to go to the hospital. Your healthcare provider will carefully watch the progress of your labor. As long as everything is proceeding normally, you should eventually have a vaginal birth. You may need to have another C-section if there are signs of:

  • abnormal bleeding
  • abnormal fetal heart rate
  • failure to make good progress in labor
  • a tear along the scar line on your uterus from the previous C-section (uterine rupture)

When can a VBAC be done?

Your healthcare provider will consider what happened during your last delivery or deliveries to decide whether you should have a trial of labor. The main concern relates to the scar left in your uterus from the previous C-section. (This is not the same thing as the scar you can see on your belly.) Your provider may allow you to have a trial of labor if:

  • The cut in your uterus was horizontal (side-to-side) rather than vertical (up and down). The cut on your skin is not always the same direction as the cut in your uterus. Your provider will look at your medical records to see which type of cut you had.
  • You have no other uterine scars or previous tears of the uterus.
  • Your pelvis is large enough for a vaginal birth.
  • You don’t have a complication in your pregnancy that suggests that labor would not be safe for you or the baby.
  • Your baby is not in a breech position (the baby's bottom or feet are down first instead of the head).
  • You don’t need prostaglandins to soften the cervix in preparation for an induction of labor. (Prostaglandins increase the risk of a tear in the scar on uterus during delivery.)
  • Staff and a delivery room equipped for an emergency C-section are available if needed.

What are the benefits?

Possible benefits of having a VBAC instead of a C-section are:

  • Generally, vaginal deliveries have fewer risks for you and the baby than cesarean delivery. For example, you are less likely to need a blood transfusion because of heavy bleeding. You are also less likely to have an infection after the delivery.
  • Your hospital stay is shorter, and your recovery at home is faster. You will have much less discomfort after the birth.
  • You and your family can be more involved with the birth.
  • VBAC usually costs less than a C-section.

What are the risks?

Most of the complications associated with trying to have a VBAC are related to problems with the scar on the uterus:

  • The uterus may tear along the scar line from the previous C-section. If there are any signs of a tear during labor, an emergency C-section will be done because both you and your baby could be in danger. Uterine rupture is more likely to happen if you have had more than one C-section in the past.
  • If an emergency C-section needs to be done, it has more risk of infection and other problems than a scheduled C-section.
  • If the uterus is damaged by a tear, it can often be repaired. However, more serious injuries to the uterus may require a hysterectomy to control bleeding and avoid more problems.

What should I discuss with my healthcare provider?

If you have had a C-section, talk to your healthcare provider about the possibility of a vaginal delivery for your next baby. Be sure to discuss the risks and whether you are a good candidate for a VBAC. Find out whether the hospital where you plan to deliver is prepared for an emergency C-section and emergency infant care if necessary.

Developed by Phyllis G. Cooper, RN, MN, and RelayHealth.
Published by RelayHealth.
Last modified: 2011-08-12
Last reviewed: 2010-05-10
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
© 2011 RelayHealth and/or its affiliates. All rights reserved.
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