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Risks
By Mayo Clinic staffVBAC poses potentially serious risks.
Failed attempt at labor
Labor results in a repeat C-section for an estimated 25 percent of women who attempt VBAC, often because the baby doesn't tolerate labor.
Uterine infection
If you must have a repeat C-section after labor has begun, you face a slightly higher risk of C-section complications — such as a uterine infection — than if you had a planned repeat C-section.
Uterine rupture
Rarely, the uterus may tear open along the scar line from a prior C-section.
If your uterus ruptures — either before or during labor — an emergency C-section is needed to prevent life-threatening complications, including blood loss, infection and brain damage for the baby.
When delivery takes place in a hospital equipped to handle such emergencies, rarely is the baby at risk. In some cases, however, the uterus might need to be removed (hysterectomy) to stop the bleeding.
If your uterus is removed, you won't be able to get pregnant again.
Pelvic floor problems
For some women, pelvic floor problems also are a concern.
The weight and pressure of pregnancy can weaken the pelvic floor muscles that support the uterus, and vaginal delivery can stretch the pelvic floor muscles even farther. This can lead to temporary urinary incontinence, particularly for women who give birth vaginally.
- Wells CE, et al. Choosing the route of delivery after cesarean birth. http://www.uptodate.com/index. Accessed March 1, 2012.
- American College of Obstetricians and Gynecologists (ACOG) Committee on Practice Bulletins - Obstetrics. ACOG Practice Bulletin No. 115: Vaginal birth after previous Cesarean delivery. Obstetrics & Gynecology. 2010;116:450.
- Berghella V. Cesarean delivery: Preoperative issues. http://www.uptodate.com/index. Accessed March 1, 2012.
- Vaginal birth after Cesarean delivery: Deciding on a trial of labor after Cesarean delivery. The American College of Obstetricians and Gynecologists. http://www.acog.org/Search?Keyword=vbac. Accessed March 1, 2012.
- Pregnancy: Labor and birth. U.S. Department of Health and Human Services Office on Women's Health. http://www.womenshealth.gov/pregnancy/childbirth-beyond/labor-birth.cfm. Accessed March 1, 2012.
- Smith JF, et al. Rupture of the unscarred uterus. http://www.uptodate.com/index. Accessed March 1, 2012.
- Stothers L, et al. Risk factors for the development of stress urinary incontinence in women. Current Urology Reports. 2011;12:363.
- Handa VL. Pelvic floor disorders associated with pregnancy and childbirth. http://www.uptodate.com/index. Accessed March 2, 2012.
- Harms RW (expert opinion). Mayo Clinic, Rochester, Minn. March 21, 2012.
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