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Risks
By Mayo Clinic staffVBAC poses potentially serious risks, including:
- Failed attempt at labor. Labor results in a repeat C-section for 20 to 40 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 may need to be removed (hysterectomy) to stop the bleeding. If your uterus is removed, you won't be able to get pregnant again.
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 may stretch the pelvic floor muscles even farther. This can lead to temporary urinary incontinence.
- Welischar J, et al. Trial of labor after cesarean delivery. http://www.uptodate.com/home/index.html. Accessed Dec. 28, 2009.
- Grobman WA, et al. Can a prediction model for vaginal birth after cesarean also predict the probability of morbidity related to a trial of labor? American Journal of Obstetrics and Gynecology. 2009;200:56.e1.
- Macones GA. Clinical outcomes in VBAC attempts: What to say to patients? American Journal of Obstetrics and Gynecology. 2008;199:1.
- Vaginal birth after cesarean delivery. American College of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp070.cfm. Accessed Dec. 28, 2009.
- Healthy pregnancy: Labor and birth. The National Women's Health Information Center. http://www.womenshealth.gov/pregnancy/childbirth-beyond/labor-birth.cfm. Accessed Dec. 28, 2009.
- Healthy pregnancy: Staying healthy and safe. The National Women's Health Information Center. http://www.womenshealth.gov/pregnancy/you-are-pregnant/staying-healthy-safe.cfm. Accessed Dec. 28, 2009.
- Baydock SA, et al. Prevalence and risk factors for urinary and fecal incontinence four months after vaginal delivery. Journal of Obstetrics and Gynaecology Canada. 2009;31:36.
- Harms RW (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 12, 2010.
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