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Why it's done
By Mayo Clinic staffWomen consider VBAC for various reasons, including:
- Fewer complications. You're less likely to get an infection and have serious blood loss with a successful VBAC than with a repeat C-section. If the VBAC fails, however, the baby must be delivered by C-section — which carries a higher risk of infection than a planned repeat C-section.
- Shorter recovery time. You'll have a shorter hospital stay after a VBAC than you would after a repeat C-section. Avoiding surgery will help your energy and stamina return more quickly, as well as reduce the expense of childbirth.
- More participation in the birth. For some women, it's important to experience a vaginal delivery. If you have a successful VBAC, you'll likely get to hold and breast-feed your baby sooner than you would after a repeat C-section.
- Impact on future pregnancies. If you're planning a larger family, VBAC might be a better option with each subsequent delivery. Repeat C-sections get more complicated each time, while repeat VBACs tend to become progressively easier.
The chances of a successful VBAC are higher if:
- You've had only one prior low transverse uterine incision — the most common type for a C-section — and no other uterine incisions
- You and your baby are healthy and your pregnancy is progressing normally
- The reason you had your prior C-section isn't a factor this time
- Your labor begins naturally on or before your due date
- You've had a previous successful vaginal delivery
The chances of a successful VBAC are lower if:
- Your pregnancy continues beyond your due date
- You have an unusually large baby
- You've had two or more C-sections and no vaginal deliveries
You're not a candidate for VBAC if you have any health conditions that might affect a vaginal delivery or you had a uterine rupture during a previous pregnancy. Similarly, VBAC isn't recommended if you've had a vertical uterine incision — the type of uterine incision most likely to rupture during labor.
VBAC might be possible with twins if the lower twin is in the headfirst position, but VBAC generally isn't an option for triplets or other multiples.
References
- 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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