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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 may 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 may 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 have only one prior low transverse uterine scar — the most common uterine incision for a C-section — and no other uterine scars
- 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 obese
You're not a candidate for VBAC if you had a uterine rupture during a previous pregnancy or any health conditions that might affect a vaginal delivery. Similarly, VBAC isn't recommended if you've had a classical incision — the type of uterine incision most likely to rupture during labor. VBAC may be possible with twins if both babies are positioned headfirst, but VBAC generally isn't an option for triplets or other multiples.
- 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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