Life stage (5)
- VBAC: Insight from a Mayo Clinic specialist
- Placenta: How it works, what's normal
- Labor pain: Weigh your options for relief
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VBAC: Insight from a Mayo Clinic specialist
Who's eligible for VBAC?
VBAC eligibility depends on many factors. For example:
- Have you had previous vaginal deliveries? A vaginal delivery at least once before or after your prior C-section increases the odds of a successful VBAC.
- What type of uterine incision was used for the prior C-section? Scars left from certain types of incisions have an increased risk of tearing during labor and delivery.
- What prompted the prior C-section? If your prior C-section was done for a reason that isn't present during your current pregnancy — such as infection or a problem with the placenta — you may be a good candidate for VBAC.
- How many C-sections have you had? You may be a less suitable candidate for VBAC if you've had multiple C-sections.
- When was your last C-section? The risk of uterine rupture is higher if you attempt VBAC too soon after having a C-section — such as within 18 to 24 months.
- Are you delivering multiples? VBAC may be a safe option if you're delivering twins and both babies are positioned headfirst — but often repeat C-sections are recommended for twins and other multiples.
- Do you have any health conditions that might affect a vaginal delivery? If you have diabetes, heart disease, high blood pressure or active genital herpes, for example, vaginal delivery may be risky for you or your baby.
- Will you deliver the baby in a facility equipped to handle an emergency C-section? A home delivery isn't appropriate for VBAC.
If you had a uterine rupture during a previous pregnancy, you're not a candidate for VBAC. Likewise, VBAC may not be allowed if your labor needs to be induced.
How does labor and delivery during VBAC differ from labor and delivery during a routine vaginal birth?
The actual physiology of labor and delivery is the same, but the precautions taken during labor are different. You and your baby will be closely monitored, and the medical team will be less tolerant of abnormal labor patterns. Your doctor will be prepared to do a repeat C-section if needed.
Some women are outspoken supporters of VBAC, while others are outspoken against it. What should a woman believe?
There's always a cohort of people within the population who adopt positions with a great deal of enthusiasm and vigor, often based on their own experiences — but it isn't possible to extrapolate the experience of one person to the experience of another. If you're considering VBAC, don't be swayed by extremes. Make your decision based on the facts and your personal values and beliefs.
What other advice do you offer women who are considering VBAC?
If you're considering VBAC, it's important to be flexible. You won't know what cards you'll be dealt until labor begins. The circumstances of your labor may make VBAC a clear choice, or you and your doctor may quickly decide that a repeat C-section would be best after all. If you choose an elective C-section, you'll never see what cards were in the deck — and for some women, that might be just fine.
Previous page(2 of 2)
- Harms RW (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 13, 2010.
- Welischar J, et al. Trial of labor after cesarean delivery. http://www.uptodate.com/home/index.html. Accessed Jan. 13, 2010.
- Macones GA. Clinical outcomes in VBAC attempts: What to say to patients? American Journal of Obstetrics and Gynecology. 2008;199:1.
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