Are You a Candidate for VBAC?

By JoLyn Seitz, MD Oct 04, 2016

Can you deliver a baby vaginally if you had a cesarean section (C-section) previously? Yes, vaginal birth after cesarean (VBAC) is considered a safe option now. In fact, the American College of Obstetricians and Gynecologists (ACOG) estimates about 60 to 80 percent of women who try to have a VBAC succeed. For many years, women who had a C-section were told future births would need to also be C-sections. That is no longer true.

Vaginal delivery, if possible, is preferable because you get to go home earlier and you recover more quickly. Whether or not you are a candidate for VBAC depends on several factors, including the reason a C-section was done previously, your medical history and the type of incision that was made on your uterus. A transverse or horizontal incision, which is used most often, makes VBAC an option. This incision is a cut across the lower, thinner part of the uterus. If you had a vertical incision, which cuts up and down through the uterine muscles that strongly contract during labor, it is riskier for VBAC because vaginal delivery could cause a tear in the uterine muscle and is not recommended. (The incision on your skin does not necessarily go in the same direction as the incision on your uterus.)

A woman who opts to have VBAC should know that a C-section could still become necessary. Your doctor may have to consider a C-section again for various reasons, such as the baby is breech or transverse, there is indication of birth defects, problems with your placenta or development of a medical condition that could make vaginal delivery risky for you or your baby. It’s important that you choose a doctor you trust to make decisions that are in the best interests of you and your baby.

There are some risks with a VBAC, but many women succeed without having any complications. If you are considering a VBAC, talk to your doctor so you can weigh the risks and benefits. Check in advance to be sure the hospital you use allows it. If VBAC is very important to you, begin looking into your options early. Ask questions and choose a provider and hospital that support working with you toward your goal.

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