What is a vaginal birth after cesarean (VBAC)?

If you have had a cesarean delivery (also called a C-section) before, you may be
able to deliver your next baby vaginally. This is called vaginal birth after ce
sarean, or VBAC.
Most women, whether they deliver vaginally or by C-section, don't have serious p
roblems from childbirth. See pictures of a vaginal birth and a cesarean delivery
.
If you and your doctor agree to try a VBAC, you will have what is called a "tria
l of labor." This means that you plan to go into labor with the goal to deliver
vaginally. But as in any labor, it is hard to know if a VBAC will work. You stil
l may need a C-section. As many as 4 out of 10 women who have a trial of labor n
eed to have a C-section.1
Is a VBAC trial of labor safe to try?
If you have had only one cesarean delivery, VBAC may be a safe option for you. Y
ou and your doctor may think about a VBAC trial of labor if:
You have only one low, side-to-side scar from a C-section.
You have had 2 cesareans before, but you have also had a vaginal delivery.
The hospital has the staff and tools to do a quick C-section in case you need on
e.
You don't have a reason for a cesarean in this pregnancy, such as a placenta pre
via.
VBAC is considered safe if you are older than 35, you have a large fetus, or you
r pregnancy goes beyond 40 weeks. But these things do lower your chance of being
able to deliver vaginally.
VBAC is not considered safe if you have:
Two C-section scars and have not delivered vaginally before.
Any scarring above the lower, thinner part of your uterus.
What are the benefits of a VBAC?
The benefits of a VBAC compared to a C-section include:
Avoiding another scar on your uterus. This is important if you are planning on a
future pregnancy. The more scars you have on your uterus, the greater the chanc
e of problems with a later pregnancy.
Less pain after delivery.
Fewer days in the hospital and a shorter recovery at home.
A lower risk of infection.
A more active role for you and your birthing partner in the birth of your child.
What are the risks of VBAC?
The most serious risk of a VBAC is that a C-section scar could come open during
labor. This is very rare. But when it does happen, it can be very serious for bo
th the mother and the baby. The risk that a scar will tear open is very low duri
ng VBAC when you have just one low cesarean scar and your labor is not started w
ith medicine. This risk is why VBAC is only offered by hospitals that can do a r
apid emergency C-section.If you have a trial of labor and need to have a C-secti
on, your risk of infection is slightly higher than if you just had a C-section.