Vaginal Birth After Cesarean Section (VBAC)

About 32% of the babies born in the U.S. are delivered by cesarean section (C-section). Many of these births are by repeat C-section, but there is another option for women who have had a C-section with an earlier pregnancy who are hoping for a vaginal birth for future births. The process is known as vaginal birth after cesarean, or VBAC.

The National Institute of Child Health and Human Development, the American Congress of Ob/Gyn and the American College of Nurse-Midwives believe that VBAC is a safe option to having a repeat C-section. Most women who have had a previous C-Section will have a safe vaginal birth in later pregnancies. VBAC is generally thought to have a 60-80% success rate.

As with most medical procedures, there are benefits and risks to consider for VBAC:

Advantages of successful vaginal birth vs. repeat C-sections include:

• Fewer wound infections
• Less pain
• Infants have fewer breathing problems
• Shorter hospital stay
• Lower cost hospital stay

Some possible risks of VBAC include:

• A tear in the uterus (rupture) needing emergency surgery, which can result in serious problems for mom and baby. Note, however, this happens in less than 1% of all VBACs.
• Some women may need a hysterectomy (removal of the uterus) Some women may experience heavy blood loss
• A baby could die or suffer brain damage during the birth

If you choose to try a VBAC, there will be a trial of labor in the hospital. Referred to as TOLAC (Trial of Labor after Cesarean), this will be done with staff who are trained to help with childbirth emergencies. Patient and baby are both monitored closely during labor, including continuous fetal heart monitoring for baby. A physician who can evaluate labor progress and perform a C-section if needed will be present. Anesthesia staff are always available in the hospital for emergency C-section is needed.

Because each woman is unique and each situation is different, patients are encouraged to speak with their pregnancy provider to ask questions, learn more, and determine if they are a good candidate for VBAC.