VBACs started in the s and have been common practice since the s. Since the late s, there has been a slight decline in the VBAC rate, due to safety concerns that VBACs should be done at hospital facilities that can provide emergent surgery, if needed. As a result, women in many smaller communities either are unable to have VBACs or need to travel long distances to be at medical facilities capable of providing safe care for VBACs. When performed in an appropriate hospital setting, the medical opinion has always been that a VBAC is a reasonable option for women who have been informed of the risks.
A: The biggest concern is the risk that the previous C-section incision opens up also known as uterine rupture. But if it occurs, both the mother and baby will have internal bleeding. It is a true emergency. For a repeat C-section patient, there are both short- and long-term risks to consider.
In the short term, C-sections carry the same risks of any abdominal surgery, such as risks of bleeding and infection, with minimal risks to the baby. The long-term risks for a C-section depend on how many C-sections a woman has had. The more C-sections a woman has, the more risks there are for future pregnancies.
This can cause severe bleeding and injury to other organs at the time of delivery. This is because close monitoring is needed so that any complications can be addressed quickly. For this reason, some remote and regional hospitals do not offer VBAC, as they are not properly equipped to handle unplanned emergency caesareans.
The risk of the scar in your womb uterus and abdomen tearing during labour is very low — about 5 to 7 in every VBACs — but this is the main reason doctors and midwives closely monitor VBACs in a properly equipped hospital. A rupture of the scar can result in serious problems for the baby death or brain injury and for you serious bleeding. For most women, any tear can be repaired, but in very rare situations where there is severe bleeding, a hysterectomy removal of the uterus may be required.
Women opting for a VBAC also have a higher likelihood of delivering via an emergency caesarean, which increases the risk of uterine infection and bleeding compared with an elective caesarean.
A VBAC is more likely to be successful if you have previously given birth vaginally, this pregnancy is straightforward, you go into labour spontaneously, you are not overweight or obese, and the previous caesarean was done because of a breech presentation, placenta praevia or fetal distress.
If you decide to go ahead with a VBAC, you can do things to boost your chances of having a successful and positive experience, such as:. Learn more here about the development and quality assurance of healthdirect content.
For many women, vaginal birth after caesarean — VBAC — is a safe and positive way to have a baby. Read more on raisingchildren. Recovery after a caesarean section - whether it's an emergency or planned - will take several weeks. Find out what to expect after you have had your baby. For example:. If you choose VBAC , when you go into labor you'll follow a process similar to that used for any vaginal delivery. However, your health care provider will likely recommend continuous monitoring of your baby's heart rate and be prepared to do a repeat C-section if needed.
If you're considering VBAC , discuss the option, your concerns and your expectations with your health care provider early in pregnancy. Make sure he or she has your complete medical history, including records of your previous C-section and any other uterine procedures.
Your health care provider might calculate the likelihood that you'll have a successful VBAC. Also, plan to deliver your baby at a facility that's equipped to handle an emergency C-section. Continue discussing the risks and benefits of VBAC throughout pregnancy, especially if certain risk factors arise.
Above all, try to stay flexible. The circumstances of your labor could make VBAC a clear choice or, after counseling, you and your health care provider might decide that a repeat C-section would be best after all. There is a problem with information submitted for this request.
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You may opt-out of e-mail communications at any time by clicking on the Unsubscribe link in the e-mail. Many health care providers won't offer VBAC if you've had more than two prior C-sections or you have a body mass index of 50 or higher at the time of delivery and you've never had a vaginal delivery.
VBAC also generally isn't an option if you are pregnant with triplets or higher order multiples. Factors that decrease the likelihood of VBAC include:. While a successful VBAC is associated with fewer complications than an elective repeat C-section, a failed trial of labor after cesarean is associated with more complications, including, rarely, a uterine rupture. If a scar on your uterus from a previous cesarean tears open during a trial of labor, an emergency C-section is needed to prevent life-threatening complications for you and your baby.
Treatment might involve surgical removal of the uterus hysterectomy. If your uterus is removed, you won't be able to get pregnant again. If you've previously had a C-section and you're pregnant, you might begin talking about VBAC at your first prenatal visit.
Discuss your concerns and expectations with your health care provider. Make sure he or she has your complete medical history, including records of your previous C-section and any other uterine procedures. Your health care provider might use your medical history to calculate the likelihood that you'll have a successful VBAC.
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