Vaginal Birth After Cesarean Delivery (VBAC)

Benefits of Vaginal Birth After Cesarean Section (VBAC) compared to an elective repeat cesarean birth:
  • No risk of cesarian surgical complications
  • Improved post-birth recovery & return to normal activities
  • Lessened hospital stay
  • Reduced risk of infection
  • Reduced risk that the baby will have breathing problems
  • For future pregnancies:
               Better chance of of having a vaginal birth
               Less risk of problems with placenta attachment
               Less risk of uterine dehiscence

Risks of VBAC:
  • The usual (low) risks of having a vaginal birth are also present for VBAC
  • A tear or opening in the uterus (womb) occurs in 5 to 10 women out of every 1,000 low risk women who try VBAC (0.5 to 1%)
Risks to the mother if there is a tear in the uterus include:
               Blood loss that may need transfusion
               Damage to the uterus that may need hysterectomy (removal of the uterus)
               Damage to the bladder
               Blood clots
               In very rare cases, death
Risks to the baby if there is a tear in the uterus include:
               Brain damage
               Note: Not all tears to the uterus harm the baby. Serious harm occurs in 5 to 10 babies out of every 10,000 VBACs (.05 to 0.1%).

Is a VBAC the right decision for you?

This is a decision you and your provider must decide together. A key factor in this decision is the type of incision you had previously:
  • Low transverse:side to side cut made across the lower, thinner part of the uterus
  • Low vertical: up and down cut made in the lower, thinner part of the uterus
  • High vertical ("classical"): up and down cut made in the upper part of the uterus (the risk of rupture is highest with this type of incision; trying a VBAC is usually not recommended)

It is important to know that no labor or delivery is risk-free. Both repeat cesarean and VBAC have risks and benefits. When considering VBAC you need to know the risks. Your doctor will help guide yourdecision to do what is best for you and your baby.


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