What are the risks, benefits of VBAC (vaginal birth after C-section)?

Vaginal birth after cesarean is possible for some women.

Women who have delivered by cesarean section (C-section) may wish to deliver vaginally at some point. While it is possible, there are several things you and your OB/GYN should discuss.

“There are risks associated with a VBAC, but there also are benefits,” said Christopher S. Watkins, M.D., Norton Women’s Specialists – Downtown. “A successful VBAC can help avoid bowel or bladder issues, hysterectomy or even issues with the placenta in other pregnancies.”

The more immediate benefits of a VBAC are a potentially shorter recovery, lower infection risk, less risk of blood loss and, of course, no surgery needed.

Higher risk of uterine rupture if uterine scar is vertical

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The largest risk with a VBAC is a uterine rupture, which means the scar from the previous C-section breaks open.

“When you have a C-section, there is an internal scar on the uterus and an external scar on the skin,” Dr. Watkins said. “If the scar on your uterus is vertical, there is a higher risk of rupture.”

According to Dr. Watkins, sometimes women may attempt a VBAC, but it is not successful. Some of the reasons include a pregnancy that has gone past 40 weeks, a large baby, high maternal weight, advanced maternal age, two or more previous C-sections or a C-section in the past 18 months. VBAC is less likely to succeed if the woman has preeclampsia, stalled labor or induced labor.

“The main thing is to talk with your obstetrician to determine what is best for you and your baby,” Dr. Watkins said.


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