Vaginal birth after cesarean section (VBAC) risks and benefits

The main VBAC risk is a uterine rupture. VBAC benefits are a potentially shorter recovery and less risk of infection and blood loss.

While it is possible to deliver vaginally after cesarean section — vaginal birth after cesarian, or VBAC — there are VBAC risks and benefits you and your OB/GYN should discuss.

“A successful VBAC can help avoid bowel or bladder issues, hysterectomy or even issues with the placenta in other pregnancies,” said Christopher Watkins, M.D., OB/GYN with Norton Women’s Specialists.

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

The VBAC risk 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.”

Aside from VBAC risks, sometimes patients may need to have a C-section for other reasons. Those can 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 patient 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.

Understand VBAC risks and benefits while planning your pregnancy

Find resources for planning, through birth and beyond.

Having a birth plan can help make sure everyone involved in delivering your baby knows what you want to happen, whether it’s a VBAC or another option.

Writing down how you imagine the birth going in detail will give you a birth plan starting point. Then, you can prioritize, strike out ideas and categorize thoughts.

It will also give you a framework for discussions with your health care provider, especially if you want to discuss VBAC risks and benefits.

Things don’t always follow the plan, so be flexible.

Include in your birth plan the childbirth classes you want to take and new parent classes to learn about taking care of your baby. Consider whether you want to discuss cord blood storage, any concerns around substance abuse and a checklist of what to take to the hospital.

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