Vaginal Birth After Cesarean Q & A

What is a vaginal birth after cesarean?

Vaginal birth after cesarean (also referred to as VBAC), is the vaginal delivery of your baby after having had a cesarean delivery. Attempting this kind of delivery requires a “trial of labor after cesarean,” or TOLAC. Undergoing this trial means you have the goal of delivering vaginally. There are definitely pros and cons that should be considered when attempting a TOLAC and some women may still need a C-section after undergoing a trial of labor.

However, we believe the option, choice, and attempt is a decision that should be available to patients. Here at Nurture Women’s Health, we are available to discuss if TOLAC is a safe choice for you.

What are the benefits of a VBAC?

Many women wish to undergo a VBAC as opposed to another C-section in hopes of several benefits:

  • Avoiding another scar on your uterus
  • Less pain after delivery
  • Fewer days in the hospital and a shorter recovery at home
  • A lower risk of infection
  • A more active role for you and your birthing partner during the delivery

What are the risks of undergoing a VBAC?

While beneficial in many ways, a VBAC harbors several risks that depend on the condition of each woman. The most severe but rare case is a C-section scar that comes open during labor. Naturally, the more C-sections you’ve had and subsequent cesarean scars you have, the higher the risk is that a scar will tear open.

Undergoing TOLAC also puts you at a slightly increased risk for infection if you end up needing a C-section than if you didn’t go through the trial of labor.  However if successful, a VBAC delivery is safer than a planned c-section.

What might increase my chances of a successful VBAC?

The pregnancy, labor, and delivery experience is different for every woman, as is the likelihood of a VBAC. A trial of labor may be most telling of how successful a VBAC might go. Generally speaking, your best chances for a successful VBAC include:

  • Your previous cesarean wasn’t done for stalled labor
  • You don’t have the same condition that led to a previous C-section
  • You’ve had a vaginal delivery or a successful VBAC in the past
  • Your labor starts on its own, and your cervix dilates well
  • You’re younger than 35 years old

What are the risk factors of having a successful VBAC?

Your chances of a successful VBAC decrease when:

  • Your past C-section was due to difficult labor
  • You are obese
  • You’re older than 35 years old
  • Your fetus is very large
  • You’re beyond 40 weeks of pregnancy
  • Your last pregnancy was within the past 18 months

Schedule a consultation online with your OB/GYN at Nurture Women’s Health to discuss your options and chances for success.


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