What is a vaginal birth after cesarean (VBAC)?
If you have had a cesarean delivery (also called a C-section) before, you may be able to deliver your next baby vaginally. This is called vaginal birth after cesarean, or VBAC.
If you and your doctor agree to try a VBAC, you will have what is called a "trial of labor after cesarean," or TOLAC. This means that you plan to go into labor with the goal to deliver vaginally. But as in any labor, it is hard to know if a VBAC will work. You still may need a C-section. As many as 4 out of 10 women who have a trial of labor need to have a C-section.1
Is a trial of labor safe?
Having a vaginal birth after having a C-section can be a safe choice for most women. Whether it is right for you depends on several things, including why you had a C-section before and how many C-sections you've had. You and your doctor can talk about your risk for having problems during a trial of labor.
A woman who chooses VBAC is closely monitored. As with any labor, if the mother or baby shows signs of distress, an emergency cesarean section is done.
What are the benefits of a TOLAC?
The benefits of a VBAC compared to a C-section include:
- Avoiding another scar on your uterus. This is important if you are planning on a future pregnancy. The more scars you have on your uterus, the greater the chance of problems with a later pregnancy.
- 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 in the birth of your child.
What are the risks of TOLAC?
The most serious risk of a trial of labor is that a C-section scar could come open during labor. This is very rare. But when it does happen, it can be very serious for both the mother and the baby. The risk that a scar will tear open is very low during VBAC when you have just one low cesarean scar and your labor is not started with medicine. This risk is why VBAC is often only offered by hospitals that can do a rapid emergency C-section.
If you have a trial of labor and need to have a C-section, your risk of infection is slightly higher than if you just had a C-section.
Frequently Asked Questions
Learning about VBAC: