If you’re pregnant again and your last baby arrived via cesarean section, you may wonder if a vaginal birth could be an option for you this time around. A vaginal birth after C-section (VBAC) is possible for many women, but there are factors to help you and your doctor decide if it’s right for you.
Safety for you and your baby is the main thing to consider. VBAC isn’t always safe for every woman.
If you try to have a vaginal birth and you’re at high risk of complications, it can cause serious problems for you and your baby -- some even life-threatening. That’s why it’s important that you talk to your doctor about the risks.
How’s Your Health?
For you and your doctor to consider a vaginal birth for you, both you and your baby need to be in good health. You might even be able to attempt VBAC if you’re pregnant with twins if your doctor says that all of you are healthy enough.
Your doctor may suggest that VBAC is too risky for you to succeed at vaginal birth. Risks could include any of the following:
- Obesity (your body mass index is 30 or higher)
- Preeclampsia (high blood pressure during pregnancy)
- Age (usually older than 35)
- Your previous cesarean was in the last 19 months
- The fetus is very large
Previous C-section Scar
One crucial detail that you and your doctor must discuss is the type of C-section scar that you have on your uterus. (This may be the same type of scar that you have on your abdomen, but it may go in a different direction.) Doctors make incisions (cuts in the abdomen and uterus) in two different directions during a C-section:
- A vertical cut goes from top to bottom
- A transverse cut goes from side to side
If your C-section scar is vertical, you cannot attempt VBAC. There is a very high risk that your scar could rupture (burst open or tear) when you try to have a vaginal birth, which could cause great harm to you and your baby. You’ll need to have a C-section again.
If your C-section scar is low and transverse, your doctor might allow you to try VBAC, if your other risk factors are low.
The Hospital Matters
Check with your doctor early to find out if the hospital you’re using allows women to attempt VBAC. Not every hospital does.
Although the risk of your old scar rupturing during VBAC is low, the hospital must be prepared to handle the emergency that could arise if it does. Some hospitals simply aren’t prepared to handle it.
Low Risk vs. No Risk
There is a very small chance for every woman who attempts VBAC that their uterus could rupture, even if they have a low transverse C-section scar and is in good health. Doctors can’t be 100% certain whether or not it may happen to you.
Even though ruptures happen in less than 1% of VBAC attempts, some women don’t want to try it at all, because if it does occur, it can be very dangerous. You need to weigh your options and talk to your doctor before you decide what to do.
Benefits of VBAC
If VBAC is an option for you and you like the idea of trying a vaginal birth, there are many reasons you might want to give it a shot. There’s a good chance that you may succeed: About 70% of women who try are able to have their babies via vaginal birth. For the rest, a C-section is needed, due to problems that arise during the attempt.
You may want to attempt VBAC for many reasons because if it is successful, it has the following benefits:
- Doesn’t require surgery
- Less blood loss
- Faster recovery
- Reduced chance of infection
- You are not likely to suffer injury to your bladder or bowel
- You will be likely to have fewer problems with future childbirth