March 11, 2016

Mothers who have given birth via cesarean delivery (C-section) are not automatically reserved to deliver the rest of their children in the same way. Many of my patients come to me asking about vaginal birth after cesarean (VBAC) as an option for their next delivery. I often field a number of questions from my patients regarding the viability and safety of VBAC. Here are a few of the most popular:

Do I qualify for VBAC?

Many of my patients who gave birth via C-section qualify for VBAC. Perhaps the most important qualification for VBAC is the type of incision made on the uterus during your previous delivery. Moms wanting to give birth vaginally after a C-section must have given birth with the assistance of a low transverse incision. Performed in a majority of C-sections, a low transverse incision uses a horizontal cut made across the lower part of the uterus. In opposition, if a vertical incision on the higher, thicker part of the uterus was used in your first C-section, VBAC is not an option.

Additionally, patients who had their first C-section due to breech or fetal distress have a better chance of VBAC success as opposed to moms who had to have their C-section after failure to progress.

What are the risks?

For patients who qualify for VBAC, the risks are minimal. In fact, only .5 – 1 percent of patients have complications. However, this does not mean that all mothers who go into labor planning on VBAC are able to deliver vaginally. The American College of Obstetricians and Gynecologists estimates between 60-80 percent of women who try to have a VBAC succeed.

Because labor is different for every mother, difficulty progressing, breech or fetal distress may necessitate a second C-section to ensure the health of both you and your baby. For this reason, every mother planning on VBAC delivery must deliver in an approved hospital with 24-hour obstetric coverage and full access to anesthesia and surgical capabilities.

What are the benefits?

Patients who deliver vaginally spend less time in the hospital than those who deliver via C-section. Because C-section deliveries require major abdominal surgery, hospital stays afterward tend to be longer. VBAC also allows for more mother participation in the labor and delivery process. If you plan on having more children, VBAC delivery helps avoid the risks of multiple surgeries, which can cause the development of scar tissue within the abdomen and pelvis.

There are risks and benefits of each method of delivery, and often times the best approach depends on each individual’s unique case. As I tell my patients, my job is to guarantee the safety of you and your child no matter the method of delivery. If you have any concerns or questions about VBAC, your OB/GYN is a fantastic resource and partner in helping you make the right decision for your family. (476)

** This blog post was written to serve as suggestions for VBAC and should not be taken as concrete medical advice, nor do the views above reflect the views of Women’s Care of Colorado or the HealthONE organization. As with any medical questions or concerns, please make an appointment with your physician to discuss your own personal situation and treatment options.

Dr. Lara Lane has more than 15 years of experience as an OB/GYN physician and is the former chief resident in obstetrics and gynecology at Kaiser Permanente Medical Center in Santa Clara, Calif. As a member of the Women’s Care of Colorado team, Dr. Lane is primarily focused on childbirth and gynecological needs and is dedicated to helping women better manage their health.