For many individuals, the possibility of a vaginal birth after cesarean (VBAC) may conflict with what they’ve always thought: A previous cesarean section (C-section) means you can’t deliver vaginally.
The good news is that both options, VBAC and repeat cesarean, can be safe in the right circumstances.
The team at Women’s Specialists of Fayette works with patients to carefully explore their options. We make recommendations based on the risks and benefits of VBAC in your specific situation so you can choose the path that best supports your health and birth goals.
Here are the basics about VBAC and what we consider when weighing the risks and benefits of VBAC after a C-section.
A vaginal birth after cesarean (VBAC) refers to delivering a baby vaginally after having previously given birth via cesarean section (C-section).
C-sections were performed in the past with a vertical incision through the belly and uterus. Most cesareans today involve a low transverse (horizontal) incision on the uterus, which generally carries a lower risk of complications in future labors.
Not everyone is a candidate for VBAC. Factors such as the number of previous cesareans and incision type, overall health, and pregnancy complications all play a role in determining whether attempting a trial of labor after cesarean (TOLAC) is appropriate.
If you do experience complications during a VBAC, we can perform an emergency C-section.
Benefits of VBAC include:
One of the biggest advantages of VBAC is a typically faster recovery. Vaginal birth avoids major abdominal surgery, meaning less postoperative pain, fewer mobility restrictions, and a quicker return to daily activities.
Good candidates for VBAC include individuals who have had a previous low transverse uterine incision, are carrying a single baby in a head-down position, and have no placenta complications.
Cesarean delivery is a major surgery. While generally safe, it carries risks such as infection, blood clots, injury to surrounding organs, and complications from anesthesia. VBAC eliminates many surgery-related risks.
Each additional cesarean may increase the risk of complications in future pregnancies, including placenta previa and placenta accreta. Successfully delivering vaginally may lower the likelihood of these issues.
Studies consistently show that babies born vaginally are less likely to experience certain transient breathing difficulties compared to those delivered by scheduled cesarean before labor begins.
For some women, VBAC offers a sense of empowerment, especially if the first cesarean was unplanned or emotionally difficult. Achieving a vaginal birth can provide a strong sense of accomplishment.
In some cases, VBAC may increase the risk of:
The most serious risk of VBAC is uterine rupture, which occurs when the scar from the previous cesarean opens during labor.
Although very rare, occurring in less than 1% of appropriately selected candidates, a rupture can be life-threatening for both mother and baby and requires immediate emergency care.
Not all attempts at VBAC are successful. If labor does not progress or complications arise, an emergency cesarean may be necessary. Emergency procedures can carry slightly higher risks than planned repeat cesareans.
While VBAC generally reduces surgical risks, unsuccessful TOLAC followed by cesarean can increase the likelihood of infection, blood transfusion, or other complications compared to a scheduled repeat cesarean.
To make a balanced decision, it’s important to understand the alternative.
For instance, a planned repeat cesarean offers predictability. The date is scheduled in advance, which can ease logistical planning. It also avoids the small but serious risk of uterine rupture associated with labor after cesarean.
For women with certain medical conditions, such as a prior classical (vertical) uterine incision or a history of uterine rupture, a repeat cesarean is likely the safest choice.
Your provider evaluates your medical history, current pregnancy, and overall health to assess your likelihood of a successful VBAC.
Choosing between VBAC and repeat cesarean is highly personal, but open communication with your obstetrician is essential. We always encourage questions at Women’s Specialists of Fayette, and provide time to consider the details, so you have a clear understanding of your options.
Schedule an evaluation at Women’s Specialists of Fayette in Fayetteville, Georgia, today for more information about VBAC and other women’s health services we offer.
