Many women approaching a birth after a prior cesarean section delivery often wonder if a vaginal delivery is an option.
According to the American Pregnancy Association, 90 percent of women who have had cesarean deliveries are candidates for a vaginal birth. The Mayo Clinic estimates that 75 percent of women who try a vaginal birth after a C-section (VBAC) have a successful vaginal birth.
Concerns about VBAC
The main concern with VBAC is uterine rupture, particularly in women who attempt a vaginal delivery after being induced. Uterine rupture after induction has been documented to happen in women with both the low transverse incision or a classical incision performed for their C-section.
“If you had a previous cesarean with a low transverse incision, the risk of uterine rupture in a vaginal delivery is .2 to 1.5% ... approximately 1 chance in 500,” according to the American College of Obstetricians and Gynecologists. (2)
The classical incision, a north-south incision along the midline, is rarely used anymore, except in emergencies. A lower uterine transverse incision, typically referred to as a “bikini cut” because it runs just below the bikini line and just above the pubic hair, is the most commonly used C-section method nowadays.
Indications and Contraindications for VBAC
You may be a candidate for VBAC if:
• You only have one prior low transverse uterine scar and no other scars
• You and baby are healthy and pregnancy is progressing normally
• The reason for the previous C-section is not a factor in this pregnancy
• Labor begins naturally on or before your due date
• A previous vaginal delivery was successful
VBAC may not be possible if:
• You experienced previous uterine rupture during a pregnancy or delivery
• Your pregnancies tend to run overdue
• Your baby is unusually large
• You have had two or more prior cesarean sections and no vaginal deliveries
• You are obese
• You are expecting multiples
Reasons for Repeat Cesarean
A repeat cesarean may be necessary if: