Vanderbilt Women's Health

Some women who have delivered previous babies by c-section would like to have their next baby vaginally. This is called vaginal delivery after c-section or VBAC. Women give many reasons for wanting a VBAC. Some want to avoid the risks and long recovery of surgery. Others want to experience vaginal delivery. Of women who try VBAC, 60 percent to 80 percent are able to deliver vaginally.

But VBAC isn't the right choice for everyone. Some women have health or pregnancy complications that make VBAC unsafe. For other women, the risks of c-section are more acceptable than the risks of VBAC. Still, others don't live near a hospital where VBAC is possible.

Your doctor can tell you if you are a good candidate for VBAC. VBAC might be an option for you if:

• You had 1 previous planned c-section done with a low, horizontal incision ("bikini" incision).
• You have no other uterine scars (aside from the prior c-section) or problems.
• You have no known problems with your pelvis.
• A doctor will be present during all of labor and delivery and can perform an emergency c-section if needed.
• A surgical team is immediately available in case an emergency c-section is needed.

Your doctor can explain the risks of both repeat cesarean delivery and VBAC. With VBAC, the most serious danger is the chance that the c-section scar on the uterus will open up during labor and delivery. This is called uterine rupture. While very rare, uterine rupture is very dangerous for the mother and baby. Less than 1 percent of VBACs lead to uterine rupture. But doctors cannot predict if uterine rupture is likely to occur in a woman. This risk, albeit very small, is unacceptable to some women.

The percent of VBACs is dropping in the United States for many reasons. Some doctors, hospitals, and patients have concerns about the safety of VBAC. Some hospitals and doctors are unwilling to do VBACs because of fear of lawsuits and insurance or staffing expenses. Many doctors, however, question if this trend is in the best interest of women's health.

Choosing to try a VBAC is complex. If you are interested in a VBAC, talk to your doctor and read up on the subject. Only you and your doctor can decide what is best for you. VBACs and planned c-sections both have their benefits and risks. Learn the pros and cons and be aware of possible problems before you make your choice.