Vaginal Birth After C Section - What to Know
In the United States, 32.3% of live births in 2023 were Cesarean deliveries. If you've had a C-section before, you might be wondering if a vaginal birth is still an option for you. The good news? It often is!
The rate of vaginal births after a Cesarean (VBAC) was 15.1% of live births in 2023—an increase every year for the past five years. VBAC offers benefits like a quicker recovery and fewer complications in future pregnancies. Let’s break down the basics so you can make an informed decision about your birth options.
Key Takeaways
VBAC is possible for many women and can offer benefits like faster recovery and fewer surgical risks.
The success rate of VBAC is around 60-80%, with higher chances if you've had a vaginal birth before.
Proper preparation and medical support play a key role in a successful VBAC experience.
What is VBAC?
VBAC stands for Vaginal Birth After Cesarean. It simply means having a vaginal birth after a previous C-section. A lot of people assume that if you've had one C-section, you'll always need another—but that’s not necessarily true. Many women can safely attempt a vaginal delivery with the right medical support and monitoring.
Benefits of a Vaginal Birth After a C-Section
There are some great benefits to a successful VBAC:
Faster Recovery: Vaginal birth usually means less pain and a quicker return to normal activities compared to recovering from surgery.
Fewer Surgical Risks: Avoiding another surgery means less risk of infection, blood clots, and excessive bleeding.
More Options for Future Pregnancies: The more C-sections you have, the higher the risk of complications in future pregnancies. A successful VBAC can help keep your options open.
Better Immediate Bonding: Vaginal birth often allows for quicker skin-to-skin contact and an easier start to breastfeeding.
Lower Risk of Breathing Issues for Baby: Babies born vaginally have a lower chance of developing transient tachypnea, a temporary newborn breathing issue.
Reduced Placental Complications: Avoiding multiple C-sections decreases the likelihood of conditions like placenta previa and placenta accreta, which can cause complications in future pregnancies.
What are the risks of VBAC?
While VBAC is safe for many women, there are some risks to consider:
Uterine Rupture: This is the biggest concern, where the previous C-section scar could tear open during labor. While rare, it can be serious for both mom and baby.
Emergency C-Section: Not all VBAC attempts go as planned, and some end up needing a C-section after all.
Longer Labor: In some cases, labor can take longer, especially if induction is involved.
Hospital Readiness: Not all hospitals are equipped to handle an emergency C-section at a moment’s notice, so you’ll need to deliver somewhere that is fully prepared.
While these risks may sound intimidating, VBAC is a safe and viable option for many women when done in the right setting with proper medical support. Understanding these risks allows you to have an informed discussion with your provider, so you can feel confident in making the best decision for you and your baby.
Who is a Good Candidate for VBAC?
Not everyone will be eligible for VBAC, but you may be a good candidate if:
You Have a Low-Transverse (Horizontal) Uterine Scar: This type of incision carries the lowest risk of complications.
You’ve Had Only One Previous C-Section: While multiple C-sections don’t rule out VBAC, having just one increases the chances of success.
Your First C-Section Was for a Non-Recurring Reason: If your C-section happened due to a breech baby or fetal distress rather than an ongoing issue, you may have better odds of success.
You’re in Good Health: No underlying complications like high blood pressure or gestational diabetes make VBAC a safer option.
You Go Into Labor Naturally: Spontaneous labor increases the likelihood of a successful VBAC.
Your Hospital is VBAC-Ready: A facility with 24/7 emergency C-section capability is essential for safety.
What to Expect from a VBAC Attempt?
Before Labor
Your doctor will determine if VBAC is a safe option for you by looking at factors like the type of incision from your previous C-section and any other health considerations. You’ll have an open discussion about the risks, benefits, and what to expect. Some women will undergo a trial of labor after cesarean (TOLAC), where they labor under close monitoring to see if a vaginal birth is possible. Your provider may also check if your cervix is favorable, as this increases the chances of a successful vaginal birth.
During Labor
Throughout labor, your medical team will continuously monitor the baby’s heart rate to ensure everything is progressing safely. You’ll still have access to pain management options like an epidural if you choose. However, if complications arise, a C-section may still be needed. Your care team will be especially vigilant for any signs of uterine rupture or fetal distress, acting quickly if necessary to ensure the safest outcome for both you and your baby.
After Birth
If your VBAC is successful, your recovery will be similar to any vaginal birth—typically involving a shorter hospital stay, less pain, and an easier return to normal activities compared to a C-section. However, if an emergency C-section is needed, your recovery will be similar to that of a planned C-section. Postpartum care will include monitoring for any signs of complications, such as excessive bleeding or uterine rupture symptoms.
What Does Recovery Look Like With a VBAC?
Recovery after a VBAC is generally smoother and faster than recovering from a C-section. Most women experience less pain, a quicker return to daily activities, and a lower risk of complications like infections or blood clots. You may have vaginal soreness, but this typically heals within a few weeks. Your postpartum care team will check for any signs of complications, such as heavy bleeding, infection, or issues with your C-section scar from your previous birth. It’s important to prioritize rest, hydration, and good nutrition to support your body’s healing.
How Successful is VBAC?
The good news is that VBAC success rates are pretty high! Studies show that around 60-80% of women who attempt VBAC have a successful vaginal delivery. If you’ve had a vaginal birth before or go into labor naturally, your chances are even better.
Final Thoughts
VBAC is an option worth considering if you’ve had a C-section before and want to try for a vaginal birth. It comes with a lot of benefits, but it’s important to talk to your healthcare provider about whether it’s the right choice for you. Childbirth education platforms like Birthly are a great way to get comprehensive information from qualified instructors so that you can feel informed.
VBAC FAQs
How do I prepare my body for a VBAC?
Staying active, eating a balanced diet, and maintaining a healthy weight can improve your chances of a successful VBAC. Discuss your birth plan with your provider, and consider prenatal exercises like pelvic floor strengthening to support labor.
What disqualifies you from having a VBAC?
Certain factors may make VBAC unsafe, including a previous classical (vertical) C-section incision, multiple prior C-sections without a vaginal birth, or a history of uterine rupture. Other risks, such as placenta previa, fetal positioning, or certain medical conditions, may also prevent VBAC. Your provider will evaluate your individual case to determine the safest option for you.
How long is labor for a VBAC?
Labor for a VBAC can vary, but for many women, it is similar in length to a first-time vaginal birth. Some women may experience a shorter labor, especially if they’ve had a previous vaginal birth.
Do you have to have an epidural with a VBAC?
No, an epidural is not required for a VBAC. While some providers may recommend it in case an emergency C-section is needed, pain management options are entirely up to you. Many women choose to labor naturally, while others opt for an epidural or other pain relief methods.
Sources
https://www.marchofdimes.org/peristats/data?lev=1&obj=1®=99&slev=1&stop=355&top=8
https://www.marchofdimes.org/peristats/data?lev=1&obj=1®=99&slev=1&stop=90&top=8
https://utswmed.org/medblog/vbac/
https://www.acog.org/womens-health/faqs/vaginal-birth-after-cesarean-delivery
https://my.clevelandclinic.org/health/articles/21687-vaginal-birth-after-cesarean-vbac
https://www.mayoclinic.org/healthy-lifestyle/labor-and-delivery/in-depth/vbac/art-20044869