If you’ve had at least one prior C-section, you may want to know if you can have a successful future birth by vaginal delivery. The answer is yes, you likely can. Studies have shown that vaginal birth after cesarean delivery has a success rate of 60% to 80%. Talk with your healthcare provider about your specific risks for each delivery method and your preferences for giving birth.
Vaginal birth after cesarean (VBAC) means giving birth through your vagina after giving birth previously by cesarean section (C-section). A C-section involves making a surgical cut (incision) through your belly, then through your uterus. Your baby is delivered through the incision.
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Because a surgical cut results in a scar on your uterus, concern had been raised that the pressure of labor could cause your uterus to open (rupture) along the scar. However, according to the American Pregnancy Association, published studies show that 60% to 80% of women who had a cesarean birth have had a successful vaginal birth in their next pregnancy. This statistic is supported by another from the National Institute of Child Health and Human Development that showed that about 75% of VBAC attempts are successful.
According to the American College of Obstetricians and Gynecologists, the risk of a ruptured uterus if you’ve had previous C-section with a horizontal (transverse) cut is about 0.9% or slightly less than 1 in 100.
If your uterus were to rupture, risks include:
The answer may not be scientifically confirmed, but there is some thought that:
Please understand that the location and direction of the outer incision in your abdomen doesn’t mean that the incision in your uterus was made in the same location or in the same direction. The information about the location and direction of the incision on your uterus should be in the medical record of your C-section(s). When you discuss the appropriateness and safety of VBAC, make sure you or your healthcare provider review your medical record and the reasons why you had a C-section.
You should talk with your healthcare provider about your unique health history, current pregnancy circumstance and the reason why you had a C-section previously.
You increase your chance of VBAC if you:
If you’ve already had a successful VBAC — without complications such as ruptured uterus — you’re more likely to have successful future vaginal deliveries.
General risks of C-section include:
Complications of labor in general include:
The benefits of VBAC compared with C-section include:
Both vaginal birth after cesarean (VBAC) and C-sections have risks and benefits. Many have been discussed in this article. Be sure to ask if there are any risks or benefits that could affect your pregnancy.
Topics to discuss include:
A note from Cleveland Clinic
Don’t assume that because a previous child was born via C-section that all of your future children need to be delivered this way. You may have read or been told that the scars from a C-section incision may rupture in a future pregnancy. The likelihood of the uterus scar splitting open is low.
Discuss VBAC and C-section options with your healthcare provider early in your pregnancy. Make sure you understand your risks and that your provider understands your preferences. As your pregnancy progresses, make sure you and your provider discuss and reevaluate your delivery plan at each late-term visit.
Last reviewed by a Cleveland Clinic medical professional on 08/23/2021.
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