What are my chances of giving birth vaginally after having a c-section?

As long as you’re an appropriate candidate for a vaginal birth after a cesarean, also known as a VBAC, there’s a good chance you’ll succeed. Of course, your chances of success are higher if the reason for your previous c-section isn’t likely to be an issue this time around.

For example, a woman who has already had an uncomplicated vaginal delivery and then had a c-section when her next baby was breech is much more likely to have a successful VBAC than one who had a c-section after being fully dilated and pushing for three hours with her first baby who was small and properly positioned. (Having given birth vaginally boosts your odds dramatically.)

That said, it’s impossible to predict with any certainty who will be able to have a vaginal delivery and who will end up with a repeat c-section. Attempting a VBAC is called a trial of labor after cesarean (TOLAC). Overall, about 60 to 80 percent of women who attempt a VBAC deliver vaginally.

If you decide to try it, you’ll need a caregiver who supports the idea. Your caregiver must also have admitting privileges at a hospital that allows VBACs and where appropriate coverage is available around-the-clock.

Not all hospitals meet the criteria for offering a VBAC. In addition, some hospitals simply avoid the controversy – and the potential for legal issues – surrounding VBACs by not allowing them. Most often, however, it’s up to individual doctors whether they’re okay letting you attempt labor after a c-section.

VBACs can be controversial, and it may be challenging to find a practitioner who’s willing to assist at one. Give yourself plenty of time to look around.

 

How should I be monitored to have a save VBAC?

You will be under monitoring by the cardiotocography throughout the labor to early predict any complication to you as uterine rupture or to your baby as fetal distress.

 

What would make me a good candidate for a VBAC?

According to the American College of Obstetricians and Gynecologists (ACOG), you’re a good candidate for a vaginal birth after a c-section if you meet all the following criteria:

  • Your previous cesarean incision was a low-transverse uterine incision (which is horizontal) rather than a vertical incision in your upper uterus (known as a “classical” incision) or T-shaped, which would put you at higher risk for uterine rupture. (Note that the type of scar on your belly may not match the one on your uterus.) Even if you’ve had two low transverse cesarean deliveries, you may safely attempt a VBAC in many circumstances.
  • You’ve never had any other extensive uterine surgery, such as a myomectomy to remove fibroids.
  • You’ve never had a uterine rupture.
  • You have no medical condition or obstetric problem (such as a placenta previa or a large fibroid) that would make a vaginal delivery risky.
  • There’s a doctor on site who can monitor your labor and perform an emergency c-section if necessary.
  • There’s an anesthesiologist, other medical personnel, and equipment available around-the-clock to handle an emergency situation for you or your baby.
  • What is the risk of uterine rupture in VBAC?

ِِAccording to the Royal college guidelines, there is a risk of uterine rupture of 1 in every 200 patients undergoing VBAC.