Disclosure :: this post is sponsored by Touro Infirmary.
It was once thought that if a woman had one cesarean delivery, all of her babies should be born that way. Today, women can undergo a trial of labor after a cesarean delivery (TOLAC), and many will be able to give birth through the vagina – called a vaginal birth after cesarean delivery (VBAC).
For many expectant mothers, the option of VBAC is desirable, especially for those who had their hearts set on a vaginal delivery with previous pregnancies that resulted in a medically necessary c-section for a host of reasons.
If you become pregnant again, you might be able to choose between scheduling a repeat C-section or attempting a VBAC. For many women, VBAC is an option; however, keep in mind that it isn’t right for everyone. The good news: research shows that of those who attempt a trial of labor after cesarean, about 60 to 80 percent have a successful vaginal delivery.
What are the benefits of VBAC?
There are many benefits to VBAC, including no abdominal surgery, shorter recovery time, lower risk of infection, less blood loss, and more participation in the birth. If you want to have more children, VBAC may also help you avoid certain problems linked to multiple cesarean deliveries.
If you and your health care provider determine that VBAC is right for you, you’ll follow the same process as any woman expecting to deliver vaginally. You and your baby will be more closely monitored during labor, and your health care provider will be prepared to do a repeat C-section if needed.
Who is a good candidate for VBAC?
If you are considering VBAC, your doctor can help you determine if you are a candidate and what’s involved. Certain factors, such as a high-risk uterine scar, can make VBAC inappropriate.
Your chances of a successful VBAC are higher if:
- You and your baby are healthy and your pregnancy is progressing normally
- The reason you had your prior C-section isn’t a factor this time
- Your labor begins naturally on or before your due date
- You’ve had a previous successful vaginal delivery
Your chances of a successful VBAC are lower if:
- Your pregnancy continues beyond your due date
- You have an unusually large baby
Who is not a candidate for VBAC?
You are not a candidate for VBAC if you had a uterine rupture during a previous pregnancy. Similarly, VBAC isn’t recommended if you have had a vertical incision in your uterus (classical incision) due to the risk of uterine rupture.
With a trial of labor after cesarean, the risk of most concern is the possible rupture of the cesarean scar on the uterus or the uterus itself. Although a rupture of the uterus is rare, it is serious and may harm both you and your baby. If you are at high risk of rupture of the uterus, TOLAC should not be tried.
Other factors to consider
- Future deliveries – multiple cesarean deliveries are associated with additional potential risks
- Prior uterine rupture – if you had this complication in a previous pregnancy, TOLAC is not advised
- A pregnancy problem or a medical condition that makes vaginal delivery risky
- The hospital in which you have a TOLAC should be prepared to deal with emergencies that may arise
As with any pregnancy and labor and delivery process, be prepared for possible changes to your delivery plan. You’ll need to stay flexible and remember that the goal is to keep mom and baby healthy and safe.
Sources: The American College of Obstetrics and Gynecology, WebMD
About Dr. Paul du Treil
Paul du Treil, MD, FACOG, has practiced Obstetrics and Gynecology with Crescent City Physicians since 2005. Dr. du Treil earned a B.S. from Loyola University and followed with his M.D. from Louisiana State University School of Medicine in 1996. He served his OB/GYN internship at the University of Florida College of Medicine from 1996-1997 and his residency from 1997-2000. Dr. du Treil is Board Certified by the American Board of Obstetrics and Gynecology and serves as the Director of Maternal and Child Health at Touro Infirmary.