The Straight Facts on Vaginal Birth After Cesarean (VBAC)

Medically reviewed by Janine Kelbach, RNC-OB on February 3, 2016Written by Chaunie Brusie, RN, BSN on February 3, 2016
Vbac Facts: Is It Possible?

There’s no “right” way to give birth. But there are many different options for how you can deliver.

There are home births, unassisted births, and water births. You can give birth vaginally, or surgically by cesarean delivery.

How your baby will enter this world isn't always in your control. But even women who’ve given birth surgically might be able to have a vaginal birth after cesarean (VBAC) in a subsequent pregnancy.

Here's what you need to know about having a VBAC.

VBAC Risks

VBAC used to be a major medical no-no. That’s because doctors worried about the risk of a woman's uterus rupturing. This was happening because of the pressure of labor and birth on the surgical site. But after medical advancements, VBACs are now on the rise and have a high success rate.

After evaluating the risks with VBAC, The National Institutes of Health recognized in 2010 that it was possible for many women who’d delivered by cesarean previously to try to deliver vaginally.

But despite this encouraging endorsement, the VBAC rate has only risen slightly in recent years. Hospitals refusing to allow a woman with a previous cesarean delivery to try another method because of liability concerns might be one reason for this.

It's important that women have all the correct information to make an informed decision about VBAC.

For women who’ve had multiple cesarean deliveries, there’s a slight increase in risk with VBAC. But studies have shown the risks can't only be attributed to the VBAC. Other factors have an impact, too, like the mother's health or the hospital's readiness.

Inductions and VBAC

Women attempting a VBAC should avoid induction unless medically necessary.

Inducing labor is associated with a higher risk of uterine rupture with a VBAC. The hospital shouldn’t use cervical ripening agents like Cytotec or Cervadil. Pitocin shouldn’t be used, either.

All of these methods carry an increased risk of complications.

Emotional Outcomes with VBAC

When it comes to giving birth, all women want to feel empowered and informed.

Some moms choose to have VBAC to experience a natural delivery. The experience can be reaffirming if they didn’t get to experience birth how they wanted the first time.

Research has shown that VBAC can have a positive impact on recovery and postpartum depression rates for mothers. Choosing a VBAC may be an empowering option if it's medically appropriate.

Recovery

The biggest difference many moms will notice with a VBAC is the difference in postpartum recovery.

Recovery from a vaginal birth is different from recovery after a cesarean delivery, usually in a good way. Healing from a cesarean will take longer physically.

The immediate differences can't be compared. You can literally get out of bed after a vaginal birth (if you haven't had an epidural) while it will be several hours before you’re able to get out of bed following a cesarean.

The Takeaway

There are risks to both repeat cesarean deliveries and VBACs. It's important to talk with your doctor to make the choice that’s best for you and your baby. 

Chaunie Brusie
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