Vaginal Births After Cesarean Deliveries

If you have had a cesarean delivery (also called a C-section) before, St. John's supports your decision to deliver your next baby vaginally.

When medically indicated by your physician, the option of vaginal birth after previous cesarean delivery is now available to you. This is called vaginal birth after cesarean, or VBAC. Our certified nurse-midwives are specialists in vaginal birth after cesareans and have received national recognition for their success in this procedure.

Having a VBAC can be a safe choice for most women. Whether it is right for you depends on several things, including why you had a C-section before and how many C-sections you've had. You and your doctor can talk about your risk for having problems during a trial of labor.

What would make me a good candidate for a VBAC?

According to the American College of Obstetricians and Gynecologists, you're a good candidate for a vaginal birth after a c-section if you meet all of 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.)
• Your pelvis seems large enough to allow your baby to pass through safely. (While there's no way to know this for sure, your practitioner can examine your pelvis and make an educated guess.)
• 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.

Factors that would work against your having a successful VBAC include:

• Being an older mom
• Having a high body mass index (BMI)
• Having a baby with a high birth weight (over 4,000 grams, about 8.8 pounds)
• Having your pregnancy go beyond 40 weeks of gestation
• Having a short time between pregnancies (18 months or less)

Why Should I Consider a VBAC?

Delivering your baby vaginally is a more natural form of childbirth. Usually, this means you will:

• Have less pain
• Recover more quickly
• Be able to resume your daily activities in less time

It also means you’ll probably be more alert during the birth and able to leave the hospital sooner after delivering. Perhaps, most important, you won’t have the scarring on your uterus that a cesarean causes. This matters if you intend to have more children. The more cesareans you have, the fewer options you have for delivery when you get pregnant again.

Experienced Care, Unconditional Support

Talk with your practitioner about your individual chance of success and carefully weigh the benefits and the risks. Whatever you decide, St. John's and our team of experts are ready to assist.