Who's eligible for VBAC?
VBAC eligibility depends on many factors. For example:
- Have you had previous vaginal deliveries? A vaginal delivery at least once before or after your prior C-section increases the probability of a successful VBAC.
- What type of uterine incision was used for the prior C-section? Most C-sections use a low transverse incision. Women who have had a low transverse incision are usually VBAC candidates. If you've had a vertical incision in the upper part of your uterus (classical incision), VBAC is not recommended due to the risk of uterine rupture.
- What prompted the prior C-section? If your prior C-section was done for a reason that isn't present during your current pregnancy — such as the baby's position in your uterus — you might be a good candidate for VBAC.
- How many C-sections have you had? You might be a less suitable candidate for VBAC if you've had multiple C-sections.
- When was your last C-section? The risk of uterine rupture is higher if you attempt VBAC too soon after having a C-section — such as within 18 to 24 months.
- Do you have any health concerns that might affect a vaginal delivery? A C-section might be recommended if you have placenta problems, a breech presentation or an infection that could be passed to your baby during vaginal delivery — such as genital herpes or HIV.
- Where will you deliver the baby? Plan to deliver at a facility equipped to handle an emergency C-section. A home delivery isn't appropriate for VBAC.
- Will you need to be induced? Likewise, VBAC should be approached with caution if medication is needed to induce labor.
Also, keep in mind that if you had a uterine rupture during a previous pregnancy, you're not a candidate for VBAC.
How does labor and delivery during VBAC differ from labor and delivery during a routine vaginal birth?
The actual physiology of labor and delivery is the same. However, you and your baby will be closely monitored. Your health care provider will be prepared to do a repeat C-section if needed.
What other advice do you offer women who are considering VBAC?
If you're considering VBAC, discuss the option with your health care provider early in pregnancy.
Find out about the VBAC policy at the facility where you'll deliver your baby, but try to stay flexible. The circumstances of your labor could make VBAC a clear choice — or, after counseling, you and your health care provider might decide that a repeat C-section would be best after all.
July 02, 2015
See more In-depth
- Wells CE, et al. Choosing the route of delivery after cesarean birth. http://www.uptodate.com/home. Accessed May 19, 2015.
- American College of Obstetricians and Gynecologists (ACOG) Committee on Practice Bulletins — Obstetrics. ACOG Practice Bulletin No. 115: Vaginal birth after previous cesarean delivery. Obstetrics & Gynecology. 2010;116:450.
- Berghella V. Cesarean delivery: Preoperative issues. http://www.uptodate.com/home. Accessed May 19, 2015.
- Lang CT, et al. Uterine dehiscence and rupture after previous cesarean delivery. http://www.uptodate.com/home. Accessed May 19, 2015.
- Hauk L. Planning for labor and vaginal birth after cesarean delivery: Guidelines from the AAFP. American Family Physician. 2015;91:197.
- Shachar BZ, et al. Interpregnancy interval and obstetrical complications. http://www.uptodate.com/home. Accessed May 19, 2015.