What is Vaginal Birth After Cesarean Delivery (VBAC)

Vaginal birth after cesarean delivery is giving birth vaginally after previously delivering a baby through a cesarean section (C-section). A VBAC may be a safe option for you, depending on your health and other factors.

It is important to discuss VBAC with your health care provider early in your pregnancy so you can understand the risks, benefits, and options. Having these discussions early will give you time to make your birth plan.

Who are the best candidates for VBAC?

The best candidates for VBAC are women who:

• Have had one or two prior cesarean deliveries, and the incision made during the delivery was horizontal (low transverse).
• Do not have a vertical (classical) scar on their uterus.
• Have not had a tear in the wall of their uterus (uterine rupture).
• Plan to have more pregnancies.

A VBAC is also more likely to be successful:

• In women who have previously given birth vaginally.
• When labor starts by itself (spontaneously) before the due date.

What are the benefits of VBAC?

The benefits of delivering your baby vaginally instead of by a cesarean delivery include:

• A shorter hospital stay.
• A faster recovery time.
• Less pain.
• Avoiding risks associated with major surgery, such as infection and blood clots.
• Less blood loss and less need for donated blood (transfusions).

What are the risks of VBAC?

The main risk of attempting a VBAC is that it may fail, forcing your health care provider to deliver your baby by a C-section.

Other risks are rare and include:

• Tearing (rupture) of the scar from a past cesarean delivery.
• Other risks associated with vaginal deliveries.

If a repeat cesarean delivery is needed, the risks include:

• Blood loss.
• Infection.
• Blood clot.
• Damage to surrounding organs.
• Removal of the uterus (hysterectomy), if it is damaged.
• Placenta problems in future pregnancies.

What else should I know about my options?

Delivering a baby through a VBAC is similar to having a normal spontaneous vaginal delivery. Therefore, it is safe:

• To try with twins.
• For your health care provider to try to turn the baby from a breech position (external cephalic version) during labor.
• With epidural analgesia for pain relief.

Consider where you would like to deliver your baby. VBAC should be attempted in facilities where an emergency cesarean delivery can be performed. VBAC is not recommended for home births.

Any changes in your health or your baby’s health during your pregnancy may make it necessary to change your initial decision about VBAC. Your health care provider may recommend that you do not attempt a VBAC if:

• Your baby’s suspected weight is 8.8 lb (4 kg) or more.
• You have preeclampsia. This is a condition that causes high blood pressure along with other symptoms, such as swelling and headaches.
• You will have VBAC less than 19 months after your cesarean delivery.
• You are past your due date.
• You need to have labor started (induced) because your cervix is not ready for labor (unfavorable).

Where to find more information

• American Pregnancy Association: americanpregnancy.org  
• American Congress of Obstetricians and Gynecologists: acog.org  

Summary

• Vaginal birth after cesarean delivery (VBAC) is giving birth vaginally after previously delivering a baby through a cesarean section (C-section). A VBAC may be a safe option for you, depending on your health and other factors.
• Discuss VBAC with your health care provider early in your pregnancy so you can understand the risks, benefits, options, and have plenty of time to make your birth plan.
• The main risk of attempting a VBAC is that it may fail, forcing your health care provider to deliver your baby by a C-section. Other risks are rare.