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Is a vaginal birth possible after a cesarean delivery?

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Vaginal birth after cesarean (VBAC) describes vaginal delivery by a woman who has had a previous cesarean delivery. The pregnant woman’s health care provider can offer her information to guide a decision about VBAC.1

VBAC may be a safe and appropriate choice for women2:

  • Who have had a prior cesarean with an incision that is across the uterus toward its base (called a low-transverse incision)
  • With two previous low-transverse cesarean incisions
  • Who are carrying twins
  • With an unknown type of uterine scar

Benefits of VBAC include2:

  • No abdominal surgery
  • A lowered risk of hemorrhage and infection
  • Shorter recovery
  • Possibly avoiding the risks of many cesareans, such as hysterectomy, bowel and bladder injury, infection, and abnormal placenta conditions
  • Greater likelihood of being able to have more children in the future.

Approximately 60% to 80% of appropriate candidates who attempt VBAC are successful.2 But it is still possible that a woman will have to have an unplanned cesarean after having a trial of labor. The risks associated with a trial of labor after having a prior cesarean are similar to having a repeat cesarean. They include2,3:

  • Uterine rupture
  • Maternal hemorrhage and infection
  • Blood clots
  • Possible need for a hysterectomy

  1. Eunice Kennedy Shriver National Institute of Child Health and Development. (2010). NIH consensus development conference statement on vaginal birth after cesarean: new insights, NIH Consensus and State-of-the-Science Statements, 27. Retrieved July 25, 2012, from (PDF - 224 KB) [top]
  2. American College of Obstetricians and Gynecologists. (2010). Ob gyns issue less restrictive VBAC guidelines. Retrieved June 18, 2012, from External Web Site Policy [top]
  3. American Academy of Family Physicians. (n.d.). Trial of labor after cesarean (TLOC): a shared physician-patient planning tool. Retrieved August 8, 2012, from​ External Web Site Policy [top]

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