Vaginal Birth After Cesarean (VBAC)

Whether you deliver vaginally or by cesarean section, you are unlikely to have serious complications. Overall, a routine vaginal delivery is less risky than a routine cesarean, which is a major surgery. But a pregnant woman who has a cesarean scar on the uterus has a slight risk of the scar breaking open during labor. This is called uterine rupture.

Although rare, uterine rupture can be life-threatening for both mother and baby. So women with risk factors for uterine rupture should not attempt a vaginal birth after cesarean (VBAC).

Risks of VBAC

The risks of VBAC include:

• Problems during labor that result in a cesarean delivery. This occurs with about 20 to 40 out of 100 women who try VBAC. But it doesn't happen with 60 to 80 out of 100 women who try VBAC.^{Reference 1}
• Reference Rupture of the scar on the uterus, which is rare but can be deadly to the mother and baby. A Reference vertical incision used in a past C-section, use of certain Reference medicines to start (induce) labor, and many scars on the uterus from past C-sections or other surgeries are some of the things that can increase the chance of a rupture.
• The chance of infection. Women who have a trial of labor and end up having a C-section have a higher risk of infection. This means that the risk of infection is lower after vaginal births and after planned cesareans.^{Reference 3}

Risks of any cesarean

The risks of cesarean delivery include:

• Infections.
• Blood loss that requires a Reference blood transfusion Opens New Window.
• Genital or urinary problems.
• Blood clots.
• Risks from Reference anesthesia Opens New Window.
• A longer recovery time.
• Injury to the baby during the delivery. The injury usually isn't serious.
• Breathing problems (Reference respiratory distress syndrome Opens New Window) for the baby after birth if the due date has been miscalculated and a cesarean is done before the baby's lungs are fully developed.

Future risks. If you are planning to get pregnant again, it's important to think about scarring. After you have two C-section scars, each added scar in the uterus raises the risk of placenta problems in a later pregnancy. These problems include Reference placenta previa Opens New Window and Reference placenta accreta Opens New Window, which raise the risk of problems for the baby and your risk of needing a Reference hysterectomy Opens New Window to stop bleeding.^{Reference 4}

For more information about cesarean risks, see the topic Reference Cesarean Section.

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