Lyndon D Taylor MD LLC

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VBAC - Vaginal Birth After Cesarean Section

Learn more about how your decision affects you and your baby.

All mothers who have had one previous low transverse (“horizontal”) cesarean section are encouraged to attempt a vaginal delivery unless the physician indicates otherwise.  Successful, uncomplicated vaginal birth carries the lowest risk to both mother and child as compared to repeated cesarean section. However, you must understand that if you choose a VBAC but end up having a cesarean during labor, you will have a slightly greater risk of problems than if you had chosen the cesarean without labor.

Not all women will be able to have vaginal birth after cesarean section. The success rate for those attempting VBAC is between 60 and 80%; however, only one in ten women in the US try VBAC.

The most serious complication of attempting VBAC is uterine rupture, which occurs in about 1% of cases. In such cases, internal and/or external bleeding may occur, and may require blood transfusions and/or hysterectomy. Rarely, fetal and/or maternal injury or death may occur.

Elective repeat cesarean section (the alternative to VBAC) also has some risks. Cesarean section is a major operation and in some cases there can be injuries to the mother’s bladder or bowel or more serious complications.

The chances of a successful VBAC are higher if:

· You have only one prior low transverse uterine scar

· You and your baby are health and your pregnancy is progressing normally

· The reason you had your prior cesarean section isn’t a factor this time

· Your labor begins spontaneously between the 37th and 40th week of pregnancy

· You’ve had a previous successful vaginal delivery

The chances of a successful VBAC are lower if:

· You’re older than 40. After age 40, the chances of a successful vaginal delivery decrease, whether you’ve delivered other babies or are attempting VBAC.

· You’re past your due date. Although the risk of uterine rupture remains the same, successful VBAC is less likely if your pregnancy continues past 40 weeks.

· You’re having an unusually large baby. If your baby weighs too much, he or she may not safely pass through the birth canal during a vaginal birth. The risk of uterine rupture increases only if you haven’t had a previous vaginal delivery.

· You have diabetes. If you have diabetes, you’re less likely to have a successful vaginal birth in all cases, including after a prior cesarean section.

LYNDON TAYLOR

OB/GYN

Lyndon D. Taylor, MD

1100 Lake Street, Suite 260

Oak Park, Illinois 60301

To contact us:

Phone: 708-848-9440

Fax: 708-848-4415

Email: lyndontaylor@msn.com

Website: http://www.LyndonTaylorObGyn.yourMD.com

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Risks of VBAC

1. Pelvic floor problems. Any vaginal birth can lead to urinary incontinence, protrusion of the uterus into the vagina (uterine prolapse), and dropped bladder (cystocele).

2. Failed attempt at labor ends in repeat c-section. The complications of cesarean after failed VBAC are higher than a scheduled repeat c-section.

3. Uterine rupture. If your uterus ruptures, either before or during labor, and emergency c-section is needed to prevent life-threatening complications, including blood loss, infection, and brain damage to the baby. When you deliver your baby in a hospital that’s equipped to handle such emergencies, rarely is your baby put at risk. For less than 1% of women who have a uterine rupture, the uterus must be removed (hysterectomy) to stop the bleeding, which means you’ll never be able to get pregnant again.

When an unplanned cesarean section might be necessary:

· There’s a problem with the placenta. Placenta previa occurs when the placenta lies low in the uterus, sometimes blocking the birth canal. Placental abruption occurs when the placenta separates from the uterus before birth. Both conditions can be dangerous.

· You develop preeclampsia. This complication causes a combination of signs and symptoms in the mother, including excessive weight gain, increased blood pressure, headaches, protein in the urine, increased muscle irritability and swelling. Preeclampsia doesn’t preclude you from trying VBAC if labor begins naturally, but this condition can require an early delivery, which is often best done by repeat c-section.

· Your baby is in the wrong position. By the time labor begins, most babies have settles into a position that allows them to be delivered headfirst through the birth canal. But that doesn’t always happen. If your baby is positioned to enter your pelvis with his or her feet or buttocks (breech presentation) or the baby is lying sideways across your pelvis (transverse lie), you’ll need a c-section.

· Your labor fails to progress. VBAC isn’t possible if your cervix doesn’t dilate completely or if your baby doesn’t move down the birth canal. Prolonged or obstructed labor increases the risk of uterine rupture.

· There’s a problem with the umbilical cord. Sometimes the umbilical cord passes into the birth canal ahead of the baby. If this happens, the baby will compress the cord during contractions. A emergency c-section is needed to prevent oxygen deprivation to the baby.

· Your baby doesn’t tolerate labor. If your baby’s heartbeat doesn’t remain within a safe range during labor, you may need a repeat c-section.

 

If you’ve read this far, you’re serious about your health and your baby’s well-being. You’ve already had a baby by cesarean section, but want to try a vaginal delivery. The information in this website is essential to making an informed decision, but does not cover all the risks or benefits that apply specifically to you. Your obstetrician can guide you in making that choice based on your particular condition and history.

If you’re ready for your Free Consultation with Dr. Lyndon Taylor, click here.

Over 300 hospitals in the US no longer allow VBAC