About 60% to 80% of women who have had a c-section are able to successfully have a vaginal birth after cesarean (VBAC). If you are able to successfully have VBAC, you will probably have a lower risk for blood transfusion and infection, a shorter hospital stay, and a faster recovery. Circumstances are different for every woman, however. If you are considering a VBAC, you should discuss your options with your healthcare provider to get information that is specific to your case.

According to the American College of Obstetricians and Gynecologists (ACOG), you may be able to have VBAC if:

• you had a low-transverse incision in the uterus when having previous c-section deliveries. Your medical records should indicate which kind of uterine incision you had.
• you have no other uterine scars or ruptures from previous c-sections or other surgeries.
• your pelvis is large enough to allow a vaginal delivery.

When a woman is planning a VBAC, ACOG has specified that an appropriate medical team should be available and an anesthesiologist should be present throughout active labor so that an emergency c-section may be done if necessary.

ACOG recommends that you not try for a VBAC if:

• you have had a high vertical (or classical T-shaped) incision in the uterus
• you have a small pelvis
• you are delivering a large baby
• you have a medical problem or obstetric condition, such as placenta previa or placenta abruptio
• you are delivering in a hospital without an available medical team for VBAC monitoring and emergency c-section

Risks

Rupture of the uterus is the most serious risk with VBAC. After a low transverse c-section, the risk of rupture is about 1%, but after a classical c-section the risk is 4% to 9%.

A recent large study found that about 1 in 2000 women who tried a VBAC had a rupture of the uterus that caused permanent brain damage to the baby. Women who tried to have a vaginal delivery were more likely to need a blood transfusion and more likely to have an infection of the uterus that required antibiotics. However, the study found that about three quarters of the women who tried had a successful VBAC. These women avoided surgery and had a quicker recovery than did women who chose to have a scheduled repeat c-section.