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Vaginal Birth After Cesarean (VBAC)


Women who have had a previous cesarean delivery might be a candidate for trial of labor after cesarean (TOLAC) for their next delivery. About 60% of women who go through TOLAC are able to have a vaginal birth after cesarean (VBAC) with no complications. Both TOLAC and repeat planned cesarean delivery have risks. Both can cause infection, injury, blood loss, and other complications. With TOLAC, the risk of most concern is the possible rupture of the cesarean scar on the uterus or the uterus itself. Although a rupture of the uterus is rare, it is very serious and may harm both mother and baby. If a woman is considered at high risk of rupture of the uterus, TOLAC should not be tried. The women with a history of vertical uterine incisions are not a candidate for TOLAC since the chance of uterine rupture is significantly higher. The factors that increase your chance of a successful VBAC may include spontaneous labor and history of a previous vaginal birth. However, there are many other factors that can affect your decision and your doctor’s recommendation in terms of the safest route of your next delivery. Your weight, your age, baby’s estimated weight, baby’s position, and the interval between your pregnancies are all important. Finally, your doctor and the hospital you choose to deliver at must have capabilities to deal with emergencies that may arise.


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Nezhat Solimani, MD
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