What are the risks of VBAC?

If you are a woman in California who has already had one baby delivered via cesarean section, and if you are pregnant again or thinking about having more children, you may want to have a discussion with your doctor about the risks of vaginal birth after cesarean section.

You may have heard that you cannot, or should not, deliver a baby vaginally after you have had a C-section, but that is not necessarily true. According to the Mayo Clinic, while some women are not good candidates to attempt VBAC, 60 to 80 percent of women who attempt a trial of labor after cesarean accomplish a successful vaginal delivery.

However, VBAC involves risks of complications for both the mother and the baby. One of the most concerning potential complications for the mother is a uterine rupture. Though rare, a rupture of the uterus can result in heavy bleeding that could be life-threatening. In the event of a uterine rupture, you will require an emergency C-section. If doctors are unable to stop the bleeding, or if the rupture is too complex to repair, you may require a hysterectomy, or complete removal of your uterus.

Assuming that you are a candidate for VBAC, the risks involved are relatively low, and multiple C-sections involve risks of their own. Any surgical procedure involves risks of postprocedure infection or blood clot formation, and multiple C-sections can build up scar tissue that could complicate future pregnancies and make additional surgery difficult. 

Nevertheless, not everyone is a candidate for VBAC. If you have had a uterine rupture in the past, or if you had a prior C-section with a high vertical incision, the risk of rupture during delivery is too great to attempt VBAC. On the other hand, your rupture risk is less if your previous C-section involved a low transverse incision (i.e., one that cut horizontally across your lower abdomen) rather than a high vertical incision. 

However, it is not the prior incision alone that determines your eligibility for VBAC. Other considerations include the following:

• Your age
• The number of babies you are carrying
• The length of your pregnancy
• Your weight before and during pregnancy
• Your surgical history
• The time that has elapsed since your most recent delivery

 The information in this article is not intended as legal advice but provided for educational purposes only.