If you’ve had a cesarean section in the past, you may wonder if it’s possible to have a vaginal birth in subsequent pregnancies. The good news is that many women who have had a C-section can safely have a vaginal birth after cesarean, or VBAC.

Who is a good candidate for a VBAC?

The possibility of a successful VBAC depends on several factors, including your circumstances and medical history. These factors are evaluated by your provider to determine if VBAC is a safe option for you, including:

• The reason for your previous C-section (some issues may be nonrecurring, such as the baby being in a breech position, while others tend to recur, such as labor failing to progress)
• The type of uterine incision and potential scarring from your previous C-section
• The number of C-sections you’ve had previously

Certified Nurse Midwife Kathleen Scott, DNP, APRN-CNM says, “The majority of women who have had one C-section are really good candidates” for VBAC. However, the more C-sections you have had, the greater the risk of complications.

What are the benefits and risks of VBAC?

The benefits of VBAC include:

1. A lower risk of complications: Vaginal birth is associated with a lower risk of infection, bleeding and injury compared to a C-section.
2. Quicker recovery: VBAC typically involves a shorter hospital stay and shorter recovery time compared to C-section, allowing you to resume daily activities sooner.
3. Future pregnancies: VBAC can potentially increase your options for future pregnancies, as multiple C-sections pose an increased risk of complications.

Many of the risks of VBAC are the same as with any vaginal delivery, including infections, blood loss and other complications.

Although rare, uterine rupture is the most significant risk associated with VBAC. It occurs when the scar from the previous C-section opens during labor, potentially leading to severe bleeding and harm to both mother and baby. However, according to Scott, the risk of rupture is low, usually less than 1%.

“The biggest potential complication is a uterine rupture, but it is still incredibly rare,” she says. “And there are many things we know how to do to mitigate that risk.”

Working with your provider

Early in your pregnancy, your provider will review your medical records, including the details of your previous C-section, and discuss whether you are a good candidate for a VBAC.

Nebraska Medicine nurse-midwives routinely work with patients who desire a VBAC, and 89% to 95% of their VBACs are successful. Scott attributes their success to the close relationship they develop with patients and the education they provide on topics like maintaining a healthy weight and exercising during pregnancy, both of which can increase the chances of a successful VBAC.

Above all, the team fosters open communication, ensuring patients are well informed about everything that is happening in their pregnancy and birthing experience, Scott says.

“We never promise anyone they’ll have a VBAC, but we’re always very hopeful and supportive. If a C-section is done, our patients will walk away knowing why and we’re there to help them process it.”