Recent Data on Vaginal Births After Cesarean (VBAC)
A topic that comes up regularly is whether (and when) it is safe to have a vaginal birth after cesarean, known in medical parlance as a VBAC. This means that a woman has a cesarean section for one pregnancy, and in a subsequent pregnancy delivers vaginally after a period of labor. According to the Mayo Clinic, between 60 and 80 percent of woman who attempt labor after a prior cesarean have a successful vaginal delivery.
Preliminary data from 2014 shows that 32.2% of all births in that year were conducted via cesarean sections. This is down from 32.9% in 2009. There is no reliable national data on the number or percentage of VBACs since about 2005, when data collection methods changed.
Let’s go through the pros and cons:
Benefits of VBAC
- Shorter recovery time: Because it is not surgery, most women who have a vaginal delivery recover sooner than those who have cesarean sections.
- Less risk of infection: As with any surgery, there are risks of infection. The incision site must be properly closed and cleaned after the surgery, or else infection can set in and cause serious injury.
- Mother’s involvement: Many mothers-to-be feel more involved in a vaginal birth when compared to a cesarean section. They can communicate more easily with their doctors.
Risks of VBAC
The main risk of a vaginal delivery after cesarean is that the uterus could tear where the prior c-section incision was (called a uterine rupture). If this happens, doctors will have to perform an emergency cesarean, and may need to remove the uterus (preventing future pregnancies). There are risks to the mother of severe bleeding and infection, and the baby may face the possibility of brain damage.
When A VBAC Should Be Avoided
The medical literature is constantly being updated, and every patient has a unique situation, so these are simply general rules. A vaginal birth after cesarean may need to be avoided when:
- Pregnancy continues past the due date
- More than two cesarean sections have been performed
- A large baby (macrosomia)
- Prior uterine rupture
- Prior vertical incision (classical)
VBAC is an important issue, particularly among women who want more control over delivery of their children, and amongst midwives. Most would agree that the most important thing is that a baby be born healthy. However, the goal is of course to determine how that can be done, and whether a vaginal birth after cesarean is safe for the baby. Doctors and midwives must adapt to new data, new research, and provide expectant parents with the best information in order to make an informed decision. If you are concerned about whether a VBAC was the right choice for you, contact our team at (440) 252-4399 or online.