If you were given the following reasons for a previous cesarean and are considering a repeat cesarean, you might consider discussing the following with your health care provider:. Dystocia : Dystocia refers to long and difficult labor due to slow cervical dilation, a small pelvis, or a big baby. Many women who are given this reason for previous cesareans deliver vaginally the next time around and tend to give birth to a larger baby than their first.
There is not evidence that a large baby requires a cesarean. During labor there are certain techniques that a woman can use to help open up the pelvis, thus allowing the birth of a large baby. Genital Herpes : For many years, because of the risk of passing herpes to the baby during delivery, women with a history of herpes almost always delivered by cesarean.
Physicians would examine cultures in the last weeks of pregnancy and if they found an active virus, would schedule a cesarean. Today, ACOG has determined and recommended that unless there is a visible lesion at the time of birth, vaginal birth is acceptable. Fetal Distress : If the life of the baby is at risk from fetal distress or other complication, there is little doubt that most mothers will consider a cesarean delivery.
Fetal heart rate monitoring to detect fetal distress can be a routine part of the VBAC procedure. Mode of delivery and risk of respiratory diseases in newborns.
Obstet Gynecol ;97 3 Vaginal birth after cesarean and the risk of uterine rupture The greatest concern for women who have had a previous cesarean is the risk of uterine rupture during vaginal birth. What criteria must I meet to be considered for vaginal birth after cesarean? If you've delivered a baby by C-section and you're pregnant again, you might be able to choose between scheduling a repeat C-section or a vaginal birth after cesarean VBAC.
In , the success rate for women in the U. VBAC isn't right for everyone, though. Certain factors, such as a high-risk uterine scar, can lower your likelihood of VBAC and make the option inappropriate. Some hospitals don't offer VBAC because they don't have the staff or resources to handle emergency C-sections.
If you're considering VBAC , your health care provider can help you understand if you're a candidate and what's involved. One of the greatest predictors of a successful VBAC is a prior vaginal delivery.
You're not a candidate for VBAC if you have any condition that would prevent vaginal delivery or you have had:. Many health care providers won't offer VBAC if you've had more than two prior C-sections or you have a body mass index of 50 or higher at the time of delivery and you've never had a vaginal delivery.
VBAC also generally isn't an option if you are pregnant with triplets or higher order multiples. Factors that decrease the likelihood of VBAC include:. While a successful VBAC is associated with fewer complications than an elective repeat C-section, a failed trial of labor after cesarean is associated with more complications, including, rarely, a uterine rupture.
If a scar on your uterus from a previous cesarean tears open during a trial of labor, an emergency C-section is needed to prevent life-threatening complications for you and your baby.
Treatment might involve surgical removal of the uterus hysterectomy. If your uterus is removed, you won't be able to get pregnant again. Here are the risks and benefits of VBAC. VBAC is a term used to describe the vaginal delivery a woman has after giving birth via cesarean. Success rates among women who attempt VBAC with a trial of labor are between 60 and 80 percent , with the remainder of babies being delivered surgically.
The riskiest scenario is an emergency cesarean delivery after a failed VBAC. A VBAC may fail because of uterine rupture. This is where the uterus tears open along the scar line from a previous cesarean delivery.
In the event of uterine rupture, an emergency cesarean delivery would be necessary to avoid dangerous complications including heavy bleeding, infection to the mother, and brain damage to the baby.
A hysterectomy, or the removal of the uterus, may be needed as well. This means you would be unable to become pregnant again. Fortunately, ACOG notes that the risk of uterine rupture in women who had low transverse incisions during their cesarean delivery is low, approximately 1 in Your chances of successfully delivering vaginally after one or two previous cesareans can be affected by a few factors, including the following.
In some cases, VBAC might not be safe for you. Learn everything you can about VBAC. Speak with your doctor about your chances of success based on your medical history and your current pregnancy. You should also consider researching and choosing a provider who is both supportive of VBACs and has a low cesarean delivery rate.
Look for a childbirth class covering VBAC, and make sure your partner is on board with the idea, too.
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