Successful VBAC

What is a vaginal birth after cesarean (VBAC)?

If you have had a cesarean delivery (also called a C-section) before, you may have a choice with your next pregnancy to attempt a vaginal birth.  This is called vaginal birth after cesarean, or VBAC.

Women consider VBAC for various reasons, including fewer medical complications with less infection and serious blood loss.  Other reasons include shorter recovery time and less time spent in the hospital, more active participation in the birth and also the impact on future pregnancies.  If you are planning to have more children, VBAC may be a better option as repeat VBACs tend to become progressively easier.

According to the National Institute of Health VBAC Consensus Statement, an estimated 74% of women that plan a VBAC will have a successful VBAC. The success rates vary between 54%-94% depending on a many factors – both medical and non-medical.  Discuss with your care provider any questions or concerns you may have.  Tucson Medical Center is proud to have the most successful VBAC rates in Southern Arizona. 

To learn about one mom's journey and Clementine's birth, visit http://www.tucsonmama.com/2011/02/24/clementines-birth-story-part-one/

The following medical factors point to higher rates of successful VBAC:

Before labor:

  • A previous vaginal delivery (before or after a cesarean delivery)
  • Nonrecurring reason for cesarean delivery (such as malposition, breech, multiples, fetal distress, placenta previa)
  • Previous delivery of a baby weighing less than 8 lb and 13 oz

Start of and during labor:

  • Spontaneous labor (no induction or augmentation)
  • Pregnancy length of 40 weeks or less
  • Greater cervical dilation at admission
  • Greater cervical dilation at rupture of membranes
  • Cervical effacement that reaches 75-90% upon admission
  • A single, vertex position baby (head down)
  • The baby’s head being engaged or lower in the pelvis
  • A higher Bishop score (a scoring system to estimate the success of induction)

While the medical factors define an “ideal” candidate, you do not need to fit into all the areas to be a good candidate, and most women do not fit into all the categories.

To maximize your chances of a successful VBAC, use a care provider willing to partner with you and answer your questions, enroll in a VBAC class, and choose a birth setting that offers individualized care. Ultimately your desire for a VBAC and your care provider’s desire to support you fully weigh heavily on your chance of success.