A VBAC, or vaginal birth after cesarean delivery, carries a number of risks. Because C-Section deliveries now account for almost 1 in 3 deliveries in the U.S., more woman are attempting to deliver vaginally after a previous C-Section. Around 60 to 80% of women are good candidates for a VBAC, although it depends on many factors, including the number of previous C Sections and complications. Here’s a look at the VBAC risks you should keep in mind, however if you’re considering a vaginal birth.
VBAC Risks: Uterine Rupture
This is the area of most concern for women who have had a previous C-Section and want to attempt a vaginal birth. The American College of Obstetricians and Gynecologists (ACOG) places this risk at 1 in 150, or a 1.5% chance, if you deliver vaginally after a previous cesarean using a low transverse incision. Further studies have found this risk increases if you have labor induced. The ACOG does feel that VBAC is generally safer than a repeat C-Section. If you do experience a uterine rupture, you have a risk of blood loss, bladder damage, infection, blood clots and a hysterectomy.
VBAC and Dystocia
Dystocia offers when the baby is very large, your pelvis is small or you have bad cervical dilation. This condition often causes women to need or desire a ceserean delivery. If you’re considering a VBAC, keep in mind there isn’t any evidence to show a large baby requires a ceserean delivery as the baby’s head and your pelvis will change shape during birth, making a vaginal birth possible.
VBAC and Genital Herpes
Many women with genital herpes in the past were almost always scheduled for a ceserean to prevent the disease from passing to the baby. The ACOG now recommends vaginal birth unless a lesion is visible at the time of birth.
VBAC and Fetal Distress
A number of cesereans were also performed due to fetal distress, although fetal heart rate monitoring can now safely and easily look for signs of distress during a VBAC procedure.
Criteria to Meet to Reduce VBAC Risks
To be a good candidate for VBAC and minimize the risk of uterine rupture, the following should be true:
- Less than 3 previous low transverse cesereans
- No extra uterine scars or previous ruptures
- The reason for the previous ceserean is not repeated in this current pregnancy
- You have no major medical conditions or health issues
- The baby is in a head-down position
- The baby is a normal size