Is Vaginal Birth Safe after a Cesarean Section?

Obie Editorial Team

Birth by cesarean section is not at all uncommon. In fact, more than a quarter of all deliveries in the United States are by C-section. For some women, a C-section with the first baby might cause some complications that could affect the vaginal delivery of any babies they have in the future. If you have had a cesarean delivery in the past and wish to have a vaginal birth, you have an increased risk for uterine rupture. The uterine rupture occurs at the site of the cesarean incision and is caused by the pressure required during vaginal birth. However, the risk is relatively low, and some studies even suggest that a vaginal birth after a prior C-section is safer than getting a second C-section.

Some women who would like to have a vaginal birth after they’ve had a cesarean delivery in the past will not be allowed to do so based on certain risk factors. If you have had more than two cesarean deliveries in the past, your risk for uterine rupture is greater, so your doctor will recommend another C-section. Your doctor might also be hesitant to let you begin the process of vaginal birth if there are no suitable cesarean facilities close by. In the event that something goes wrong during the vaginal birth, your doctor might need to administer an emergency cesarean. In that case, an open operating room with sufficient staff would have to be available at a moment’s notice. If they are not, you will probably have a planned cesarean.

There are certainly benefits to having a vaginal birth after you’ve had a cesarean in the past. As long as you’re a good candidate for a vaginal birth, your hospital stay will be shorter after you’ve delivered. Usually, women only need to stay hospitalized for two days after giving birth vaginally. Women who have C–sections usually stay in the hospital for four days. Also, after a vaginal birth, the pain and discomfort around the vagina is temporary. The same is not true for C-sections, as the pain and discomfort around the incision will be long lasting. Finally, your baby might be healthier after vaginal delivery, since there are birth complications like respiratory problems associated with C-sections. As long as your doctor thinks you are a good candidate with no possible complications, opting for a vaginal birth after a previous C-section is worth the risk.

Source: M McDorman et al: Recent Trends And Patterns In Cesarean And Vaginal Birth After Cesarean (VBAC) Deliveries In The United States. Clinics in Perinatology Volume 38 Issue 2 pp. 179-192 2011