Vaginal Delivery in Southern New England

Some women who have a history of a cesarean section are candidates for a vaginal delivery with a subsequent pregnancy. There are several reasons why you might want to try to VBAC over a repeat cesarean section including:

• No abdominal surgery
• Shorter hospital stay
• Lower risk of infection
• Less blood loss

You may be a candidate for a VBAC if:

• You have had only one prior cesarean section
• If the incision on your uterus was a “low transverse incision”

The success rate of VBAC is 60 – 80 percent, however you will have a better chance of succeeding if your prior cesarean section was for:

• Breech presentation
• Fetal distress
• Placenta Previa

Your success rate may be lower if your prior cesarean section was for:

• Failure to dilate to 10 centimeters
• Failure to deliver after pushing

VBAC has risks and benefits. In the setting of a woman who has a prior low transverse scar on her uterus, there is a 1 percent risk of that scar opening in labor (uterine rupture). Uterine rupture is an emergency for both the mother and infant and requires an emergency cesarean section.

Induction of labor is more difficult in the setting of a prior cesarean section. Certain medications given to help open and soften the cervix to aid in the induction process are contraindicated in women with a prior cesarean section because they increase the risk of uterine rupture.