If you’ve previously delivered a baby via a cesarean section, you might wonder if you must deliver via C-section for all subsequent pregnancies.
The answer to that question is: No, you don’t have to keep having C-sections once you have one. It’s possible to have a vaginal birth after cesarean (VBAC).
But determining whether you're a suitable candidate requires careful consideration of various factors, and it’s nothing you have to decide on your own. Our midwifery team takes into account all of these factors to help determine if you're a candidate for VBAC.
Here’s what you need to know about VBAC, courtesy of our team here at Westover Hills Women’s Health.
VBAC refers to the delivery of a baby through your vagina after a previous C-section delivery.
When compared to a repeat C-section, VBACs offer many benefits such as:
A VBAC also provides you with the opportunity to experience a vaginal birth, and if you’d like more children in the future, a VBAC can help you avoid multiple C-sections.
You might be a candidate for a VBAC if:
The more C-sections you’ve had, the more likely you’ll need a repeat C-section. So if you’ve only had one C-section, there’s a good chance that you might qualify for a VBAC.
We often recommend VBAC for women who have had a previous C-section delivery with a low-transverse incision, which is a horizontal incision made across the lower part of your uterus.
This type of incision is less likely to cause complications during a subsequent vaginal birth. Vertical incisions and high incisions are more likely to contribute to complications during a VBAC.
Certain conditions may always require a C-section for a safe delivery. For example, if you have placenta previa — where your placenta is covering your cervix and, therefore, blocks your baby’s access out of the birth canal — your only safe option is a C-section.
Your Westover Hills Women’s Health midwife can review the list of uterine and placental conditions that may make you ineligible for a VBAC.
The more C-sections you have, the higher your risk for complications, such as uterine rupture. With that in mind, your desire for more children can influence your decision to pursue VBAC.
The takeaway: Minimizing the total number of C-sections that you have is beneficial, especially if you envision a larger family with three or more children.
We also take into consideration the reason for your initial C-section. If your first C-section was due to fetal positioning issues like breech presentation, you might be eligible for a VBAC as long as your baby is in a good position for birth.
But if maternal pelvic issues (such as a contracted pelvis) or other anatomical concerns (such as a bicornuate uterus) necessitated your first C-section, VBAC eligibility depends on whether these issues have resolved or improved.
Part of moving forward with a VBAC is understanding all of the risks, such as uterine rupture and the possibility of needing a repeat cesarean delivery. While these risks are generally low, it's important to discuss them with our team.
As many as 80% of VBACs are successful, and the key to that success is honestly and thoroughly examining all criteria for VBAC.
And if you need a C-section after attempting a VBAC? That’s OK, too. Our team can pivot if that’s what’s best for you and your baby.
If you're not a candidate for VBAC, stay positive knowing that our team prioritizes your health and safety above all else.
During your next prenatal appointment, let us know if you’re considering a VBAC. We’re happy to review your medical history, your preferences, and the reasons for your previous C-section.
To schedule your next appointment, call the San Antonio, Texas, location closest to you, or simply click here to get started.
