Deciding About Vaginal Birth After Cesarean

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Years ago, if you had a cesarean birth, all of your future babies had to be born this way. Today, even if you had a cesarean in the past, you may be able to try to have a vaginal birth for the next baby. This is called vaginal birth after cesarean, or VBAC (say "VEE-back").

VBAC isn't possible for some people. There may be concerns about their health and the baby's health. Ask your doctor or midwife if trying labor is right for you. You could still need a cesarean even if you go into labor.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

Why would you have a VBAC?

  • You want to experience a vaginal birth.
  • The scar on your uterus is the kind that would allow a safe VBAC.
  • You feel that the benefits of vaginal birth outweigh the small risk of the scar on your uterus breaking open during labor. If a scar breaks open, it can be very dangerous for both you and your baby.

Why would you not be able to have a VBAC?

  • Your hospital does not offer VBAC.
  • You are at greater risk of your uterus tearing because:
    • The scar on your uterus is vertical. This kind of scar does not usually allow a safe VBAC.
    • You have had more than two cesareans.
    • You are carrying triplets or more.
  • You have a placenta problem or another medical issue that could make a vaginal birth risky.
  • Something happens during your pregnancy or labor that requires a cesarean. For example:
    • You develop a problem with your blood pressure.
    • Your baby is not head-down or is breech (bottom-down) or sideways.
    • Your labor is not progressing well.
    • Your baby is having problems.
    • The scar on your uterus is bleeding or getting weak.

Where can you learn more?

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The Health Encyclopedia contains general health information. Not all treatments or services described are covered benefits for Kaiser Permanente members or offered as services by Kaiser Permanente. For a list of covered benefits, please refer to your Evidence of Coverage or Summary Plan Description. For recommended treatments, please consult with your health care provider.