I don’t want to have another cesarean section…

So you previously gave birth via Cesarean and you are expecting your next child. Do you know how you will give birth this time around? You may be able to deliver vaginally, referred to as “vaginal birth after cesarean” (VBAC). Women who opt for VBAC are closely monitored. If the mother or baby shows signs of distress, an emergency C-section is done. VBAC is also possible for pregnancies with twins.

If you and your physician agree to try VBAC, you will go through a “trial of labor after cesarean,” or TOLAC. This means you plan to go into labor with the intent of delivering vaginally. But like any other type of labor, it is impossible to predict its success and some women may still need to undergo a C-section.

What are some benefits for TOLAC?

  • one fewer scar on your uterus which is important if you are planning on a future pregnancy – more scars on the uterus may cause problems with a later pregnancy
  • less pain after delivery
  • shorter recovery period
  • a lower risk of bleeding, infection, Deep vein thrombosis
  • decreased duration for hospitalization

What are the risks of TOLAC?

The most serious risk is that a C-section scar may open during labor. Although it is a rare occurrence, it can be quite serious for the mother and her baby, which is why VBAC is typically offered by hospitals that can do a rapid emergency C-section.

According to WebMD Medical Reference from Healthwise, “Pregnancy, labor, and delivery are different for every woman and difficult to predict. Even if your first pregnancy required a cesarean, the next one may not. The likelihood of a successful vaginal birth after cesarean (VBAC) is influenced by many things. Usually a combination of things affects how well or poorly a trial of labor goes.”

You reduce your chance for a successful VBAC when:

  • Your BMI is greater than 30
  • You are older than age of 40
  • Your baby is large for gestational age
  • You have surpassed 40 weeks of pregnancy
  • Your last pregnancy was less than 18 months ago
  • Your previous cesarean section was for failure to dilate or descend

What are some risks for VBAC:

  • The biggest complication is the rupture on the scar of the uterus – rare but can be deadly to mother and child.
  • Infection – women who have a TOLAC and end up having a C-section face greater risk of infection.

In order to make the most informed decision, please consult with your healthcare provider and read the most recent published studies for this topic.

Disclaimer

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualifies health provider before making any health, medical or other decisions based upon the data contained herein. Information provided is for informational purposes and is not meant to substitute for the advice provided by your own physician or other medical professionals.

Related Topics

Sean Daneshmand MD

Sean S. Daneshmand, M.D. is one of the busiest and most caring people you may ever meet. As the founder of the charity, Miracle Babies, as well as a full-time doctor, father, husband and business owner, it is hard to believe that he sleeps at all—or perhaps, he has found a portal to the 36-hour day. Dr. Daneshmand is a perinatologist (high-risk obstetrician) whose expertise includes obstetric and surgical management of invasive placentation, care of pregnancies following in-vitro fertilization, and management of maternal medical problems during pregnancy at the San Diego Perinatal Center. He was recognized by CNN, in their CNN Heroes segment, for his work with Miracle Babies and his dedication to his patients.