Delivery after previous caesarean section

Delivery after previous caesarean section
Other names	VBAC (Vaginal Birth After Caesarean)
Specialty	{{#statements:P1995}}

Delivery after previous caesarean section refers to the birth of a baby through the vagina in a woman who has previously had a caesarean section. This type of delivery is often referred to as VBAC, an acronym for Vaginal Birth After Caesarean. The decision to attempt a VBAC is influenced by various factors including the type of incision used in the previous caesarean, the overall health of the mother, the reason for the previous caesarean, and the number of previous caesareans.

Indications

VBAC is considered for women who have had one or two previous caesarean sections with a low transverse incision and who have no contraindications to vaginal delivery. The benefits of VBAC include a shorter recovery period, lower risk of infection, and decreased likelihood of respiratory problems in the baby.

Contraindications

Contraindications to VBAC include more than two previous caesarean sections, a previous uterine rupture, certain types of uterine incisions (such as a vertical incision), and other medical or obstetric conditions that preclude vaginal delivery.

Risks

While VBAC is associated with benefits, it also carries risks, the most significant being the risk of uterine rupture. This is a rare but serious complication where the scar from the previous caesarean tears. Other risks include endometritis, blood transfusions, and operative injuries.

Procedure

The process of VBAC involves close monitoring of the laboring mother and the fetus. If there are signs of distress or if labor does not progress normally, a repeat caesarean section may be necessary. The decision to proceed with VBAC should be made in consultation with a healthcare provider who can assess the individual risks and benefits.

Statistics

The success rate of VBAC varies but is generally reported to be between 60-80%. Factors that may influence the success include the reason for the previous caesarean, the presence of any pregnancy-related complications, and the onset of natural labor.

See also

• Caesarean section
• Childbirth
• Obstetrics