Attempting a vaginal birth after cesarean (VBAC) is a safe and appropriate choice for most women who have had a prior cesarean delivery, including for some women who have had two previous cesareans, according to guidelines by The American College of Obstetricians and Gynecologists.
Of the women who elect to have a VBAC, between 60-80 % are successful. In keeping with past recommendations, most women with one previous cesarean delivery with a low-transverse incision are candidates for and should be counseled about VBAC and offered a Trial of Labor After Cesarean (TOLAC). In addition the College guidelines now clearly say that women with two previous low-transverse cesarean incisions, women carrying twins, and women with an unknown type of uterine scar are also considered appropriate candidates for a VBAC.
Because every woman and every birth is unique, you will want to counsel your patient about the benefits and risks well in advance of the expected delivery date to make the right decision for both mother and baby.
Below is information on an easy-to-use calculator to determine if your patient is a candidate for a VBAC. You may also review this quick reference table.
|Good Candidate||Possible Candidate||Not A Candidate|
|Had a prior vaginal delivery||Yes|
|Has a spontaneous labor||Yes|
|Requires induced labor||Yes|
|Prior cesarean delivery was due to a
non-recurring condition (breech birth, etc.)
|Prior uterine rupture||Yes|
|Two prior lower transverse sections||Yes|
In order to determine if your patient is an appropriate candidate for a VBAC, there is an easy-to-use calculator available when a repeat cesarean section is scheduled electronically in the Labor and Delivery application. You will be required to fill out the calculator when booking a repeat cesarean section.
This calculator is based on a prior validated study. There are other factors you may also consider.
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