Cesarean birth (c-section) is surgery in which your baby is born through a cut that your health care provider makes in your belly and uterus. It used to be that once you had a baby by c-section, all of your future babies would have to be born by c-section, too.
Health experts now believe that a vaginal birth after a c-section (called VBAC) can be safe for many women and their babies, even though there may be some risks. Talk to your health care provider to find out if VBAC may be a good choice for you and your baby.
What are some benefits of having VBAC?
About 6 to 8 out of 10 women (60 to 80 percent) who try a VBAC are successful in having a vaginal birth. Even women who’ve had more than one c-section in the past may be able to have a VBAC safely. Some of the benefits of having a VBAC include:
Is VBAC a good choice for you?
VBAC is a good choice for many women, but not all. You may be able to have a VBAC if:
Talk to your provider if you think VBAC may be right for you.
Are there any risks?
Even when both mom and baby are healthy during pregnancy, VBAC can have some risks. VBAC risks include:
Are all c-section incisions safe for VBAC?
No. Knowing whether or not you can safely have a VBAC depends not only on your and your baby’s health, but also on the kind of c-section incision you had in your past pregnancy.
A low transverse incision is the most common kind of c-section incision. It’s made side-to-side in the lower part of your uterus, where the wall of your uterus is thinnest. This incision usually bleeds less than other incisions. It also makes stronger scars, making it less likely that the scar on the uterus will rupture. If you had a low transverse incision in your c-section, you may be able to have a VBAC.
Other types of c-section incisions aren’t safe for VBAC. Talk to your provider about the kind of incision you had to see if VBAC is a safe option for you.
Who should not have a VBAC?
Some health conditions lower your chance of having a safe VBAC. A VBAC may not be a safe choice for you if:
Do all providers and hospitals offer VBAC?
The American College of Obstetricians and Gynecologists (ACOG) says that providers should offer VBAC to all women with healthy pregnancies who are good candidates for VBAC and who don’t have any of the complications listed above.
But ACOG also says that providers should do VBACs only in hospitals and facilities that have certain emergency care services. These services may not be available everywhere, so some providers and hospitals may not offer VBAC.
Remember that most (about 7 in 10) VBACs are successful. If you want to have a VBAC, talk to your provider. If she can’t provide a VBAC, you may need to look for other care options near you.
See also: C-section: Medical reasons, Inducing labor, Stages of labor
An epidural is the most popular and effective kind of pain relief for labor. You get a needle with a small tube attached placed in your lower back. Medicine goes through the tube while you're in labor. It numbs your lower body so you can't feel the pain from your contractions. The medicine doesn't make you go to sleep, so you can be wide awake when your baby is born!
During labor, your cervix dilates (opens) to let your baby out. Your cervix is the opening to the uterus that sits at the top of the vagina. In order to have fetal-scalp blood sampling, your cervix must be dilated enough that your provider can reach your baby’s head.
The test may remind you of a pelvic exam. It takes about 5 minutes. You lie on your back with your feet in stirrups. Your provider places a plastic cone in the vagina that fits up against the baby’s head. Your provider pricks your baby’s scalp and takes a small amount of blood. The blood is tested, and results are ready in a few minutes.
You may feel some pressure during the test, but it shouldn’t hurt. Your baby may have some bruising or bleeding at the spot where he’s pricked.
If you have an infection, like HIV or hepatitis C, your provider may not recommend fetal blood sampling. This is because you can pass these infections to your baby through the spot where he’s pricked.
Your body also makes oxytocin during breastfeeding. Oxytocin helps your uterus shrink back to its original size after giving birth.
If labor is slow to start or your contractions stall, your health care provider may give you a medicine called Pitocin. Pitocin acts like oxytocin and can help start contractions or make them stronger.
Pitocin is a medicine that acts like oxytocin, a hormone your body makes to help start labor contractions. Contractions are when the muscles of your uterus get tight and then relax. They help push your baby out of your uterus (womb). Health care providers often use Pitocin to:
You may start having labor contractions shortly after you get Pitocin. It can make your contractions very strong and lower your baby's heart rate. Your provider carefully monitors your baby's heart rate for changes and adjusts the amount of Pitocin you get, if needed.