Sanford Obstetrics & Gynecology

Information on a vaginal birth after cesarean

Peter Klemin, MD

I had a C-section with my first pregnancy. Now that I'm pregnant again, do I have to have a C-section? Many women are successful in having a vaginal birth after cesarean. However, pregnancy, labor, and delivery are different for every woman and differ from one pregnancy to the next. Talk to your OB/GYN about whether or not you are a good candidate for a vaginal birth after cesarean. If you proceed with the intention of a vaginal birth after cesarean, the goal will be to let you go into labor with the intention of vaginal delivery. Be prepared, though, for the reality that you may still need a C-section again.

Is it safe to try a vaginal birth after cesarean?

In most cases, a vaginal birth after cesarean is a safe choice. Whether it's right for you depends on factors such as why you had a previous C-section, how the C-section was performed and how many C-sections you have had. If either you or the baby shows signs of distress during labor, you may need to have an emergency C-section.

What are the pros and cons of a vaginal birth after cesarean?

With vaginal births, women generally have less pain following delivery, lower infection risks, a shorter hospital stay and faster recovery at home. Each C-section also results in a scar on your uterus. The more scars you have, the greater your chance of problems with successive pregnancies. However, if you attempt a vaginal birth after cesarean and then need a C-section, your risk of infection increases over having a planned C-section.

What results in a successful vaginal birth after cesarean?

Again, each woman's situation is different. Usually, it's a combination of factors that influence the success of a vaginal birth after cesarean. Your chances are better if you do not have the same condition that led to the previous C-section, you go into labor on your own, your cervix dilates well and you have previously had a successful vaginal delivery or a vaginal birth after cesarean. Your chance of possible success declines if you are over 35, obese, carrying a baby estimated at more than 9 pounds, diabetic, have narrow pelvic bones, or are beyond your 40th week of pregnancy.

When should I decide if I want to try a vaginal birth after cesarean?

It should be a consideration when you choose your provider. Some doctors are not willing to consider a vaginal birth after cesarean. While a vaginal birth after cesarean is becoming much more accepted, there is the concern that a prior C-section scar can reopen during labor. Although this happens very rarely, it is a serious health risk for both mom and baby. You not only need to be comfortable with your decision to choose a vaginal birth after cesarean, but your provider also needs to be willing to work with you toward that goal.

Dr. Peter Klemin is a board-certified obstetrician/gynecologist at Sanford Obstetrics & Gynecology. For an appointment, call 701-.323-8262 or click here to request an appointment online.