by Lauren Feder, M.D.

Can you explain what a VBAC is?  Vaginal birth after cesarean section, this means having a vaginal birth following a previous birth delivered by cesarean section.

What are some of the benefits for mom and baby with having a vaginal birth? 

The ability to give birth vaginally is coveted by many women, as it is the way in which nature intended. Delivery in the birth canal has many advantages that include some of the following considerations:

-Important for breathing in newborns. This may be due to compression a baby experiences during contractions while going thru the birth canal.  Studies show an increased incidence of respiratory distress syndrome in babies born by cesarean section.

-Exposure to vaginal flora in the birth canal helps colonize a baby’s intestines and promotes healthy growth of intestinal bacteria which is important for a newborn’s immune system.

Many women have a common fear of having their uterus rupture, how common is this? I believe a woman’s fear of uterine rupture comes from the physicians.  The good news is that according to ACOG (American College Obstetricians And Gynecologists) a VBAC is considered to be safer than undergoing a repeat cesarean delivery.  A rupture is considered rare and for a woman who has had a previous cesarean (with a low transverse incision) the risk is .2 to 1.5% or 1 in 500 (this is considered a low rate).  Induction of labor with such medications as Pitocin is considered a risk factor for uterine rupture.

How do you decide if someone is a candidate for a VBAC?

Most physicians believe that if a woman had a cesarean delivery with a vertical cut, there can be increased risk for a uterine rupture considering this to be a contraindication to VBAC,  Another contraindication would be if a woman has had a previous uterine rupture.


How should an expectant mother prepare for a VBAC?  It is important to find a healthcare provider who is in favor of VBAC, this can include options that are beyond a hospital birth such as birth center or home birth.  As with any pregnancy, I advocate a healthy diet, regular prenatal visits, exercise, and positive outlook. I believe it is important to take a birth class and/or refresher course.

Are there any resources you would recommend?  Due to the fact that cesarean delivery has been on the rise, there are many VBAC groups. The International Cesarean Awareness Network (ICAN) offers wonderful support groups and community services.