Intermountain Health Experts Offer Advice on Safely Choosing a Vaginal Birth After Cesarean

After moms deliver a baby via Cesarean section, they may have questions if it’s safe to try for a vaginal or VBAC birth. Intermountain Health experts say having a conversation with your trusted OB-GYN provider can help you know what the risks and benefits are to trying for a vaginal birth, given your past medical history.

For the majority of women who’ve had a previous Cesarean section delivery, it’s usually possible to try for a vaginal birth,” said Dr. Darrick Peters, DO an OB-GYN with Intermountain Health.

“I talk with moms about their medical history and what led to that C-section. We review the operative notes about the type of incision and where in the uterine muscle the incision was made. And then I help explain the risks and benefits of trying a vaginal birth,” he added.

Understanding the risks and benefits of a VBAC delivery can help moms make their decision

“Incisions and scar tissue can vary. But generally speaking, with a previous transversal or horizontal incision done at the bottom of the uterus where contractions don’t take place, there is a very low risk – just one percent – that there could be uterine rupture where that scar tissue breaks,” said Dr. Peters.

According to Peters, if a patient’s C-section also required a vertical incision, where the scar tissue would be in a T-shape, the risk of uterine rupture may be more like 10 percent.

“We’re very open to letting moms try for a VBAC birth. And they may feel more comfortable trying a VBAC delivery in a hospital, which has highly trained staff and monitoring equipment available if complications arise for mom or baby, and an operating room ready for an emergency Cesarean,” said Dr. Peters.

Having a birth plan helps, but it also needs to be somewhat flexible.

“OB-GYNs and labor and delivery nurses talk to each mom about their desired birth experience and a plan for how we can support that, at the same time knowing the ultimate goal is to keep mom and baby safe and healthy,” said Dr. Peters.

“Each patient varies on how risk averse they are and what type of birth experience they prefer. Some moms may have enjoyed the predictability of having a Cesarean section and don’t want to try a VBAC at all. And that’s ok too,” he added.

What moms can do to increase their chances of a vaginal birth after a previous Cesarean section:

• Get your support person involved in preparing for childbirth and being there during the birth experience.
• Eat a healthy diet that includes plenty of fresh vegetables and fruit, lean sources of protein, whole grains and unsaturated fats. Limit ultra-processed foods high in simple carbohydrates and sugars and reduce intake of saturated fats.
• Stay physically active during pregnancy.
• Stay active and walk around in the early stages of the birthing experience.

To learn more visit the pregnancy and baby page on intermountainhealth.org. To see a virtual tour of your local hospital’s labor and delivery department visit the webpage for your local hospital.

About Intermountain Health

Headquartered in Utah with locations in six states and additional operations across the western U.S., Intermountain Health is a not-for-profit system of 34 hospitals, approximately 400 clinics, medical groups with some 4,600 employed physicians and advanced care providers, a health plans division called Select Health with more than one million members, and other health services. Helping people live the healthiest lives possible, Intermountain is committed to improving community health and is widely recognized as a leader in transforming healthcare by using evidence-based best practices to consistently deliver high-quality outcomes at sustainable costs. For up-to-date information and announcements, please see the Intermountain Health newsroom at https://intermountainhealthcare.org/news.