Birth Options After Having a Cesarean

Abstract

Overall, your risk of having complications is less if you give birth vaginally. You will likely spend less time in the hospital and recover faster with less pain. Your baby has less chance of breathing problems shortly after a vaginal birth when compared to babies born by cesarean.

You have a higher chance of uterine rupture (uterus opening at the old scar), which is dangerous for you and your baby. Uterine rupture is very rare. Uterine rupture happens to about 7 or 8 of every 1000 people who labor after having a previous cesarean. This is a less than a 1% chance of uterine rupture if you have labor after a cesarean. If your uterus does rupture, there is a higher chance your baby will die. This means that of 10,000 people who had a cesarean and try to have a VBAC, 2 babies will die.

You can schedule when your birth will likely happen and know what to expect from surgery. You can talk to the surgeon about being awake for the surgery and safely involving family in the cesarean birth.

Overall, about 3 out of 4 people who try to have a VBAC will have a successful vaginal birth. Some things in your medical history affect your chance of success.

Choosing your method of birth is an important and very personal decision. Before you make your decision, talk to your health care provider who can help you learn about your chance of having a successful VBAC and your risk of uterine rupture. Your health history, what happened during your last labor, and how your current pregnancy is going will help guide your health care provider to counsel you if a VBAC or repeat cesarean is the best plan of care for you. If your baby is breech, you are carrying more than one baby, or you have had more than one cesarean, your provider may be less likely to recommend that you have a VBAC. You and your family can also discuss how you feel about the following reasons to have a VBAC or repeat cesarean.

It is safest to have a VBAC in a hospital so you and your baby can be monitored during labor. Signs of distress in the baby are usually the first sign of uterine rupture. Because of this, you will have continuous fetal heart rate monitoring during labor. An IV will be placed so that it is available in case there is an emergency. You should be able to have any type of pain medicine you would like.

Flesch-Kincaid Grade Level: 7.4

Approved May 2025. This handout replaces “Birth Options after Having a Cesarean” published in Volume 61, Number 6, November/December 2016.

This handout may be reproduced for noncommercial use by health care professionals to share with patients, but modifications to the handout are not permitted. The information and recommendations in this handout are not a substitute for health care. Consult your health care provider for information specific to you and your health.