Is having a vaginal birth after a cesarean delivery safe?
Most women can safely have a vaginal birth after a cesarean (VBAC) delivery, although this depends on the circumstances of the previous cesarean delivery and the status of the current pregnancy. Special considerations must be given to women with vertical or classic uterine incisions, women with uterine or pelvic abnormalities, women delivering in hospitals without 24-hour anesthesia or obstetrical coverage, women with more than 1 previous cesarean birth, and women carrying multiple pregnancies. Almost 70% of women can have a VBAC, and the risk of a uterine rupture during the attempt is less than 1%. If the pregnancy is induced or contractions are augmented with Pitocin, incidence of rupture is closer to 2%. Most physicians and hospitals require a signed permit specifying the woman’s wish to have an elective repeat cesarean or a VBAC. Women also should understand that even in cases of planned repeat cesarean delivery, a woman occasionally presents in an advanced stage of labor, when ope
