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Is Vaginal Birth After Cesarean Section (VBAC) an Option?


Cesarean section (C-section) rates are high — per the CDC, in 2015, 32 percent of all deliveries (first child or beyond) were C-section. For the state of Nevada, in 2012, 23.5 percent of all first deliveries were a C-section. And the data shows that if you have a C-section, the odds that you go on to delivery vaginally for your next child are only about 10 percent — most people tend to elect for a repeat C-section.

But don’t worry — not all is lost if you’re part of the group that has ended up with a C-section for your delivery. A vaginal birth after cesarean section (VBAC) is an option for some women (depending of course on why you had the first C-section), and success rates of delivering vaginally are quoted as high as 60-80 percent

Something to know about VBAC deliveries is that there are certain factors that can negatively influence your success, including obesity, age over 40, large fetal size, short maternal stature, having previously failed to dilate, large pregnancy weight gain, gestational diabetes, or pregnancies over 41 weeks.

The biggest concern with vaginal births after cesarean has been, and still is, uterine rupture — and can happen in 0.5-1 percent of women. This is the reason that there is a strong recommendation from the American College of Gynecologists and Obstetricians for women to deliver in a hospital where there are capabilities for an urgent C-section if needed.

I had a scheduled cesarean section with my daughter as she was breech — we did try a cephalic version (my OB physically tried to move her to the head-down position) which was not successful. My personal decision with this delivery has been that if I go into labor, I will have a “trial of labor after cesarean” (TOLAC) and see what happens — otherwise, I will have a scheduled repeat C-section at 40 weeks.

It’s worth having the discussion with your obstetrician about whether or not VBAC is a good option for you.



About Amanda Magrini

Amanda Magrini
Amanda Magrini, MD, is a board-certified family medicine physician at Northern Nevada Medical Group’s Los Altos location in Sparks. She completed her undergraduate degree at the University of Nevada, Reno and her medical training at the University of Nevada School of Medicine. Dr. Magrini has practiced family medicine for seven years, including residency, and enjoys her specialty, because she likes taking care of the whole family, from newborns to grandparents. She likes preventative medicine, helping people take care of themselves and the relationships she is able to form with her patients. Dr. Magrini grew up in Sparks, NV and likes that it is a safe place to live with great educational opportunities and beautiful scenery. She thinks Northern Nevada is a great place to raise a family and looks forward to raising her own children here. In her spare time, she enjoys outdoor activities such as hiking, biking, camping, boating, running and traveling the world. Dr. Magrini is also very close with her family; she is married to her high school sweetheart and values spending time with him and the rest of her family. Disclosure: "The author is a licensed physician practicing with Northern Nevada Medical Group, but all opinions expressed are solely the opinions of the author and do not necessarily reflect the views of Northern Nevada Medical Group or any other affiliates of Universal Health Services, Inc."

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