If you’ve already delivered a baby via cesarean (C-section), does that predetermine that you must deliver your next child that way too, or is it safe to attempt a conventional birth? You need to weigh these seven factors carefully if you are considering a vaginal birth after cesarean (VBAC):


1. The old myth has been busted: Having one C-section birth does not automatically lead to another. Experts cite that about 60-80% of women who choose to have a VBAC succeed (and the success rate is even higher if you had a vaginal delivery before an earlier C-section).


2. A key factor is the type of uterine incision you had the first time. “Women with high vertical uterine scars have greater risks of a dangerous uterine rupture (a tear in the uterine wall, often on the site of a prior incision) and infection than women who have more modern low-transverse (horizontal) scars,” said Rosalyn Miller, M.D., board-certified OB-GYN with Houston Methodist Obstetrics & Gynecology Associates at Sugar Land. Uterine rupture puts you and your baby at risk.


3. VBAC brings big benefits, which includes avoiding major surgery, decreased risk of medical complications and infection for both mother and baby, less blood loss, fewer blood transfusions, lower cost and a shorter hospital stay with a quicker postdelivery recovery time overall.


4. Patients who have a failed VBAC (when they must be switched to a C-section midway through delivery) have higher risks of uterine rupture and infection than patients who have a successful VBAC or elective repeat C-section. “As with any attempt to deliver vaginally, your doctor will recommend a C-section midway if there are any signs of fetal distress, if the infant is too large for your pelvis, or if the contractions are not productive and the cervix doesn’t dilate,” Miller added.


5. Experts advise against home VBAC deliveries. You must have an obstetrician and an anesthesiologist ready to perform an emergency C-section delivery in the event of a uterine tear, which can threaten the lives of both you and your baby.


6. Take your overall health into consideration — your doctor will. C-sections have been more frequently performed for women with medical risk factors or complications of delivery, such as diabetes, eclampsia, genital herpes, high blood pressure, incompetent cervix and uterine bleeding.


7. Neither an elective repeat C-section nor VBAC is risk-free; discuss the matter carefully with your partner and your health care provider.


Explore Your Birthing Options


With the adition of 24/7 OB hospitalists and OB emergency services, Houston Methodist Childbirth Center at Sugar Land can now offer VBACs as a birthing option. To schedule an appointment online with Rosalyn Miller, M.D., visit houstonmethodist.org/obgyn or call 281.882.3130. Together, you can discuss birthing options that may be right for you.


To learn more about Houston Methodist Sugar Land Hospital, visit houstonmethodist.org/sugarland or our Facebook page at fb.com/methodistsugarland for the latest news, events and information.