Between 60 and 80 percent of women who have had a cesarean are later able to give birth vaginally, according to recent studies. Women with the best chance of a VBAC are those who had a cesarean because of a breech presentation or other factors that are unlikely to recur.
However, even two thirds of mothers whose cesarean was for cephalopelvic disproportion (CPD) or failure to progress in labor can give birth vaginally. Today, rather than automatically recommending a repeat cesarean, most obstetricians encourage their patients to try to give birth vaginally.
If you are contemplating a VBAC, you need to meet these criteria, according to the American College of Obstetricians and Gynecologists (ACOG).
- Your previous uterine incision was made horizontally rather than vertically; this incision may or may not be similar to your skin incision.
- You do not have a contracted (unusually small) pelvis.
- You are not expecting more than one baby (although you may be able to have a VBAC under some circumstances).
- Your baby is entering the birth canal headfirst.
ACOG also has recommendations about your VBAC birthing facility. It should offer:
- The ability to perform an emergency cesarean within a 30-minute period.
- The availability of continuous electronic fetal monitoring.
- The services of a fully equipped, round-the-clock blood bank.