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June 20, 2013
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Vaginal Birth After Cesarean Delivery (cont.)

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Predicting Successful Vaginal Birth after Cesarean Delivery

Although each woman's pregnancy is unique, and no one factor can predict with certainty who will be successful in having a vaginal birth after cesarean (VBAC), certain factors can help a doctor predict which women might be more successful in delivering their babies vaginally after a cesarean birth:

  • VBAC is less successful in women weighing over 200 pounds.
  • Women over older than 35 years have higher rates for cesarean delivery, and women older than 40 years have a 3-fold higher risk of requiring a cesarean. VBAC tends to be successful much less often in these women.
  • The greater the baby's birthweight, the less the likelihood of successful VBAC.
  • The reason for a previous cesarean delivery can help in decision making. The doctor will carefully examine medical records of previous births to find out why a woman had a cesarean, such as a breech position or other complication. The reason for a previous cesarean birth can be a predictor of success with VBAC.
    • Women who have had a cesarean because of breech positioning or placenta previa had high rates of success with VBAC (77-89% in some studies).
    • A woman who has had no vaginal deliveries or a cesarean delivery performed in the second stage of labor is not a good candidate for VBAC.
    • A woman who has had a previous vaginal delivery may have an 89% success rate for VBAC.
    • If a woman has delivered vaginally after cesarean before, her success rate is 93%.

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