The possibility of a vaginal birth after a previous cesarean section is an important issue for many reasons. Normal childbirth is more physiological, so the recovery period is shorter. The woman in labor feels strong and stable to take care of the newborn immediately after birth. Complications in the form of infection, excessive bleeding, venous thromboembolism, trauma to abdominal organs adjacent to the uterus, are much rarer than with cesarean section. Vaginal birth after a C-section is an event that should be approached with the necessary prior awareness and preparation. It has its benefits, but also risks. Because the surgical incision results in a uterine scar, there is concern that the pressure of labor may cause the uterus to rupture at the site of the incision. However, according to the American Pregnancy Association, published studies show that 60 to 80 percent of women who give birth by cesarean section have a successful vaginal birth afterward for their next child. This statistic is supported by another from the National Institute of Child Health and Human Development, which shows that about 75% of vaginal birth attempts after C-section are successful. According to the American College of Obstetricians and Gynecologists, the risk of uterine rupture with a previous horizontal (transverse) cesarean section is less than 1 in 100. What problems can occur with uterine rupture? Profuse blood loss; Hysterectomy; Formation of blood clots; Bladder damage; Infection. Does the type of incision made during a cesarean section affect the risk of future uterine rupture? A low transverse incision is associated with the lowest risk of uterine rupture. This horizontal incision is made through the lower, thinner part of the uterus. A low vertical incision is associated with a higher risk of rupture than a low transverse incision. This vertical incision is made in the lower, thinner part of the uterus. A high vertical incision at the top of the uterus is associated with the highest risk. This type of incision is sometimes done to deliver premature babies. It is important to note that the location and direction of the external incision in the abdomen does not mean that the incision in the uterus is made in the same place or in the same direction. Information about the location and direction of the uterine incision should be in the birth medical record. The chances of a vaginal delivery after cesarean are increased with a previous low-cut cesarean delivery, no uterine scarring or abnormalities, or a previous vaginal cesarean delivery without complications such as uterine rupture. What are the benefits of vaginal birth after cesarean section? The advantages of a vaginal delivery after a C-section compared to a C-section include:Faster recovery; Birth without abdominal surgery; Less blood loss; Vaginal birth helps clear the baby’s lungs as the baby passes through the birth canal. This better prepares the baby for the act of breathing after birth; A boost to babies’ immune systems can come from the good bacteria they pick up on their journey through the birth canal. References: 1. National Partnership for Women & Families. Childbirth Connection. VBAC Basics. (http://www.childbirthconnection.org/giving-birth/vbac/basics/) 2. Lamaze International. Reasonable Choices for Bringing Back VBAC. (https://www.lamaze.org/Connecting-the-Dots/Post/TitleLink/Reasonable-Choices-for-Bringing-Back-VBAC) 3. American Pregnancy Association. Vaginal Birth After Cesarean: VBAC. (https://americanpregnancy.org/healthy-pregnancy/labor-and-birth/vaginal-birth-after-cesarean/) 4. National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development. What is vaginal birth after cesarean section (VBAC)? (https://www.nichd.nih.gov/health/topics/labor-delivery/topicinfo/vbac) 5. National Institutes of Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development. What are some common complications during labor and delivery? (https://www.nichd.nih.gov/health/topics/labor-delivery/topicinfo/complications)