In plain words
VBAC stands for vaginal birth after cesarean. It means a woman who had a in an earlier pregnancy gives birth vaginally in a later one. Many women who try have a VBAC. Others end up with a repeat cesarean. Access to VBAC has changed a lot over the past decades, and it depends on where you give birth and on the type of incision from your earlier surgery. Your provider can tell you whether a VBAC is possible for your history. The choice is yours, and a repeat cesarean is also a safe option for many women.
The deeper version
VBAC is the outcome measure of a trial of labor after cesarean. The US VBAC rate fell from about 28 percent in 1996 to under 9 percent in 2006, after a 1999 ACOG bulletin (Practice Bulletin 5) emphasized the need for immediate surgical availability and hospital restrictions followed. It has risen to about 14 to 15 percent of births to women with a prior cesarean in CDC natality data for 2021 to 2023. Success rates are roughly 60 to 80 percent in cohorts of women with one prior low transverse incision. ACOG Practice Bulletin 205 (2019) supports TOLAC for appropriate candidates and describes the risks of uterine rupture, which are low but more consequential than in primary cesarean delivery. Access depends on hospital policy and surgical staffing, and this is the main controversy.
Where it comes up
- VBAC: birth after a cesareanGetting Ready for Birth
- Planning a cesareanGetting Ready for Birth
- Hospital, birth center, or homeGetting Ready for Birth
- What happens in a cesareanBirth and the First Days
What mothers here say about VBAC
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Sources
- American College of Obstetricians and Gynecologists — Practice Bulletin 205: Vaginal Birth After Cesarean Delivery, 2019
- American College of Obstetricians and Gynecologists — Practice Bulletin 5: Vaginal birth after previous cesarean delivery, 1999
- Centers for Disease Control and Prevention, National Center for Health Statistics — Natality data on birth by method and prior cesarean, 2021 to 2023