Who is Eligible for a Vaginal Birth After Cesarean (VBAC)?
Not all women are suitable candidates for a vaginal birth after cesarean (VBAC). However, there are certain factors that can determine if a woman is eligible for this option. For instance, women who are pregnant with only one baby and have a history of one or two low transverse C-sections or one C-section with an unknown incision type, may be considered good candidates for a VBAC. It is important to note that if the doctor suspects a high vertical incision, this may affect the eligibility for a VBAC.
In the case of twin pregnancies, a woman with a history of one low transverse C-section could be deemed as a suitable candidate for future vaginal births.
Who Does Not Qualify for VBAC?
While vaginal birth after a cesarean (VBAC) can be a safe option for many women, there are certain circumstances in which it may not be recommended. Here are some factors that make a woman ineligible for VBAC:
- High Vertical or Classic Incision: If a woman had a previous cesarean with a high vertical or classic incision, VBAC may not be possible due to the increased risk of uterine rupture.
- Prior Uterine Rupture: If a woman has experienced a uterine rupture in a previous pregnancy, attempting a VBAC is generally considered unsafe.
- Prior Uterine Surgery: Certain types of uterine surgery, such as a myomectomy (removal of fibroids) or a surgery to repair a uterine malformation, may make VBAC less likely to succeed.
- Multiple C-Sections: Women who have had multiple previous cesarean deliveries may have a higher risk of complications during a VBAC.
- High BMI: Women with a body mass index (BMI) higher than 40 are generally not recommended for VBAC due to increased risks associated with obesity.
- Pregnancy with Triplets or Higher-Order Multiples: The presence of multiple fetuses can increase the complexity and potential risks of a VBAC, making it less likely to be recommended.
There are also other factors that can indicate a lower chance of success with a VBAC:
- Induction of Labor: If labor needs to be induced, the chances of a successful VBAC may decrease.
- Stalled Labor: If labor fails to progress or becomes prolonged, a VBAC may not be feasible.
- Advanced Maternal Age: Women who are of advanced maternal age (typically above 35 years) may have a lower likelihood of a successful VBAC.
- Excessive Pregnancy Weight Gain: Excessive weight gain during pregnancy can increase the risks associated with VBAC.
- Preeclampsia: Women with preeclampsia, a condition characterized by high blood pressure during pregnancy, may not be suitable candidates for VBAC.