Can I Have a Vaginal Birth If I Had a Previous C-Section?

I had a C-section with my first child. Now that I'm pregnant with my second, I'd really like to try to have a vaginal delivery. But is that safe — for me and my baby?
– Danae

Many women who have had a cesarean section (or C-section) with their first pregnancy are interested in a vaginal delivery for their second or later births. For years, women who'd had a C-section were encouraged to skip vaginal deliveries altogether and schedule C-sections for all future births.

But these days, a vaginal birth after cesarean (or VBAC) is considered a safe option for many women and their babies. And, with a vaginal delivery, you can come home sooner and recover quicker.

The reason for your first C-section, the type of incision made on your uterus, and other factors in your medical history will determine whether or not you can have a VBAC:

• A transverse incision (also known as a horizontal incision) cuts across the lower, thinner part of the uterus. It is used during most C-sections and makes a VBAC much more likely.
• A vertical incision cuts up and down through the uterine muscles that strongly contract during labor, and is riskier for a VBAC because it might cause uterine rupture (a tear in the uterine muscle).

The incision on your skin does not necessarily go in the same direction as the incision on your uterus. Also, if you've had more than one C-section, a VBAC might not be an option.

Of course, not all women who try to have a VBAC succeed. The American College of Obstetricians and Gynecologists (ACOG) estimates that about 60% to 80% of women who try to have a VBAC succeed.

Although a VBAC does come with risks, many women are able to have one with no complications at all. If you're interested in having a VBAC, talk to your doctor to weigh the risks and benefits. And check with your hospital well in advance to make sure they'll allow it — if they don't and you have your heart set on a vaginal birth, you may need to change hospitals.