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We get this question frequently from mothers who have had one or more c-sections and would prefer a vaginal birth with a subsequent pregnancy.
We asked Seth Brody, OB/GYN and executive medical director for women’s services at WakeMed, to provide some guidance for expectant mothers on this question. Here is his answer:
“In general, we are very supportive of VBACs at WakeMed’s three birthing centers and at WakeMed Physician Practices – OB/GYNs and Maternal Fetal Medicine. The majority of time, a vaginal birth after one c-section is successful with no complications. However, there is still a slightly higher risk, less than 1% in most cases, of uterine rupture even after one c-section. But, as long as a thorough review of the history as well as the benefits and risks of VBAC are discussed, and the patient and the physician agree, then WakeMed and WakeMed’s physicians are supportive of a VBAC.
If the mother has had two or less cesarean sections and her records confirm a transverse or side-to-side cut in the lower part of the uterus, then we do support VBAC after counseling with a physician.
Things get more complicated if the mother has three of more c-sections because her risk for uterine rupture will be higher. This is not to say that a VBAC is out of the question, but it would be very important for the mother to be well-informed of the risks, have a strong partnership with a physician who specializes in high-risk deliveries and the delivery should occur at Raleigh Campus where there are high-level services available in the event of complications.
It is also a great idea for any mother, regardless of the number of c-sections, to have a consultation with a maternal fetal medicine provider. WakeMed Physician Practices – Maternal Fetal Medicine physicians offer appointments at both Raleigh Campus and at WakeMed North.
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