A vaginal delivery after a previous cesarean delivery. One of the most common reasons for cesarean sections is the presence of a uterine scar from a previous cesarean section. A previous uterine scar can tear or open up during a hard labor with a subsequent pregnancy. For many years it was thought that once a cesarean, always a cesarean. This is not so. If the incision from the previous cesarean section has been performed low on the uterus, the scar is often sufficiently strong to withstand labor.
The advantages of a VBAC are decreased risk of surgical complications and a shorter recovery period. However, a VBAC is not possible for everyone. The type of incision previously made is one important determinant. For example, if you had a classical incision through the uterus, which is high up on the uterus, an attempted vaginal birth would not be a good idea because there is a risk of uterine rupture during labor. Multiple fetuses, medical complications such as high blood pressure or abnormal fetal position may all require a cesarean section and prevent a VBAC trial. If a VBAC is attempted you will need fetal monitoring and IV in case a c section becomes necessary. The risk of uterine rupture is low, but if it occurs, the consequences can be severe for both the mother and the baby.