Pregnant-Woman

Once a C-Section, Always a C-Section?

Pregnant-WomanUAB Women & Infants Services is here for every mom-to-be, from family planning through pregnancy, delivery, and beyond. Our care teams are dedicated to providing the most comfortable, safe birthing experience for each of our patients, no matter the delivery method.

As a world-class medical center, UAB is equipped to help many moms who have had a prior c-section safely deliver future babies vaginally. It was once thought that if a woman had one c-section, any future birth would have to be via c-section. Today however, it’s a different story.

On average, 45 babies are born via VBAC (vaginal birth after cesarean) every month at the UAB Women & Infants Center. Women who are interested in having a VBAC are screened to determine the likelihood of successful delivery, says OB/GYN Sabrina Wyatt, MD.

Several factors contribute to a woman’s probability of having a successful VBAC. “Patients with the highest likelihood of success and thus the best candidates are women who have had a prior vaginal delivery, whether before or after their cesarean delivery, and those whose cesarean delivery was performed for a nonrecurring indication such as breech presentation or nonreassuring fetal monitoring,” Dr. Wyatt says.

“The patients with the lowest likelihood of success are those with recurring indications for their prior cesarean (labor dystocia or failure to progress) as well as no prior vaginal deliveries, maternal obesity, and gestational age longer than 40 weeks,” Dr. Wyatt says. “Induction of labor also increases the risk of failure if performed.”

Patients who are deemed acceptable candidates will discuss in detail the risks as well as the likelihood of their success with their care team, and the ultimate decision is left to the patient. “Women who undergo a trial of labor after cesarean after being found to be good candidates have a success rate—those achieving vaginal birth—of about 75 percent,” Dr. Wyatt says.

The American College of Obstetricians and Gynecologists recommends that facilities that offer trial of labor must have personnel who are able perform an emergent cesarean delivery immediately available. “At UAB, we have the luxury of always having just such staff on the labor and delivery unit at all times including obstetricians, anesthesiologists, and surgical/nursing staff,” Dr. Wyatt says. “We also have neonatology available at all times in case care of the newborn is needed.”

To learn more about the UAB Women & Infants Center and our services, and to take a virtual tour of our award-winning facilities, visit uabmedicine.org/women.

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