If you've already had a baby by cesarean section, it doesn't rule out the possibility of vaginal birth for your next delivery. Many women deliver a baby vaginally after a previous cesarean without incident. But along with the benefits of vaginal birth after cesarean (VBAC), there are risks you need to be aware of. Read these important facts, and discuss your concerns and wishes with your obstetrician.

Who can have a VBAC?
According to the American College of Obstetricians and Gynecologists (ACOG), of the women who attempt VBAC about 60 to 80 percent are successful. The remaining women end up having another cesarean. If you're healthy, and have no pregnancy risk factors, then VBAC may be a possibility your obstetrician can help you evaluate.

What are the benefits of VBAC?
There are several reasons why you might want to try VBAC. Some women simply want to try the experience of vaginal birth. There are also medical reasons why VBAC appeals to women and their health-care providers instead of a repeat cesarean:

• Elimination of the need for abdominal surgery, which has inherent risks (infection, hemorrhage, and anesthesia-related complications, for instance)
• Reduction of the risk for possible blood transfusions, thus decreasing risk of blood-borne disease
• Decreased length of hospital stay
• Shorter time needed for recovery

What are the risks of VBAC?
The primary risk factor for VBAC is the possibility of uterine rupture. Uterine rupture can be life-threatening for mother and baby. The likelihood of uterine rupture is rare, but because it's a serious situation, your risk must be carefully evaluated by your health-care provider. A development in a July 2001 study by researchers at the University of Washington in Seattle published in the New England Journal of Medicine indicates that there's an increased risk of uterine rupture with VBAC, especially if you need to be induced. The risk varies depending upon previous deliveries, length of labor, and other factors your health-care provider will determine upon evaluating you as a possible candidate for VBAC.

Also, according to the ACOG there's a greater risk of infection for mother and baby in cases of attempted VBAC followed by cesarean. Nevertheless, if you're going to have a VBAC, you should give birth in a facility that's equipped to do emergency cesareans, should the need for one arise.