If you have already had an emergency or planned Cesarean, you may be able to attempt a vaginal birth with this baby. This birth is known as a VBAC.
The decision will be one that you and your health care provider will make together.
These are the guidelines for being able to have a VBAC, according to the American College of Obstetricians and Gynecologists (ACOG):
You should not attempt a home vaginal birth. The ACOG recommends that a surgeon, nurses and an anesthesiologist are immediately available in case an emergency Cesarean is needed.
You and your health care provider should review the benefits and risks of a VBAC and consider what is best for you. He or she will fully talk about the risks with you.
There is no guarantee that a VBAC will work. About 60 to 80 percent of women who try a VBAC are successful.
If it is not successful and a Cesarean is needed, the risk of problems for both you and your baby is greater with an unplanned or emergency Cesarean than with a planned repeat Cesarean.
There is an increased risk of uterine rupture, which is a tear or opening in the uterus. This happens for five to 15 out of every 1,000 women who try a VBAC. The risk is slightly higher for a VBAC than for other vaginal deliveries.
You have options to control pain during a labor and vaginal birth. The most common option is a labor epidural.
The doctor inserts a small catheter (thin plastic tube) into your lower back. The tip of the catheter rests in the area just outside the spinal cord. This area is called the epidural space. Medicines to control labor pain are given through the catheter
Your health care provider will explain the benefits and risks of a labor epidural. He or she can explain other pain control options that are available. Together, you and your health care provider can create a pain management plan before your delivery.
You may have mixed or negative feelings about giving birth vaginally.
You may be afraid to attempt labor, not knowing what to expect. You may favor a Cesarean because you know what to expect. If your last birth started with labor and ended with a Cesarean, you may not want to go through labor again.
Remember, each pregnancy and labor is different. In deciding if a VBAC is right for you, your health care provider will take your specific health into account.
Childbirth and VBAC classes can help answer your questions.
Allina Health's Patient Education Department, Beginnings: Pregnancy, Birth and Beyond, seventh edition, ob-ah-90026
Allina Health's Patient Education Department experts
Watch a short video on labor epidurals.