Labor Lens presents information neutrally. Choices belong to you and your care team.
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What is it
Labor and vaginal birth after one or more previous cesareans, after assessing eligibility and discussing risks and benefits.
How your body works here
A prior low-transverse uterine scar heals strongly but is not quite as elastic as unscarred muscle. During labor, contractions stretch the lower uterine segment repeatedly; in a small percentage of VBAC labors the scar can separate (rupture), which is why continuous monitoring and an available OR are standard. Most people whose labor starts spontaneously with a favorable cervix successfully deliver vaginally, because a spontaneously-progressing labor doesn't require the higher contraction intensity that induction agents produce.
Benefits (B)
- Avoids repeat major surgery.Review sources ↓
- Generally faster recovery.Review sources ↓
- Implications for future pregnancies are typically more favorable.Review sources ↓
Risks (R)
- Small but serious risk of uterine rupture (often quoted around 0.5–0.9% for prior low-transverse cesarean).Review sources ↓
- Need for continuous monitoring and an immediately available surgical team.Review sources ↓
Alternatives (A)
- Planned repeat cesarean.Review sources ↓
Evidence summary
ACOG considers VBAC a safe and reasonable option for many candidates, particularly with one prior low-transverse cesarean. Success rates and risks depend on individual factors.
Sources
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Questions to ask your provider
- Am I a candidate?
- What's the hospital's experience with VBAC?
- What is the plan if labor doesn't progress?
Intuition & Nothing/Wait (the I and N in BRAIN)
What is your gut telling you? What happens if you do nothing or wait?
Add to my birth plan
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This is a personal preference, not a decision. Final choices happen in conversation with your care team.
After you talk it through
Once you've discussed this with your care team, log the outcome — the decision, why you chose it, and the evidence you saw — in your private decision journal.
Log this decision →