You may be wondering, if I have one VBAC what happens in my next pregnancy? Am I still viewed as a VBAC?

The short answer, is yes, with a uterine scar there are risks associated with each subsequent pregnancy. The good news is these risks decrease with each additional vaginal birth after your cesarean section birth. There is not much available in updated research and literature, but there was a secondary analysis of a large study that looked at over 13,000 women attempting a VBAC in 2008.

VBAC Success

Vaginal delivery was achieved in women who had no prior VBAC 63.3% of the time, one prior VBAC 87.6% of the time, and two or more VBAC’s 90.0% of the time. There seemed to be no statistical difference once a woman had experienced two or more VBACs.

Uterine Rupture

The risk of uterine rupture decreased from 0.87% of women with no prior VBAC to 0.43-0.45% in women with a prior VBAC.

Other Risks Associated with VBAC

These risks also decreased with 1 or more VBACs

· Blood transfusion

· Blood clots

· Uterine infection

· Uterine dehiscence

· Hysterectomy*

· Poor neonatal outcomes*

· Maternal death*

* showed downward trends that were not statistically significant

So while the answer is yes, once a VBAC, always a VBAC, there is reassurance in the risks to a VBAC are decreased after one or more VBACs. And since these risks are low to begin with, perhaps the substantial rise in vaginal delivery after one successful VBAC is some of the most hopeful data gleaned from this study. When staring down your first VBAC, one of the greatest questions is, “will I deliver vaginally”? When facing your second VBAC, you can almost assuredly say, “yes I will deliver vaginally!”