Many pregnant women with a prior cesarean delivery have the option to attempt a vaginal birth after cesarean (VBAC), also known as TOLAC (trial of labor after cesarean). The decision whether to attempt VBAC or to schedule a repeat cesarean delivery depends on the woman’s preferences, as well as two clinical factors: the risk of VBAC and the likelihood of a successful VBAC. The risk of VBAC depends on several factors regarding the original cesarean delivery, as well as the overall health of the mother and her pregnancy. Regarding the likelihood of success, one important variable is the reason for the previous cesarean. For women who achieved full cervical dilation and began pushing but had a cesarean for “arrest of descent” (the baby did not descend into the pelvis), they were traditionally told that the likelihood of a successful VBAC was 50% or less.
At MFMA, we care for many women with previous cesarean deliveries and, under the right circumstances, support and encourage women who want to attempt VBAC.
In a recently published study in the Journal of Maternal-Fetal and Neonatal Medicine, we reported a high VBAC success rate for women with a prior cesarean delivery for arrest of descent under the care of our physicians. The overall VBAC success rate was 84% (92% for women with a prior vaginal delivery; 72% for women with no prior vaginal deliveries). This study demonstrates that women under our care with a prior cesarean delivery for arrest of descent need not be discouraged from attempting VBAC solely for concerns about low success rates.
For a more personal insight, see this calculator.
Maternal Fetal Medicine blogs are intended for educational purposes only and do not replace certified professional care. Medical conditions vary and change frequently. Please ask your doctor any questions you may have regarding your condition to receive a proper diagnosis or risk analysis. Thank you!