Vaginal birth after cesarean section: What are the risks?

Vaginal Birth After Cesarean Section: What Are the Risks?

A vaginal birth after a Cesarean section (VBAC) is a viable and safe option for many women, offering a chance for a natural birth experience and a swifter recovery. However, VBAC is not without risks, and the thin line between a successful VBAC and an adverse outcome can be influenced by various factors, including medical malpractice

This article provides an in-depth look at VBAC, including potential risks, to help expectant mothers make informed decisions in cases of birth trauma and consult a birth trauma lawyer.

Understanding VBAC and Its Risks

VBAC refers to giving birth vaginally after a previous pregnancy was delivered by Cesarean section. This approach is considered for women who have had one or two previous Cesarean deliveries and are pregnant again, but want to avoid another surgery.

The success rate of VBAC varies, but typically falls between 60% and 80%, depending on numerous individual factors.

Risks Associated With VBAC

While VBAC is associated with lower morbidity than repeat Cesareans in some cases, it also carries risks that must be carefully weighed. Understanding these risks and the potential for medical malpractice is crucial for both patients and healthcare providers to make informed decisions and ensure the safety of both mother and child.

One of the most severe risks associated with VBAC is uterine rupture, where the scar from the previous C-section tears open. When uterine rupture happens, it can lead to severe blood loss in the mother and oxygen deprivation in the baby, potentially resulting in life-threatening situations for both.

The signs and symptoms of uterine rupture include the following:

  • Fetal distress: The first sign of uterine rupture may be a sudden change in the baby’s heartbeat, often slowing down drastically (bradycardia).
  • Vaginal bleeding: Uncontrolled bleeding may occur, though it is not always present.
  • Abdominal pain: Some women experience intense pain in the abdomen as the uterus tears.
  • Shock and rapid pulse: In severe cases, the mother may experience signs of shock, including a fast heart rate and low blood pressure.

Other Complications

Other potential risks associated with VBAC include:

  • Infection: Both VBAC and repeat C-sections carry a risk of infection, but the risk profiles differ based on individual health and procedural circumstances.
  • Labour complications: These can include stalled labour or issues with the baby’s heart rate, leading to emergency interventions.
  • Perineal trauma: This is more common in vaginal births, but a considered risk in VBAC due to potential interventions.

When is VBAC considered safe?

The following factors are crucial in determining whether a VBAC might be successful or if the risks outweigh the potential benefits:

Type of Previous Cesarean Incision

  • Low transverse incision: This horizontal cut across the lower part of the uterus is associated with the highest VBAC success rates due to lower risk of uterine rupture.
  • High vertical (classical) incision: A vertical cut in the upper uterus significantly lowers the chances of successful VBAC because it increases the risk of uterine rupture.

Number of Previous Cesareans

  • Single previous Cesarean: Women with only one prior Cesarean often have a higher success rate for VBAC.
  • Multiple Cesareans: Success rates decline with each additional Cesarean due to increased scar tissue and other complications.

Interval Between Pregnancies

  • A shorter interval between deliveries (less than 18 months) can reduce VBAC success due to insufficient healing time for the uterine scar.
  • Longer intervals typically increase the chances of success.

Maternal Age

  • Women younger than 35 tend to have higher VBAC success rates than older women, possibly due to more favourable biological and health conditions.

Pelvic and Uterine Factors

  • A favourable pelvic shape and a positive history of vaginal delivery (even after a Cesarean) enhance the likelihood of a successful VBAC.
  • Conditions like a high Bishop score, indicating a cervix favourable for delivery, also improve VBAC prospects.

Labour Characteristics

  • Induced labour: Using certain methods to induce labour can lower VBAC success compared to spontaneous labour due to the increased risk of complications.
  • Progress of labour: Women who have previously reached full dilation before a Cesarean have a higher chance of a successful VBAC.

Fetal Factors

  • Size of the baby: Larger babies (macrosomia) can reduce VBAC success due to the higher risk of complications during labour.
  • Position of the baby: Non-vertex positions (like breech) decrease the likelihood of successful VBAC.

Experience and Attitudes of the Healthcare Provider

  • The expertise and support of the healthcare team are critical. Providers who are experienced and supportive of VBAC can significantly influence outcomes.
  • Hospital policies, including guidelines for fetal monitoring and immediate surgical support, are also crucial.

The Role of Medical Providers

Obstetric caregivers have a heightened responsibility when managing VBAC patients. They must do the following:

  • Monitor labour progress: Careful monitoring of fetal health through fetal monitoring strips is essential. There is a lower threshold for intervening with a Cesarean section if there are signs of fetal distress.
  • Assess and respond quickly: Medical staff must be ready to perform an emergency Cesarean if the risks to the mother or baby escalate.
  • Thoroughly educate: Women considering VBAC should be well-informed about the risks, benefits, and potential outcomes to help them make a decision that aligns with their preferences and values.

Medical Negligence in VBAC Cases

Negligence may manifest when healthcare providers overlook pertinent medical histories or, fail to engage in comprehensive discussions regarding the associated risks with expectant mothers and require the involvement of a birth trauma attorney.

Healthcare providers must navigate the complexities of VBAC with utmost care to avoid medical negligence. Common issues in VBAC negligence cases include:

  • Failure to communicate risks and benefits: A lack of comprehensive discussion about potential outcomes, including uterine rupture, the likelihood of successful vaginal delivery, and emergency Cesarean scenarios.
  • Misjudging suitability: Permitting a VBAC when medical history or other health factors make the procedure too risky.
  • Delayed emergency response: Failing to quickly switch to a Cesarean delivery when there are signs of distress or other complications.
  • Inadequate monitoring: Not properly monitoring vital signs during VBAC, delaying the detection of fetal distress.
  • Lack of trained staff: Attempting VBAC in a facility where staff are not adequately trained can lead to substandard care.
  • Poor response to distress signals: Not acting swiftly on signs of fetal distress or other risk indicators to the baby.
  • Inadequate facilities: Performing VBAC in a hospital lacking the equipment or protocols for emergency Cesarean sections increases the risk of complications.
  • Absence of clear protocols: Failing to have or follow policies that guide the response to VBAC-related emergencies.

The Imperative of Informed Consent

Informed consent is vital in VBAC discussions. Patients must be made aware of the following:

  • The risk of uterine rupture and its potential consequences.
  • The likelihood of requiring an emergency Cesarean section.
  • Comparative success rates and possible outcomes of opting for a VBAC.

Negligence claims can also arise when it is perceived that a healthcare provider failed to provide comprehensive risk information, especially if an adverse outcome was not fully communicated as a possibility.

Contact a Birth Trauma Lawyer Today for Help After a VBAC Complication

Obstetric malpractice claims are complex, requiring both medical expertise and legal acumen. Birth trauma lawyers possess in-depth knowledge and extensive trial experience in medical malpractice law. Moreover, consulting a birth trauma law firm can help guide you through your compensation for medical negligence. 

If you or your child has suffered from obstetrical malpractice resulting in birth trauma, seek legal guidance from a reputable birth trauma lawyer. At Sommers Roth & Elmaleh, we specialize in obstetrical malpractice and have a proven track record of advocating for families affected by birth injuries.

We offer compassionate, skilled, and knowledgeable guidance to ensure your case is handled with the care and attention it deserves. Contact Sommers Roth & Elmaleh online or call us at 1-844-940-2386 for a free consultation.

Disclaimer and Liability Exclusion

The information on this page is provided for general information purposes only. It should not be construed as legal advice. It does not constitute legal or other professional advice or an opinion of any kind. Readers should seek specific legal advice regarding any specific legal issues. We do not in any way guarantee or warrant the accuracy, completeness or quality of the information on this page. The posts on this page are current as of their original date of publication, but they should not be relied upon as timely, accurate or fit for any particular purpose.

Accessing or using this web site or the content herein does not create a lawyer-client relationship.

This page may contain links to third party web sites. We are unable to, and do not, monitor and guarantee the quality of the information disseminated and accessible through those links, which are provided for convenience only. We do not endorse the information contained in linked web sites nor guarantee its accuracy, timeliness or fitness for a particular purpose.

    If you have been affected by medical malpractice anywhere in Canada contact us for a free consultation.
    You pay us nothing unless we win.



    A lawyer from Sommers Roth & Elmaleh will be in touch with you as soon as possible. Please note that no lawyer-client, advisory, or fiduciary relationship is created by your inquiry. All information provided is confidential.

    The above information is not legal advice. Past results of cases and recoveries by our medical malpractice lawyers against hospitals, doctors, midwives, nurses and other healthcare professionals are not necessarily indicative of future results. The amounts recovered and other litigation outcomes will vary according to the facts in individual cases.


    See Our Lawyer's Reviews

    Hilt this Tamrate
    Hilt this Tamrate
    23 May 2023
    Trustindex verifies that the original source of the review is Google.
    Dear Mr Hilik Y. And Jeremy Syrtash. I would like to express my deepest gratitude to you and Sommers Roth and Elmaleh Professional Corporation staff for all you have done with respect to my wife case. My wife was a victim of Medical Malpractice after giving birth to our daughter. She become legally disabled both physically and mentally. The entire family devastated emotionally as my wife struggle to cope with the new reality. The case of Medical Malpractice is quite often a complex case to prove. However, due to your strong commitment, knowledge and dedication combined with strong professionalism the case was successfully won after a long arduous fight. The victory would not have been possible without your dedication and thorough research in the implementation of the standards of the Sommers Roth and Elmaleh Professional Corporation. Justice prevailed at last which in turn allowed my vulnerable wife to feel more optimistic about her future and that of our family. The positive outcome of this case has changed our lives forever. It would not have been possible without the excellent representation of Sommers Roth and Elmaleh Professional Corporation and its legal counsel. My wife and I will be deeply grateful for the successful outcome of this case for many years to come. Solomon Regassa
    Hector Cardenas
    Hector Cardenas
    4 January 2023
    Trustindex verifies that the original source of the review is Google.
    I would like to take this opportunity to express my most sincere gratitude towards Sommers Roth & Elmaleh, from the day I met with Hilik and his team, they been not only highly knowledgeable but also extremely sensitive towards me and my family, providing us with the best legal service possible. It goes without saying, that I strongly recommend them to anyone looking for a charismatic, quality and result oriented legal team.
    JERRY ZHOU
    JERRY ZHOU
    10 October 2022
    Trustindex verifies that the original source of the review is Google.
    We deeply appreciate Sommers Roth & Elmaleh for their professional skills and hard-working through the whole process of my son’s case. I still remember the first conversation we took with Mr. Hilik Y Elmaleh in his lawyer office sixteen years ago. From then on, your dedication, patience, understanding and continuous communications kept our encouragements and expectations for my son and our family. With the case settled down, my son can receive the full financial support, continuous therapies and finishing his university course. It is no doubt to say that Sommers Roth & Elmaleh not only changed our family’s life but also did contributions to the society, because my son can grow in a happy and health way in his teenage and receive university education from this autumn. Again we hereby strongly recommend the services provided by the lawyer office Sommers Roth & Elmaleh to those who needs the similar legal consultation and support. Even the door of your family was closed by some unfortunate events, there are more windows can be opened. The lawyers in Sommers Roth & Elmaleh are exactly the people who can open the windows and convert the sun-shine again to your family: Mr. Hilik Y Elmaleh,Mr.Jeremy Syrtash, Miss Fanny Peter ...etc. Finally, we express the deepest gratitude and appreciation again to Mr. Hilik Y Elmaleh and lawyer office Sommers Roth & Elmaleh. Wish a brighter future of Sommers Roth & Elmaleh !
    Meggie Zhangkrk6hdjybfjt
    Meggie Zhangkrk6hdjybfjt
    6 October 2022
    Trustindex verifies that the original source of the review is Google.
    I am so glad that my son's CP medical case was completely successful. I appreciate lawyer Hilik Elmaleh, Jeremy Syrtash, Fanny Peter and their team's hard work. They are so knowledgeable, responsible and reliable. Thanks is not enough to express my gratitude. Mr. Hilik Elmaleh deserves "The Best Lawyer in Canada" award.
    Tony Zhou
    Tony Zhou
    29 September 2022
    Trustindex verifies that the original source of the review is Google.
    I would like to extend my gratitude towards Mr. Hilik Elmaleh, Jermey Syntash, and Fanny Peter for their dedication, time, effort, and knowledge invested into my case. This is honestly the best team of lawyers in Canada. I would highly recommend them for any of your cases.
    Dianne Keckes
    Dianne Keckes
    18 July 2022
    Trustindex verifies that the original source of the review is Google.
    I would like to take this opportunity to thank our daughter's "Dream Team", Hilik Elmaleh, Jeremy Syrtash and Fanny Peter. The compassion, dedication, knowledge, experience and their recognition in the legal community have ensured us that we were on the right track working with the firm Sommers, Roth and Elmaleh. Words cannot express enough my gratitude! I will be forever grateful!
    Ivica J Sokic
    Ivica J Sokic
    6 June 2022
    Trustindex verifies that the original source of the review is Google.
    Thank you does not begin to express the depth of gratitude I have for Sommers Roth & Elmaleh Professional Corporation. From the first day I sat in Hilik's office, not once did I feel apprehensive. My concerns and worries were put at ease due to the kindness and compassion of Hilik, Jeremy and Fanny and their relentless persistence to secure my daughter's future. This has been a long but successful endeavor during some difficult times and through it all, the Team has been resilient, informative and were always available. I highly recommend this dedicated and professional law firm and I will be forever in their debt.
    Arden Melnechuk
    Arden Melnechuk
    1 December 2021
    Trustindex verifies that the original source of the review is Google.
    I was in a serious horse accident where the horse was injured and should never have been ridden. The owner of the horse was aware that the horse had chronic arthritis issues and the veterinarians at Guelph had told him the horse could decompensate at any time and could cause serious injury whether being led or ridden and could never be jumped again. The horse had been shown at the grand prix level and the owner had payed quite a bit of money for him. After consulting with several lawyers and having one that did represent me at the discoveries who later quit, Jeremy Syrtash took on the case and followed through with guelph university. That is how we found out that the vets had recommended the above. Without Jeremy's efforts and follow through the case would never have continued on. Because of these efforts the case was successful. Thank you so much Jeremy. You are a dedicated, thorough, excellent lawyer and it's been a pleasure to have you as my lawyer!!
    Megha Sharma
    Megha Sharma
    16 April 2021
    Trustindex verifies that the original source of the review is Google.
    Mr. Elmaleh and his team are very professional and experts in their field. Recommend to everyone who has suffered medical negligence.
    Nick & Whitney Maraschiello-Basnett
    Nick & Whitney Maraschiello-Basnett
    18 July 2020
    Trustindex verifies that the original source of the review is Google.
    We want to start by saying how much we highly recommend Sommers, Roth and Elmaleh for anyone who is dealing with a situation involving medical malpractice. Hilik and the entire firm have allowed us the opportunity to give our little girl the life she deserves. There is no taking back what happened, but they truly turned such a tragedy into a victory. They fought long and hard, and put forth so much time and effort into making the individuals accountable and responsible for the mistakes that were made. They always showed true compassion for our family, guided us with ease, and supported us through every step. This was such a life changing experience with the firm, and honestly we will always be forever grateful and thankful.