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Evidence to Improve Care

4

Previous Vaginal Birth

Pregnant people who have had both a previous Caesarean birth and a previous vaginal birth are informed that they have a high likelihood of successful vaginal birth if no contraindication is present.


The strongest predictor of successful vaginal birth after Caesarean (VBAC) is a previous vaginal birth; in this scenario, the VBAC success rate is high—approximately 85% to 90%. Previous vaginal birth is also independently associated with a reduced risk of uterine rupture. Physicians and midwives should inform pregnant people who have had a previous Caesarean birth and a previous vaginal birth or VBAC that they have a high likelihood of VBAC success for the current pregnancy. Physicians and midwives should encourage planned VBAC if no contraindication is present because of the faster recovery time, lower risk of abnormal placentation with future pregnancies, and lower risk of harm from uterine rupture.

For Pregnant People

If you have had a vaginal birth before, you are very likely to have a successful vaginal birth after Caesarean, as long as there are no medical reasons to avoid one in this pregnancy.


For Clinicians

Inform pregnant people who have had both Caesarean and vaginal births, and who have no contraindications to vaginal birth in their current pregnancy, that they have a high likelihood of successful VBAC.


For Health Services

Ensure that processes and systems are in place to inform people who have had both Caesarean and vaginal births, and who have no contraindications to vaginal birth in their current pregnancy, that they have a high likelihood of successful VBAC.

Outcome Indicator

Percentage of pregnant people who have had a previous Caesarean birth and a previous vaginal birth, and who are planning a VBAC for their current pregnancy

  • Denominator: number of pregnant people who have had a previous Caesarean birth and a previous vaginal birth

  • Numerator: number of people in the denominator who are planning a VBAC for their current pregnancy

  • Data source: Better Outcomes Registry and Network


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