Did you know that if you had a previous C-section you are still able to have a safe vaginal delivery?
Yes, it is totally possible and the odds are in favour of a successful and safe vaginal birth.
According to the Society of Obstetricians and Gynaecologists of Canada (SOGC) practice guidelines, the success rate of Vaginal Birth After Cesarean (VBAC) in Canada is of 76.6%. They also recommend that a woman with a healthy pregnancy and no contraindications should be offered a Trial of Labour (TOL) or VBAC.  (Canadian Guidelines for VBAC-SOGC-Feb-2005)
One of the reasons why VBAC is emphasized by SOGC recommendations, as well as by the American College of Obstetricians and Gynecologists (ACOG) is that a repeat Cesarean can increase the risks of placenta accreta (e.g. placenta abnormally attaches to the uterine wall. It does not detach normally after the baby is born). In fact, the rate of placenta accreta after two Cesareans is greater than the risk of uterine rupture after one Cesarean. Potential problems with placenta accreta include maternal and/or neonatal death. 
What are the benefits of a VBAC?
The benefits of a VBAC instead of a repeat Cesarean include :
- No risk of complications from an abdominal surgery;
- Decreased risk of blood loss;
- Less pain;
- Decreased risk of a postpartum fever;
- Decreased risk of an infection;
- Being able to walk sooner after birth;
- Much shorter recovery time;
- Satisfaction of having a vaginal birth;
- Earlier start to breastfeeding and better success with breastfeeding at three to six to six months;
- Fewer potential complications for the newborn.
What are the Contraindications to VBAC?
The contraindications to a woman planning a VBAC by most guidelines and professional organizations are:
- Previous uterine scars of the following types: classical or inverted “T” (Uterine Incision Types);
- Previous surgeries entering the uterine cavity, such as hysterotomy (an incision in the uterus, normally performed during a C-section, or fetal surgery, and/or various gynaecological procedures) or myomectomy (surgical procedure to remove uterine fibroids — also called leiomyomas);
- Previous uterine rupture;
- Presence of a contraindication to labour such as placenta previa or baby in breech position.
- A woman declining VBAC and requesting a Cesarean section.  
What are the risks associated with VBAC?
- Uterine rupture. This is a tear near the scar on your uterus from your previous Cesarean birth(s). If this occurs, an emergency C-section birth will be done. Uterine rupture can lead to the need for a blood transfusion and/or the removal of your uterus.  The risk of uterine rupture is about 0.4% to 0.9% after one prior Cesarean and is dependent on multiple factors. This is a similar rate to other obstetrics emergencies that first time mothers can experience. 
Risks associated with a VBAC are higher for women who:
- Have had a Cesarean birth less than 18 months ago;
- Are older than 35 years of age;
- Have a body mass index (BMI) greater than 30 kg/m2;
- Are given medication to start (induce) or speed up (augment) their labour;
- Even after 2 or more Cesarean births, a VBAC can be attempted, although the risk of complications is higher.  
It is important to be informed of the benefits and risks associated with VBAC, as well as of what is happening to your own body. Also to know the reasons why VBAC is recommended as a first choice to women who had previous C-sections.
I hope this info brings valuable information to your decision making regarding your pregnancy and birth choices and empowers you as well.
- Martel MJ, MacKinnon CJ; Clinical Practice Obstetrics Committee, Society of Obstetricians and Gynaecologists of Canada, Guidelines for Vaginal Birth After Previous Caesarean Birth, J Obstet Gynaecol Can. 2005 Feb;27(2):164-88.