Vaginal Birth After Cesarean

Systematic Review


What are the risks of planned vaginal birth vs. planned cesarean section after previous cesarean section?


The risk of uterine rupture among women with a previous cesarean section increases by 2-9/1,000 for those planning vaginal versus cesarean delivery. Risk of uterine rupture increases when labour is induced and is reduced with a history of previous vaginal birth. Maternal mortality is 0.2-0.4/1,000 more frequent in planned caesarean versus vaginal birth. Comparisons of perinatal and neonatal mortality favoured caesarean section with differences in the range of 1-8/1,000. Overall, this review suggests that risks of serious adverse outcomes are elevated in association with planning vaginal birth after caesarean but that these risks are infrequent at less than 1%.