By Mark Schemmel, M.D.
Patients often ask if having had a cesarean once means that they will always require a cesarean. The fact is that most women who have had a single prior cesarean are candidates for what we call TOLAC, or a trial of labor after cesarean. Many of these women have a high likelihood, 60-70% or better, of succeeding in achieving a VBAC (vaginal birth after cesarean). Individual likelihood of success is variable depending on a number of factors. This can be determined through consultation with your obstetrician as part of an overall discussion of the pros and cons of TOLAC.
When discussing chances of vaginal deliver after cesarean, your doctor will consider the reasons for having had a prior cesarean as well as medical conditions and disorders, gestational diabetes, and current pregnancy complications. There is always a risk associated in attempting a vaginal delivery after cesarean. Risks to the mother include having another unsuccessful labor leading to repeat cesarean. Risk to the baby (and mother) include uterine rupture.
Your obstetrician will assist you in consider all of this information and deciding whether or not TOLAC is the best choice for you.