The most rare yet most serious risk of vaginal birth after cesarean (VBAC) is that the scar on the uterus may break open (rupture) during labor. Women who have a low transverse cesarean scar have a lower risk of rupturing than women who have a vertical incision scar. About 5 out of 1,000 women (0.5%) with a low transverse scar have a uterine rupture during a trial of labor.
A woman's risk of uterine rupture increases with:
- Each additional uterine surgical scar.
- Any uterine scar that reaches above the lower, thinner part of the uterus, such as a vertical (classical) scar.
- The use of medicine to start (induce) labor. Some doctors avoid the use of any medicine to start a VBAC trial of labor. Other doctors are comfortable with the careful use of certain medicines to start labor.
In the rare event that a uterine scar ruptures, it can be dangerous to both the mother and her infant.
Depending on severity, a rupture can:
- Be mild and harmless.
- Often be repaired. If it is not repairable, the uterus is removed (hysterectomy).
- Cause severe maternal bleeding and a decrease in oxygen to the baby.
- Cause fetal brain damage or death.
Current as ofMay 29, 2019
Author: Healthwise Staff
Medical Review: Sarah A. Marshall, MD - Family Medicine
Adam Husney, MD - Family Medicine
Kathleen Romito, MD - Family Medicine
Kirtly Jones, MD - Obstetrics and Gynecology, Reproductive Endocrinology
Current as of: May 29, 2019