Vaginal birth after cesarean section – literature review and modern guidelines

Cesarean section is a major surgical procedure, with significant risks of developing postoperative complications. Consequently, any attempt of vaginal birth after an initial cesarean section (VBCS) aims to avoid such possible complications. The decision on how to give birth in patients with a previous cesarean section, which is complex and based on several factors, should be taken by the pregnant woman together with the obstetrician.

To understand the importance of VBCS, it is first necessary to evaluate its benefits and risks compared to C-section of the uterine scar. By choosing the natural birth route to the detriment of an iterative cesarean section, the potential complications of the latter are avoided. Patients with good labor trial and well monitored have generally better results in terms of complications, both for mother and child. Nevertheless, potential subjects for VBCS should be chosen following rigorous criteria.

As a conclusion, the VBCS decision should be taken by the pregnant woman in consultation with the obstetrician, the medical indications and contraindications being fundamental in choosing the method of birth. The most suitable candidates for the labor test after cesarean section would be those with a low risk of intrapartum uterine rupture. VBCS can decrease the incidence of cesarean section, reducing thus the complications associated with cesarean section for both mother and child.