How Do I Know If I Can Have a Vaginal Birth?

If you have a C-section in your first pregnancy, you have about an 87% chance of having one in subsequent pregnancies. Here are some things you can do to reduce your chances of needing a C-section if this is your first pregnancy: 

Be careful with weight gain

Gaining more than the recommended amount of weight during pregnancy increases your odds of having a C-section. You should ask your doctor about your specific situation, but general guidelines for weight gain during pregnancy include: 

• Women who were underweight before pregnancy should gain 28 to 40 pounds. 
• Women who were a normal weight before pregnancy should gain 25 to 35 pounds. 
• Women who were overweight before pregnancy should gain 15 to 25 pounds. 
• Women who were obese before pregnancy should gain 11 to 20 pounds. 

Hire a doula

A doula is someone trained to give you nonmedical support during your labor and delivery. Doulas provide emotional support as well as information about your labor progress. Even if you have a supportive partner or family, you are less likely to have a C-section if you have a doula at your side. 

Expect to have a long labor

Stalled labor is the most common reason for C-sections. The American College of Obstetricians and Gynecologists (ACOG) does not recommend C-sections for prolonged early stage labor. Early stage labor is labor that occurs before you're 6 centimeters dilated. This stage of labor can last over 20 hours, so be prepared for a wait. Expect the pushing stage of labor to last up to 3 hours with your first baby. 

Take a childbirth class

Women who take a childbirth class are less likely to have a C-section. Childbirth classes offer other benefits as well. Taking a childbirth class can help you prepare for birth and know what to expect before labor starts. You are more likely to feel empowered and actively participate in your labor process. Childbirth classes can also increase your odds of successfully breastfeeding.

Although your chances of having a repeat C-section are very high, you may be able to have a VBAC if your first delivery was a C-section. If you're a good candidate for VBAC, you have a 60% to 80% chance of having a successful VBAC. 

• You have a better chance of having a successful VBAC if:
• You had a low transverse (horizontal) incision with your C-section.
• You've had a previous vaginal delivery, including a successful VBAC. 
• You're younger than 35.
• The reason for your C-section wasn't related to your labor process. 

You should discuss it with your doctor, but you may not be eligible for a VBAC if:

• You had a classical (vertical or T-shaped) incision with your C-section.
• You've had multiple C-sections. 
• Your C-section was because of an abnormally slow or difficult labor. 
• You are having a baby who may weigh over 10 pounds. 
• You are past your due date. 
• You have health problems such as lung disease or a heart defect. 

Although C-sections are riskier than vaginal deliveries, they are life-saving in emergencies. They can also help you avoid dangerous complications if your delivery is high-risk. Some reasons you may need a C-section include: 

• Your baby is breech (in a feet-first or bottom-first position) and can't be turned.
• Your placenta is too low and is covering your cervix.
• Your baby has a birth defect that makes vaginal delivery dangerous.
• You have a medical condition that could cause vaginal delivery to be dangerous for you or your baby, such as HIV. 
• Your labor isn't progressing the way it should.
• Your placenta separates from the wall of your uterus too early.
• The umbilical cord is pinched or enters the birth canal before your baby.
• Your baby is not getting enough oxygen or is otherwise in distress.
• Your baby's head or body is too big to fit through the birth canal.