Women having their second birth vaginally whose first birth was by caesarean section

Clinical commentary

For women who have had a previous caesarean section, the choice for method of birth in their next pregnancy is either a trial of vaginal birth after caesarean section (VBAC) or a repeat caesarean section (RCS).

Caesarean section in a first pregnancy makes a subsequent caesarean section more likely, with 86% of pregnant women with a history of caesarean section birth having a subsequent caesarean section, while the remainder have a vaginal birth (AIHW 2019).  

Both RCS and VBAC are associated with benefits and harms. Risks of planned VBAC when compared with planned RCS include haemorrhage, need for blood transfusion, uterine rupture, and perinatal death (Guise et al. 2010). About 70% of women who had a caesarean section are good candidates for non-instrumental vaginal birth, with 70–87% who attempt succeeding (Frass & Harazi 2011; Potera 2010).

Indicator specifications and data

Excel source data tables are available from the Data tab.

For more information refer to Specifications and notes for analysis in the technical notes.

References

  • AIHW (Australian Institute of Health and Welfare) 2019. Australia’s mothers and babies 2017 — in brief. Perinatal statistics series no. 35 Cat. No. PER 100. Canberra: AIHW.
  • Frass K & Harazi A 2011. Outcome of vaginal birth after caesarean section in women with one previous section and spontaneous onset of labour. Eastern Mediterranean Health Journal 17(8):656–50.
  • Guise JM, Eden K, Emeis C, Denman MA, Marshall N, Fu RR et al. 2010. Vaginal birth after caesarean: new insights. Evidence Report Technology Assessment (Full Report) 191:1–397.
  • Potera C 2010. Back to VBAC: a new look at guidelines on vaginal birth after caesarean section. The American Journal of Nursing 110(6):15.