Vaginal birth after c-section safe post due-date: Study

Women who have undergone a prior cesarean delivery can safely attempt to give birth vaginally.

Women who have undergone a prior cesarean delivery can safely attempt to give birth vaginally in a subsequent pregnancy, even when they're at or beyond 40 weeks, US researchers report. However, the chances of being able to complete a vaginal birth are reduced.

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The safety of vaginal birth after cesarean (VBAC) in a variety of situations has been investigated before, the team explains in the journal Obstetrics & Gynecology, but little has been published about VBAC attempts for women at or past their expected delivery date.

Dr. Kara M. Coassolo from the Hospital of the University of Pennsylvania, Philadelphia, and colleagues looked at outcomes for 11,587 women attempting VBAC before and after 40 weeks of gestation.

Women at or after their estimated date of delivery were less likely to be successful (69 per cent) than were women before their estimated date of delivery (78 per cent), the authors report.

Doctors "can counsel women that the chances of VBAC success are decreased in gestations that continue beyond the estimated delivery date compared with those before 40 weeks," the team concludes. "However, patients can be reassured that the success rate of almost 70 percent is still quite good."

Still, the researchers note, women attempting VBAC fared somewhat worse overall than those opting for repeat cesarean delivery.

However, "the absolute risk is small," the team notes. For example, "In women past 40 weeks of gestation, the risk of uterine rupture is 1.1 per cent in women attempting VBAC compared with 0.08 per cent in those electing repeat cesarean delivery."

Thus, the researchers write, "The risks of a VBAC attempt are not increased simply because the due date has passed."