As mentioned before both the options of VBAC and repeat Caesarean hold certain risks for complications. The main health complication that is possible for women planning a VBAC is the risk of the previous Caesarean scar opening or splitting during labour, known as 'uterine rupture', as well as the constant possibility that a repeated Caesarean could become necessary.
Be aware that the following information describes various complications that some readers may find disturbing. You may choose not to read all or parts of this section.
There are 2 ways a scar from a previous Caesarean can separate, they are either a complete rupture or a 'window' forming, called a 'dehiscence'. There is also the very rare situation where the uterus can rupture for a woman who has never had a Caesarean, which is important to consider when placing this complication into perspective. All these as well as the signs of rupture are discussed below.
Uterine rupture
Uterine dehiscence
Uterine rupture with no scar
Signs of uterine rupture
Uterine rupture is possible in up to 0.7% of women who have had a previous Caesarean with a uterine scar in the lower segment of their uterus. If you have already had one successful VBAC then the chances of a ruptured uterus are reduced with subsequent vaginal births.
A ruptured uterus is a life threatening complication for the baby, up to 25 to 30% of babies can die (this works out to be about 3 in every 10,000 VBACs). Some babies will survive without problems if a Caesarean is performed rapidly enough (within 15 to 20 minutes). Others can suffer brain damage.
In rare cases a uterine rupture can also be life threatening for the mother, due to shock from excessive blood loss (or haemorrhage), but the most likely complication is that up to 30% of women will need to have a hysterectomy (removal of their uterus).