Uterine rupture risk drops significantly after first VBAC

As we know, the risks of cesareans increase with each surgery which is why family size should be considered when evaluating your post-cesarean birth options. Couple that fact with the results of Mercer (2008) which found that successful VBAC also provides a level of protection to future deliveries.

Mercer found that not only do the risks of uterine rupture, uterine dehiscence and other peripartum complications decrease after the first VBAC, but “VBAC success increased with increasing number of prior VBACs” to rates over 90% for women with two or more prior VBACs.  They also found that while two or more VBACs did not decrease the risk of rupture further (so a scarred mom’s risk of rupture never goes down to the risk of an unscarred mom), it’s important to note that the risk of rupture did not increase with subsequent VBACs as women are sometimes told in an effort to obtain their consent for a repeat cesarean.


Mercer, B. M., Gilbert, S., Landon, M. B., & Spong, C. Y. (2008). Labor Outcomes With Increasing Number of Prior Vaginal Births After Cesarean Delivery. Obstetrics & Gynecology , 11, 285-91. Retrieved from http://journals.lww.com/greenjournal/Fulltext/2008/02000/Labor_Outcomes_With_Increasing_Number_of_Prior.6.aspx


10 thoughts on “Uterine rupture risk drops significantly after first VBAC

  1. Tash

    Just found out I’m pregnant again!! Super excited!
    I had a successful vbac with my baby 6 months ago. So I would like to know what the chances of another vbac will be so close together – it will ultimately be 14 months apart.
    Also, any moms with kids so close together, please give me some good mommy advise of what to expect and how you deal with it?

    1. Jen Kamel Post author

      Hey Tash!

      ACOG reports that the odds of acheiving a VBAC are lower with short birth intervals. Keep in mind that the evidence on short birth intervals is limited. I suspect that the most important factors for achieving a VBAC – understanding the evidence and hiring a supportive provider – hold true for you too.

      I shared your question here and a few people have replied already.

      If you are interested in learning more about the evidence on short birth intervals, uterine rupture, VBAC success rates, and repeat cesarean, you can get up to speed quick here.



  2. Tara

    I have been searching for this information.

    It is fantastic to find a study that isn’t just about the first VBAC.

    Thanks for posting it.


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