VBAC Success Probability Calculator
Understanding Your VBAC Success Rate
Vaginal Birth After Cesarean (VBAC) is a safe option for many women who have previously undergone a cesarean delivery. The "Trial of Labor After Cesarean" (TOLAC) allows women to attempt a vaginal birth. Success rates vary based on individual medical history and demographic factors.
How This Calculator Works
This calculator utilizes a regression model similar to the widely cited Maternal-Fetal Medicine Units (MFMU) Network calculator. It analyzes specific coefficients that have been statistically shown to influence the likelihood of a successful vaginal delivery.
Key Factors Influencing Success
- Maternal Age: Generally, younger maternal age is associated with slightly higher success rates, though successful VBACs occur frequently across all childbearing ages.
- BMI (Body Mass Index): Calculated from your height and pre-pregnancy weight. A lower BMI typically correlates with a higher statistical probability of success, while a higher BMI may present additional challenges during labor.
- Prior Vaginal Delivery: This is the single strongest predictor of success. If you have delivered vaginally before (either before your C-section or a successful VBAC since), your odds of success increase significantly.
- Reason for Previous C-Section: The "indication" matters. If the C-section was performed for a non-recurrent reason (like a breech baby or placenta previa), the odds of a successful vaginal birth in the next pregnancy are higher than if the surgery was due to "arrest of labor" (the cervix stopped dilating or the baby stopped descending).
Interpreting the Results
The percentage generated represents the likelihood that a Trial of Labor (TOLAC) will result in a vaginal birth. For example, a result of 70% means that out of 10 women with a similar profile, approximately 7 would deliver vaginally, while 3 might require a repeat cesarean section.
What constitutes a "Good" Candidate?
There is no specific cutoff for attempting a TOLAC. However, the American College of Obstetricians and Gynecologists (ACOG) suggests that women with a calculated probability of at least 60-70% have the same probability of vaginal delivery as women having their first baby. Even with lower calculated probabilities, many providers support TOLAC after a thorough counseling session regarding risks and benefits.
Benefits vs. Risks
Choosing between a repeat C-section and a VBAC involves weighing benefits and risks:
- Benefits of VBAC: No abdominal surgery, shorter recovery time, lower risk of infection, less blood loss, and easier bonding/breastfeeding initiation.
- Risks of TOLAC: The primary risk is uterine rupture (occurring in roughly 0.5% to 0.9% of cases), which is an emergency situation requiring immediate surgical intervention.
Always discuss your specific medical history, future family planning desires, and risk tolerance with your healthcare provider.