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A recent prospective, multicenter study showed that the risk of uterine rupture decreases after the first successful VBAC (vaginal birth after cesarean) and doesn't increase thereafter. The success of VBACs also increases with each successful VBAC. In a sample of 13,532 women, the success rate of VBAC increased from 63.3% with the first attempt to 87.6% for women with 1 previous VBAC. In women with 2 prior VBACs, the success rate was 90.9%, and in women with four or more previous VBACs, the success rate was 91.6%.

At the same time, the risk of uterine dehiscence (separation of the uterine muscle tissue along the scar) and other complications at birth also decreased the more VBACs a woman has. After the first successful VBAC, the rate of uterine rupture was 0.87%. After the second VBAC the rate was 0.45%, and after the third is was 0.38%. In this study, there was no increase in neonatal morbidities with increasing number of VBACs.

This is good news for women who have needed a C-section with their first babies. And MAMA's VBAC success rate was 80% in the first 7 months of fiscal year 2007!

Obstet Gynecol. 2008;111:285-291.