VBAC Delivery


There are many benefits to delivering your child vaginally as opposed to having a cesarean section (C-section). For women who have previously delivered a child with a C-section, you may still choose to deliver your next child vaginally with a VBAC (vaginal birth after cesarean) as opposed to a RCS (repeat cesarean section).

If you and your clinician plan to attempt a VBAC delivery, this is referred to as a “trial of labor after cesarean (TOLAC). There are a number of factors which can contribute to the likelihood of a successful VBAC attempt:

  • Prior delivery of a baby weighing 13 ounces or less
  • Prior vaginal delivery
  • Pregnancy of less than 41 weeks
  • Cesarean indications (i.e. malposition, fetal distress, multiples, placenta previa) are not present
  • Baby’s position is not breech or transverse
  • Higher than average Bishop score
  • Nonrecurring reason for cesarean delivery (such as malposition, breech, multiples, fetal distress, placenta previa)
  • Baby’s head is lower in pelvis or engaged
  • Cervical effacement has reached 75-90% at the time of hospital admission


Although the aforementioned variables can serve as potential indicators of a positive VBAC outcome, the skill-set and competency of the physician performing the VBAC is perhaps the most crucially important element of all.  At Grazii, Kramer & Lanzkowsky, with convenient office locations in Manhattan and Brooklyn, NY, our well-respected team of board certified Obstetricians/Gynecologists specialize in successful vaginal birth and VBAC (vaginal birth after cesarean) deliveries, as evidenced by their exceptionally low cesarean delivery rate of 6%, which is far below the national average of 33%,[1] and is well within the recommended range of optimal cesarean rates set forth by the World Health Organization (WHO). The WHO reported that the best outcomes for women and babies appear to occur with cesarean section rates of 5% to 10%, and that rates above 15% seem to do more harm than good.[2]

The WHO findings are reinforced by new guidelines issued by the American College of Obstetricians and Gynecologists, which recommend that pregnant women should plan for vaginal birth unless there is a medical reason for a cesarean.[3]

The consensus among these major organizations about the importance of attempting vaginal delivery whenever possible is rooted in the numerous benefits associated with giving birth vaginally, including:

  • Shorter hospital stays and reduced post-delivery pain
  • Decreased risk of: infection, excessive bleeding during birth, or the need for blood transfusions
  • More expedient recovery period
  • Babies born vaginally are at a lower risk of developing respiratory problems
  • Cesarean surgery puts women at greater risk of bowel or bladder injuries, and potential complications in future pregnancies
  • Risk of uterine rupture, placental problems, and emergency  hysterectomy increase with subsequent cesarean deliveries
  • Vaginal births avoid additional uterine scarring, which decreases the likelihood of complications with later pregnancies
    • With a vaginal birth, the mother is more alert and can take a more active role in the birth of the child and in the immediate care of the child after delivery

As a OBGYN on the Park patient, you will receive a customized birth plan that takes into consideration your personal preferences and medical history, while prioritizing the health of both mother and child. Your obstetrician will take the time to ensure that you have a thorough understanding about all of your VBAC birthing options, and that you are 100% comfortable with every facet of your labor and delivery plan. We are affiliated with the prestigious Mt. Sinai Hospital in New York, where our patients have access to the best possible amenities throughout their labor and delivery experiences.

Contact OBGYN on the Park

At OBGYN on the Park, we take pride in providing a superior level of patient care and clinical expertise in a compassionate and comfortable environment. Our exceptional staff members are experts in the field of Obstetrics/Gynecology and all our physician are faculty members at the Icahn School of Medicine at Mount Sinai. As a patient at OBGYN on the Park, you will experience an unparalleled level of attentiveness and responsiveness—we will always make time to thoroughly address every question and concern you might have, and will work tirelessly to ensure that your experience is a positive one.

Our multidisciplinary approach involves cooperative collaboration with your primary care physician and a network of highly esteemed specialists (when necessary) in order to create a customized treatment plan that meets your unique obstetric/gynecological concerns.  If you would like additional information about abnormal Pap smear results, and the necessary follow-up testing or treatment, please contact OBGYN on the Park today. We look forward to speaking with you, and to scheduling your initial appointment with one of our board certified physicians.

[1] “Births—Methods of Delivery,”  Centers for Disease Control and Prevention http://www.cdc.gov/nchs/fastats/delivery.htm

[2] “Why Is the National U.S. Cesarean Section Rate So High?” Childbirth Connection https://www.childbirthconnection.org/article.asp?ck=10456

[3] American College of Obstetricians and Gynecologists “Vaginal Delivery Recommended Over Maternal Request Cesarean.” http://www.acog.org/About_ACOG/News_Room/News_Releases/2013/