The C-section rate has climbed steadily in the United States since 1996. This results in longer hospital stays and longer recovery times for patients.

One reason that the Cesarean rate is so high is that many hospitals no longer offer vaginal delivery after Cesarean (VBAC). This forces women to have a repeat C-section even when they would have preferred a vaginal delivery.

MetroHealth OBGYNs work with their patients to keep the C-section rate low and offer vaginal births as often as possible. As a result, MetroHealth's rate of VBAC is markedly better than the national rate. In 2010 at MetroHealth, 34% of women with prior C-sections attempted a trial of labor, and 82% were successful. In the United States, less than 10% of women who have had previous C-sections have vaginal births.

Any woman who has had two or fewer C-sections with a low transverse cut of the uterus may be a candidate for a VBAC, says Jennifer Bailit, MD, Director of Labor and Delivery at MetroHealth. The chances for a successful VBAC also depend on the reasons for the previous C-section. "You are a better candidate for VBAC if the reasons for the first C-section are not present in the second pregnancy. An example of that would be a first Cesarean done for a breech baby or that the baby wasn't tolerating labor."

C-sections accounted for 32% of all births in the United States in 2007, the latest year for which national statistics are available. In 2010, MetroHealth's C-section rate was 26%.

At MetroHealth, doctors talk with patients about the facts, risks and benefits of a VBAC. "Some fears are justified," says Dr. Bailit. For example, the chance of a previous C-section scar rupturing is small - less than 1% - but can be devastating if it happens "The ability to get the baby delivered very quickly if an emergency happens is critical."

Dr. Bailit points out that MetroHealth has a dedicated obstetrical anesthesiologist and an obstetrician on site 24 hours a day, ready to deal with any issues which might arise when a woman is attempting a VBAC.

Benefits of a VBAC include faster recovery, fewer chances of problematic bleeding and fewer breathing problems for baby. "The goal must always be to do what's best for the patient," she adds.