VBAC and the Risk of Uterine Rupture. The greatest concern for women who have had a previous cesarean is the risk of uterine rupture during a vaginal birth. Recently, ACOG stated that VBAC is safer than a repeat cesarean, and VBAC with more than one previous cesarean does not pose any increased risk. Jul 6, - Is a vaginal birth after cesarean an option for you? Know the factors that might affect your decision and the possible risks.