Vaginal Birth After Caesarean

Vaginal birth after caesarean (VBAC) is exactly what it sounds like. It means you give birth vaginally after having at least one baby by caesarean surgery. You may hear you healthcare provider refer to a VBAC as a Trial of Labor After Caesarean (TOLAC).

Can I have a VBAC?
Your healthcare provider will assess your individual case and decide whether you are an appropriate candidate for a VBAC. If your healthcare provider gives you the go ahead for a VBAC, there is a good chance you will succeed. Up to 80% of women who attempt VBACs give birth vaginally.

Benefits of VBAC

  • avoids the need for major surgery and the associated risks
  • postpartum recovery tends to be longer after caesarean birth
  • looking after a toddler and newborn will be much easier after a VBAC

Risks of VBAC

  • there is a small risk that your caesarean scar will rupture during delivery. This affects only one in 200 women.
  • there is a slightly increased risk of you developing a rupture or infection of the uterus
  • there is a slightly increased risk of blood transfusion

Success rates
A quarter of women who attempt VBACs go on to have caesarean births. This rate is only slightly higher than the caesarean rate for first time mothers. Nearly 80% of attempted VBACs end in vaginal births.

If you have previously had a vaginal birth, you are more likely to have a successful VBAC. If your previous caesarean was because of a condition unique to your last pregnancy, such as a breech baby or low-lying placenta, then you have a good chance of  having a VBAC.

Some women are considered unsuitable candidates for VBAC, this is usually due to an ongoing condition such as a small pelvis or a maternal health condition that requires the baby to be born early.

VBAC success rates are slightly lower for women who:

  • are induced
  • are given drugs to speed up labour
  • have only ever given birth by caesarean
  • had a previous caesarean because the baby became stuck during labour
  • had a prepregnancy BMI of over 30

I’ve decided I want a VBAC
You should speak to your healthcare provider about having a VBAC. They will assess your case and, if they decide you are a suitable candidate, they will advise you of how to go about it. Some US hospitals do not have the facilities to offer VBAC, so you may need to rethink your birth location. If your healthcare provider is not supportive of your desire for a VBAC, speak to a number of other healthcare providers to see if you can find one who will help you achieve the birth you want.

For women considering VBACs, what they really want to hear about are real life experiences, so please share yours in the comments below. Did you have a VBAC, and would you recommend it?

Written by Fiona, proud owner of a toddler, @fiona_peacock

This information is not intended to replace the advice of a trained medical doctor. Health & Parenting Ltd disclaims any liability for the decisions you make based on this information, which is provided to you on a general information basis only and not as a substitute for personalized medical advice.  All contents copyright © Health & Parenting Ltd 2017. All rights reserved.