What is VBAC?
VBAC (Vaginal Birth after Cesarean) means giving birth vaginally after having one or multiple cesarean sections. You may also see this referred to as TOLAC (trial of labor after cesarean). It can take place in a hospital, a birth center, or at home.
Why do women choose VBAC?
Recovery from c-section was very painful, never wanted to experience that again
Natural birth is exhilarating and completely empowering
Vaginal birth provides important microbes for the baby (The Microbiome & Your Baby's Immune System)
C-section is a major abdominal surgery
Repeat c-section is more risky than VBAC
Vaginal birth squeezes the fluid from babies lungs so they can breathe better
The chance of uterine rupture is very low and can happen whether or not you've had a c-section (VBAC Facts)
Hormones occurring in natural birth promote bonding and breastfeeding while reducing the chance of postpartum depression (Nature's Hormonal Blueprint for Labor)
Why do women choose planned repeat cesarean?
What are the facts?
Concern for VBAC
Uterine rupture occurs when both layers of the uterus separate or open. Not all uterine ruptures are created equal.
0.42% of women who have TOLAC (trial of labor after cesarean) without any interventions such as pitocin or epidural experience a uterine rupture. If your labor is augmented, the risk goes up. (Inductions)
6% of uterine ruptures result in a serious outcome for babies.
Out of the 0.42% of women who experience a uterine rupture, only 6% of those babies have serious outcomes.
The maternal mortality rate for VBAC is about 1 in 26,000.
0 maternal deaths were reported in the U.S. related to uterine rupture.
Concern for repeat cesarean
Placenta Accreta is a potentially life-threatening condition, occurring when the placenta abnormally attaches to the uterine wall.
The risk of having placenta accreta increases with repeat cesareans.
The incidence of placenta accreta is 1 in 533 from the year 1982-2002.
This condition is associated with 70% hysterectomy (permanent removal of the uterus)
The maternal mortality rate for accreta is 7% (or 1,820 in 26,000).
Who is a candidate for VBAC? (ACOG)
Your previous c-section was for breech or some malpresentation of the baby
Your previous c-section incision is low and transverse
You've had a vaginal birth before your c-section
You and your baby are healthy and want to try for a VBAC
Who is not a candidate for VBAC? (ACOG)
You or your baby have serious health issues
You've have a prior uterine rupture
Your previous c-section incision is vertical
Placenta previa (placenta covering the cervix)
How do I prepare for my VBAC?
Find a care provider who fully supports your choice and has a high success rate of VBAC (Choosing Your Care Provider)
Gather your support team of people who fully support your choice and will advocate for you. This might include a birth doula.
Do your research so you can advocate for yourself (Birth Options)
Take a childbirth or VBAC class and practice labor coping techniques
Consider birth trauma therapy
Create or download a vaginal birth plan and back-up cesarean birth plan (just in case) (5 Step VBAC Checklist)
Listen to, read, and watch empowering VBAC stories (find in the resources section below)
Stay active by walking, swimming, and doing yoga
Practice Spinning Babies exercises - promotes baby's optimal position
Get chiropractic care (Quicker Labor, Less Pain & Better Birth Outcomes with Chiropractic Care)
Drink red raspberry leaf tea to strengthen the uterus
Buy a birth/exercise ball to sit on instead of reclining - promotes baby's optimal position
Practice hypno-birthing or self-hypnosis (Self-hypnosis for Pain Management)
Avoid being induced (learn how)
Stay at home as long as possible
Call your doula to your home before going to the hospital
Use your birth/exercise ball
Listen to calming music or hypnobirthing tracks
Take a shower or bath
Move your body - try different positions
Eat snacks and stay hydrated to keep up your energy (Evidence on: Eating & Drinking During Labor)
Practice the 3 R's - relaxation, rhythm, and ritual
What if I try for a VBAC and end up with an emergency cesarean?
Birth is wild. It's unpredictable. And we discover a new part of ourselves that emerges through the unfolding of such a life-altering process. When we're faced with an uncontrollable event, we can either resist and get stuck in our fears, or we can accept what is and know that we made the best choice with the information we had. This is something we get to practice throughout the intensity of labor, the adventure of parenthood, and our whole lives. If you end up with a c-section, it's ok. What's important is that you and your baby are healthy and you prepared to have the kind of birth that really matters to you.
“I had wanted all my babies to be born vaginally, but my first ended up a C-Section. It was likely needed, but I was disappointed and knew I'd try again with the next. Just felt like my body was made to birth that way (it was) and risks were much lower for VBAC than repeated Cesarean. My second was a successful hospital VBAC, but not drug free like I'd hoped. I didn't really do much to prepare, but hired a doula who was super awesome and I'd highly recommend it. My third was born at home, intervention free--nobody telling me to stay in bed or not to eat (though it was the middle of the night/early morning so I wasn't hungry anyway), no poking me with needles, etc. It was the birth I'd hoped for for all them.” - Anonymous Badass Mama
VBAC Birth Stories
Please share your birth story below!