Can I have a VBAC (Vaginal Birth After Cesarean)?

August 3, 2017

| Intuitive Birth


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?


During Pregnancy 

  • 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)


During Labor

  • 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)

  • Use affirmations

  • 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


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