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Vaginal Birth After Having a C-Section (VBAC)

Learn the facts about VBAC so you can decide if this is right for you.

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You had a cesarean section with your first baby. Now you're pregnant again and wonder if you will need a C-section this time, too. You might like to try a vaginal birth but don't know if it's safe for you and the baby.

Many believed women who had a C-section would need one for later births. Now, they know women can attempt a trial of labor after a C-section (TOLAC) and have a safe delivery. This means starting labor when contractions begin and if there are no signs of problems for mother or baby, delivering the baby vaginally. A successful vaginal birth after a previous C-section is called VBAC.

Is TOLAC/VBAC right for me?

You and your doctor can decide if this is a good choice for you. Many women want to try TOLAC/VBAC to experience vaginal birth or for various other reasons, including:

  • A lesser risk of infection, blood clots and other complications of surgery
  • A shorter hospital stay with an easier recovery
  • The chance for your partner to be more involved during the birth
  • If you want more children, you may avoid risks associated with having many C-sections
  • Future children may be able to be delivered vaginally

Criteria for TOLAC/VBAC

If the benefits of TOLAC/VBAC sound like the right reasons for you, you should ask your doctor to determine if you meet certain conditions. You may be able to have a TOLAC/VBAC if:

  • You've had a previous low-transverse C-section. (Ask your doctor to review your medical records to determine this. The scar on your abdomen does not indicate the position of the scar on your uterus.)
  • You have no other uterine scars from previous births or surgeries.
  • Your pelvis seems large enough to deliver a baby vaginally.

Risks of TOLAC/VBAC

The main concern for many women considering TOLAC/VBAC is the chance of tearing the previous C-section uterine scar. It can be very serious for the mother and baby, but it is rare in women with low-transverse incisions. It is important to try TOLAC in a facility that can care for you and your baby.

About  6 to 8 out of 10 women who try TOLAC/VBAC are successful, but there is also a chance that you may go through hours of labor and still end up having a C-section. You have a better chance of having a successful TOLAC/VBAC if:

  • The baby is of normal size
  • The baby is positioned head-down
  • There are no major medical problems with you or the baby
  • You've given birth vaginally before
  • You are not obese

Note that all methods of childbirth have risks and benefits. Learning more about each of your choices along the pregnancy and delivery path can help you feel at ease and more confident about what to expect. Talk to your doctor to learn more about TOLAC/VBAC and other means of childbirth.

By Libby Ryan, Contributing Writer

Sources
American College of Obstetrics and Gynecology. Vaginal birth after cesarean delivery – deciding a trial of labor after cesarean delivery. FAQ070. Accessed: June 24, 2016.
National Institutes of Health. NIH development conference on vaginal births after cesarean: New insights. Accessed: June 24, 2016.
WomensHealth.gov. Healthy pregnancy: Labor and birth. Accessed: June 24, 2016.
Cunningham FG, Wells CE. UpToDate. Patient information: Vaginal birth after cesarean delivery (VBAC) (beyond the basics). Accessed: June 24, 2016.

Last Updated: June 24, 2016

The information provided is for general informational purposes only and is not intended to be medical advice or a substitute for professional health care. You should consult an appropriate health care professional for your specific needs and to determine whether making a lifestyle change or decision based on this information is appropriate for you. Some treatments mentioned may not be covered by your health plan. Please refer to your benefit plan documents for information about coverage.