What You Need to Know About VBAC

Reasons to Choose a Vaginal Birth After Cesarean

Many people consider having a vaginal birth after a past cesarean because it can offer several health advantages. These include avoiding major abdominal surgery, which means less chance of surgical complications and infections. People generally experience less blood loss than with repeat C-sections, which lowers the chance of needing blood transfusions.

A vaginal delivery after a previous C-section often leads to a shorter hospital stay and a quicker recovery, allowing parents to return to their routines sooner. Studies show that babies born through VBAC often have a lower risk of breathing problems compared to those delivered by cesarean.

For those planning more children, VBAC can help reduce problems in later pregnancies, such as placenta accreta or placenta previa. Multiple cesareans increase the risk of these conditions, which involve issues with how the placenta attaches inside the uterus.

Main Advantages Table

Benefit	Impact
No major surgery.	Less pain and fewer surgical risks.
Lower infection risk.	Fewer chances of infection or blood clots.
Shorter recovery.	Home sooner and easier return to activities.
Better for future pregnancies.	Less risk of placenta problems.
Less risk for baby.	Lower chance of breathing problems.

What Are the Dangers of Trying for a VBAC?

Trying for a vaginal birth after cesarean does come with risks. If labor does not lead to a vaginal birth and surgery becomes necessary, the chance of health problems rises. Some issues can include serious bleeding, infection, and a greater risk of complications during an emergency C-section.

One of the main risks is uterine rupture. This happens when the old C-section scar on the uterus tears open during labor. Uterine rupture is rare and affects fewer than 1 in 100 people who try VBAC, but it can be very dangerous for both parent and baby. Emergency surgery may be needed, and in severe cases, removal of the uterus (hysterectomy) might be required, which means no future pregnancies are possible.

Other possible risks include heavy bleeding, blood clots, and the chance of fetal distress (the baby not getting enough oxygen during labor). Planned C-sections do not have the risk of rupture, but they have their own possible complications.

Key Risks List

• Uterine rupture (very rare but severe)
• Need for emergency hysterectomy
• Heavy bleeding or hemorrhage
• Infection risk with unsuccessful VBAC
• Higher chances of complications if C-section happens after labor starts

Who Is a Good Fit for Trying a Vaginal Delivery After Cesarean?

Not everyone with a past cesarean can safely try for a VBAC. The best candidates usually have a low-transverse uterine incision from the earlier C-section—a side-to-side cut low on the uterus. Those with a high vertical cut or “classical” incision usually should not try VBAC because the risk of rupture is higher.

People who have not had a history of uterine rupture or other major uterine surgery, like removal of fibroids, are more likely to be able to try safely. Having at least one previous vaginal delivery, either before or after the cesarean, can also increase the chances of success. Providers check factors like:

• Type of previous uterine incision (low-transverse is preferred).
• History of uterine surgery or rupture (raises risk).
• Number of previous C-sections (more than two raises concerns).
• Previous vaginal births (improves chances of VBAC).
• How close pregnancies are (less than 18 months between births can raise risk).
• Current pregnancy factors (multiple babies, placenta problems, baby’s position).

Hospitals or birth centers with the staff and tools for emergency C-sections are the only safe places for VBAC attempts. Home birth is not safe for those trying for a VBAC because of the rare but serious risk of uterine rupture.

Factors That Help with Successful VBAC

Factor	Safe for VBAC?
Low-transverse uterine incision	Yes
Vertical (classical) uterine incision	No
No history of uterine rupture	Yes
Previous vaginal birth	Yes
Multiple C-sections	Sometimes
Less than 18 months since last birth	Caution advised
Multiples or placenta problems	Usually no

How Is Going Through Labor and Delivery Different When Trying a VBAC?

People who try for a VBAC usually go into labor the same way as with any vaginal birth, but there are important differences. Hospitals use continuous monitoring of the baby’s heart rate during labor. This helps the team spot early signs of trouble, especially those linked to uterine rupture or fetal distress. The healthcare team makes a detailed delivery plan and prepares to perform an immediate C-section if needed.

Providers use medications to start labor less often because some can raise the risk of rupture. Each hospital or birth center may have slightly different rules for managing labor in VBAC cases, but they always prepare for emergencies. VBAC attempts only happen in places with trained staff, quick access to operating rooms, and all needed equipment for urgent care.

Comparison: VBAC Labor vs. Regular Vaginal Labor

Feature	Regular Vaginal Birth	VBAC Attempt
Heart monitoring	Sometimes, not always	Always (continuous)
Emergency prep	Needed but less urgent	Always ready
Labor induction	Often used	Used carefully
Place of birth	Many settings	Hospital only

Other Important Points for Those Thinking About a Vaginal Birth After Cesarean

Before making a decision, people should meet with a healthcare provider early in pregnancy. Sharing details about prior pregnancies, C-section records, and any surgeries on the uterus helps doctors advise on the safest plan.

Individuals should talk about hopes and concerns, and prepare for both VBAC and unplanned repeat C-section outcomes. Some people may become better candidates for VBAC as the pregnancy goes on, while for others, new issues might make a planned repeat C-section safer.

It is also important to learn how the chosen hospital would handle an urgent situation. Ask the care team about emergency procedures, staff availability, and how quickly a C-section could happen if needed.

Flexibility matters—sometimes, even with careful preparation, a VBAC may become unsafe during labor. People should be open to changes and trust the advice of the health team.

Tips for Preparation and Decision-Making

• Share your complete medical and birth history.
• Explore the benefits and risks with your provider.
• Choose a hospital ready for emergency C-sections.
• Stay open to changing your delivery plan if new issues come up.
• Ask about ongoing fetal monitoring and staff readiness.

Summary Table: Topics to Discuss with Your Care Team

Topic	Why It Matters
Full medical/birth history	Determines risk and options.
Delivery location	Ensures emergency resources.
Recovery expectations	Plans for coming home and healing.
Chances of successful VBAC	Helps manage hopes and concerns.
Risks to future pregnancies	Supports long-term planning.