VBAC (Vaginal Birth After C-Section): Is It Safe for You?

For many women who’ve previously delivered via cesarean section (C-section), the idea of giving birth vaginally in a subsequent pregnancy can feel both empowering and uncertain. This choice—known as VBAC, or Vaginal Birth After Cesarean—is becoming an increasingly common and well-supported option under the right circumstances.

But is it safe for you? Let’s explore the facts, the risks, the benefits, and how to make an informed decision with expert guidance.

What is VBAC?

VBAC stands for Vaginal Birth After Cesarean, a delivery method that allows a woman who has had a previous C-section to attempt vaginal delivery in her next pregnancy. For decades, the prevailing belief was "once a C-section, always a C-section." However, current evidence shows that many women are good candidates for VBAC, and that vaginal delivery may, in fact, be a safer and more satisfying option than repeat surgery for some.

Why Consider a VBAC?

Choosing VBAC may come from a desire to experience natural childbirth, reduce recovery time, or avoid the complications associated with multiple C-sections.

Benefits of VBAC include:

• Faster recovery: Vaginal delivery usually means shorter hospital stays and quicker return to daily activities.
• Lower risk of infection: Surgical procedures carry inherent risks; VBAC avoids these.
• Reduced blood loss and less risk of surgical injury
• Fewer complications in future pregnancies: Repeated C-sections can increase the risk of placental problems and uterine rupture in future deliveries.
• Emotional and personal satisfaction: Many women feel more empowered and connected during a vaginal birth.

Who is a Good Candidate for VBAC?

Not every woman who has had a C-section will be a candidate for VBAC. A detailed medical evaluation is essential. Factors that make VBAC more likely to be successful include:

• Previous low-transverse (horizontal) uterine incision: This type of incision is the most common and carries the lowest risk of uterine rupture.
• No more than one prior C-section
• No history of uterine rupture
• Healthy pregnancy with no complications
• Spontaneous onset of labor
• Supportive hospital and medical staff equipped for emergency C-section if necessary

Your obstetrician will thoroughly review your previous delivery records, including surgical notes, to evaluate your individual risk profile.

What Are the Risks of VBAC?

Like all medical decisions, VBAC comes with potential risks. The most serious is uterine rupture, where the scar from the previous C-section tears open during labor. While rare—occurring in less than 1% of VBAC attempts—it can be life-threatening to both mother and baby and requires emergency intervention.

Other risks include:

• Failed VBAC, leading to emergency C-section
• Potential for more complex C-section if attempted VBAC is unsuccessful
• Stress and anxiety during labor regarding VBAC outcomes

This is why choosing the right hospital and having an experienced obstetrician is crucial for monitoring and safety.

VBAC Success Rates

The success rate for VBAC ranges from 60% to 80%, depending on individual circumstances. Women who have had a vaginal birth before (either before or after their C-section) are more likely to succeed with VBAC.

Discussing your previous birth experience in detail with your obstetrician can help you understand your likelihood of success and prepare accordingly.

Planning for VBAC: What to Expect

If you and your doctor decide to attempt VBAC, you will undergo a trial of labor after cesarean (TOLAC)—a monitored attempt to deliver vaginally. This means:

1. Close monitoring during labor to detect any signs of distress or uterine rupture.
2. Access to emergency C-section facilities should complications arise.
3. Avoidance of induction unless medically necessary, as induced labor can slightly increase the risk of uterine rupture.
4. Pain management options, such as epidurals, remain available.

If at any point your labor doesn’t progress safely or if either you or the baby show signs of distress, your healthcare team will move swiftly to perform a C-section.

The Emotional Side of VBAC

VBAC can be both physically and emotionally rewarding—but it can also come with a lot of pressure and anxiety. Some women feel guilt or disappointment if VBAC is unsuccessful, while others feel empowered just by attempting it.

It’s important to focus on what matters most: the health and safety of both you and your baby. Regardless of the delivery method, every birth is valid and should be celebrated.

Talking to other women who have gone through VBAC, joining support groups, and having open conversations with your doctor can help you feel more confident and informed.

When Is a Repeat C-Section Safer?

VBAC may not be recommended if:

• You have a vertical uterine scar (classical incision)
• You’ve had more than two previous C-sections
• There’s a history of uterine rupture
• You have placenta previa or other complications
• You have a large baby or are significantly past due
• Labor needs to be induced for medical reasons

In such cases, a planned repeat C-section is often safer and more predictable.

Final Thoughts: Is VBAC Right for You?

VBAC is a viable and often safe option for many women—but it’s not the right choice for everyone. Making this decision requires a personalized risk-benefit analysis, open communication with your obstetrician, and access to appropriate hospital resources.

The key is informed choice. With proper planning, support, and monitoring, VBAC can be a fulfilling and safe experience.

Consult with an Expert

Thinking about VBAC? Let expert guidance ease your journey.

Talk to Dr. Sunita Arora

With years of experience in managing high-risk pregnancies and supporting women through both C-sections and VBAC, Dr. Sunita Arora is here to help you make the safest and most empowering decision for your delivery.

Book your consultation today and get the clarity you need for your birth plan.