So, you had a C-section with your first baby. Maybe it was planned. Maybe it wasn’t. Maybe it was smooth and calm, or maybe it was the kind of chaotic whirlwind that made your head spin. Whatever your birth story, here you are pregnant again and wondering if you have options this time around. What is VBAC?
The short answer? Yes, you do.
Enter: VBAC, or Vaginal Birth After Caesarean.
It’s a term you may have come across on parenting forums, heard mentioned by your obstetrician, or typed into Google at 2 am with a head full of questions and a belly full of baby. I’ve been there. I gave it a go. And yes, it’s possible. But it’s also personal, sometimes complicated, and worth talking about more.
So if you’re considering a VBAC or just want to know more before deciding, here’s everything I wish I’d known from the medical stuff to the emotional side and everything in between.
What is VBAC
First things first: What is VBAC?
VBAC stands for Vaginal Birth After Caesarean. In a nutshell, that’s all there is to it. You’ve had a c-section and are now considering giving birth to this baby in the traditional way, vaginally.
A VBAC is a vaginal birth, but it differs in one important way: You have a scar on your uterus from a previous caesarean. It changes how your pregnancy and labour are monitored. This scar is why doctors will keep an eye on you in the weeks leading up to your birth, and even during labour.
What is the main concern? Uterine rupture
Let’s not panic. The uterine rupture occurs when the scar of your previous C-section tears during labour. It sounds horrifying (and it can be serious), but it is also uncommon. It’s estimated that it occurs in 1 out of 200 VBACs, or 0.5%. Despite the risks, your doctor will prepare and take it seriously.
Why choose a VBAC?
The question I am asked most often is: “What do you want to buy?”
Why not schedule another C-section?
“It’s easier!”
Why take the risk?
The first time went well?
My first caesarean section was a smooth operation. No drama. No trauma. When baby number two arrived, I felt different. I heard a quiet, stubborn voice in my head saying: Try to give birth vaginally. Just try.
Was the purpose of this to prove something? Not really. Was the redemption story, or was it a rewrite of a birth story? Perhaps a little. It was more than anything else, this instinct that I could not shake. I wanted to feel the pain of labour. I wanted to push. I wanted to push.
Everybody has a different reason for wanting to get a VBAC — and each one is valid.
Some women desire a faster recovery. Some women want to avoid major surgeries. Others are curious. Some are empowered. Some people want to do something new.
It’s also okay if some women decide to go with instead of when attempting a VBAC. It’s always your decision based on medical advice and your gut feeling.
Making the right choice: The emotional side
It’s not always easy to choose a VBAC. It can stir up all kinds of emotions: hope, anxiety, fear, and determination. If you’re like me, it can also bring up a good dose of Google-fueled confusion.
What I wish someone had told me.
- Even if you had a “fine” first C-section, it’s fine to want another one.
- It’s OK to be nervous.
- You can make your choice even if others don’t understand it.
- You can change your mind at any time.
The hardest part for me was not deciding whether or not to try, but navigating other people’s opinions. Some doctors were supportive. Some were hesitant. Friends had horror stories. Families questioned the dangers. Everyone had an opinion, and not all were helpful.
What helped me was to do the research, ask a million questions, and find a care provider who treated me as a person rather than a liability.
When Should You Make a Decision?
It’s not a set-in-stone timeline to decide if you want to try a VBAC. However, most doctors suggest making your decision around 36-38 weeks. It gives you the time to mentally and physically prepare, and your medical team can put in place proper monitoring.
There are several factors that could influence your decision.
- What happened during your C-section?
- Your previous C-section was for a reason (e.g. Breech baby, fetal stress, stalled labour)
- Pregnancy complications and your current health
- What type of uterine incision did you have?
- It is best to leave a minimum of 18 months between pregnancies.
You and your care provider can assess this together. It’s not about your desire, but about safety for you and your child.
VBAC Benefits – What are they for you?
There are a lot of pros:
1. Faster recovery
Vaginal births are usually associated with a shorter recovery period than major abdominal surgeries. With less pain, you can get up and move around sooner. This makes those first weeks with a newborn easier.
2. Avoiding Surgery
Some women are attracted to the idea of avoiding complications from another surgery, such as infection, blood loss or scar tissue.
3. More Options for Birth
A successful VBAC may reduce the risks associated with multiple C-sections.
4. A Sense of Empowerment
It is often the biggest and most personal. A VBAC is a healing experience for many women. This can be a way to rewrite the story of a birth that was disappointing or uncontrollable. It’s not a matter of “proving” something, but rather reclaiming your experience on your terms.
VBAC Risks – What you need to know
There are risks associated with all birth methods. VBAC has some unique risks.
1. Uterine Rupture
This is rare, but serious. This can cause heavy bleeding and harm to the child. In extreme cases, it may even require emergency surgery.
2. Emergency Section C
VBAC is a possibility, not a guarantee. Around 20-40% VBACs that are planned end up in an emergency C-section. It’s therefore important to know that things can change before you go into labour.
3. Monitoring of Labour
VBACs are monitored more closely to ensure safety. This can mean continuous fetal monitoring, which may limit your movements and make active labour or water birth more difficult.
VBAC is not always an option
Medically, VBACs are not always safe, no matter how hard you try. If:
- You have had a uterine rupture
- You are carrying twins or multiples
- You have a “classical”, vertical uterine incision, rather than a lower transverse or horizontal incision.
- Certain pregnancy complications are present (like placenta prévia).
- Your baby is breech but won’t turn
In such cases, repeating a C-section is the safest and responsible option. This doesn’t mean that you failed or made a mistake. It means you chose the best option with the information available.
Tips for Preparing a VBAC
You can prepare yourself mentally and physically if you and your doctor agree that a VBAC would be safe for you.
1. Select a Supportive Provider
VBAC is not supported by all doctors or hospitals. You need someone to walk with you and not get in your way. You can ask about their VBAC rates. Do not be afraid to change providers if necessary.
2. Educate yourself
Read about VBAC success. Watch documentaries. Listen to podcasts. You should be aware of both the risks and benefits to avoid feeling intimidated.
3. Attend a VBAC-Friendly Childbirth Class
The classes will provide you with tools, tips and realistic expectations.
4. Stay Flexible
Plan your birth, but keep it flexible. VBAC is not a promise, but a hope. You should trust your body, but also the process and team that will be caring for you.
My VBAC Verdict
What happened to me?
I have done all the research. I asked all the tough questions. I found a physician who backed my decision and never made me feel like a danger. Yes, I went ahead with it. It was not the perfect labour. It was long. It was intense. It was intense. But I made it. When I held my child in my arms and knew what my body just did, I felt this wild, quiet pride. VBAC was not “better”, but it was what I wanted. I had tried.
Would I do it all over again? In a heartbeat.
Conclusion
Your birth story is yours.
It’s up to you whether you decide on another C-section or a VBAC. Or, if you want to keep your options open, wait until the last moment. Your body. Your baby. Your decision.
VBAC doesn’t aim to prove anything to anyone. Listening to yourself is key. Asking the right questions and surrounding yourself with those who respect your decisions are also important.
If you are thinking about it, do the research. Talk to people. Find your people. Then go and get them, Mama.
You can do it, no matter what your path is.
