Vaginal birth after caesarean

Women who have had a caesarean (also known as a caesarean section or C-section) are often able to give birth to subsequent children vaginally. Approximately three in four women who prepare for a vaginal birth after a caesarean (VBAC) do give birth vaginally.

Advantages and risks of VBAC

There are many advantages to giving birth vaginally. There are no risks of complications from surgery, you get to hold your baby for as long as you want right after she is born, you are more mobile, and your recovery time is shorter.

However, vaginal birth after caesarean does carry a very low risk of uterine rupture. If this happens, an emergency C-section will be necessary. Uterine rupture is rare, but can have very serious consequences for both mother and baby.

A planned caesarean also carries the risk of complication (see Caesarean).

Decision to have a VBAC

If your last baby was delivered by C-section, you may be wondering how you will bring your baby into the world this time: vaginally or by C-section?

To help you make this decision, your doctor or midwife will assess your situation and tell you what factors could increase or decrease your chances of giving birth vaginally. When discussing this question, make sure to express your preferences and needs with respect to the options available.

In some cases, vaginal birth is contraindicated and will not be recommended.

Your plans may also change. For example, your decision to give birth vaginally may be re-evaluated during your pregnancy, and your healthcare provider may in the end recommend a caesarean. Conversely, if you are planning a C-section, your labour may begin before the date set for your caesarean and you and your doctor may decide that you can deliver vaginally.

Preparing for a VBAC

Preparing for a VBAC is no different from preparing for any other vaginal birth. For example, you can take prenatal classes or learn more about pain relief (see Techniques for coping with childbirth pain).

Having a friend or family member or doula at your side throughout labour and the birth can be helpful. Research shows that this kind of support makes delivery go more smoothly and reduces the risk of having a C-section. Also remember that you can have an epidural during labour.

Labour: Process by which the baby passes from the uterus to the outside world, primarily through contractions of the uterus.

Uterine rupture: Tearing of the uterine scar from a previous caesarean.