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Vaginal birth after caesarean

Many women who have had caesarean will be able to give birth vaginally in their next pregnancy, this is known as vaginal birth after caesarean (VBAC). Vaginal birth can also include a birth assisted by forceps or venthouse. 

What are the advantages of VBAC?

The advantages of vaginal birth after caesarean (VBAC) include:

  • A greater chance of an uncomplicated birth in future pregnancies.
  • A shorter recovery and a shorter stay in hospital.
  • Many women want to avoid further major surgery. 
  • Less chance of infection, thrombosis (blood clots) or the need for a blood transfusion if you have vaginal birth. 

What are the disadvantages of VBAC?

The disadvantages could include the following:

  • During your labour it could become apparent that you will be unable to give birth vaginally and need to have another caesarean section.
  • There is a small risk of the scar on your womb from the previous caesarean section separating during labour. Many studies have shown that this risk low and that it may even occur if you are not in labour. An emergency caesarean section will be necessary if this happens.  

How will the decision be made? 

Your midwife will discuss this with you at your first antenatal visit and give you information to help you to consider your options. Before any decisions are made, you will be able to discuss your birth choice options with your obstetrician and midwife. This will include your personal wishes and future pregnancy plans. 

There are a few occasions when VBAC is not advisable and repeat caesarean section is considered a safer choice. Your healthcare professional will discuss these directly with you and provide you with information to make an informed decision. 

Is there anything I can do to increase my chance of a vaginal birth?

Preparing for birth, having lots of encouragement to get through labour, and feeling well cared for is known to help women cope with labour. It may also affect the length of labour and what sort of birth you have. 

Keeping mobile and adopting different positions is also likely to help your labour. Women often find movement a helpful way of coping and being upright will help get your baby’s head into a good position to encourage them to descend into your pelvis.

You may find it useful to attend your active antenatal classes. Ask your midwife for details about local classes in your area. 

What happens if I go into labour when I’m planning a VBAC?

You will be advised to give birth in hospital so that a caesarean birth can be carried out if necessary. Contact the hospital as soon as you think you are in labour or your waters break, and you will be advised when to come to hospital.

Where can I get more information?

There are some differences in how we would care for you in labour when you are having a VBAC compared to someone who has never had a caesarean. Your midwife and obstetrician are available to discuss any questions that you may have about any aspects of your pregnancy or birth. 

Ask your midwife about attending a Birth Choices Clinic where you will be able to discuss options in more detail.

Further information and resources