VBAC to the Future
- Sarah Ludwig
- Nov 18
- 3 min read
Great Scott! Thinking about a VBAC? If your last baby was born via cesarean and you're wondering if you can go for a vaginal birth this time, welcome to the future. We've got your support, no flux capacitor required.
A VBAC (Vaginal Birth After Cesarean) just means you're hoping for a vaginal delivery after a previous c-section. When you decide to try, that's called a TOLAC (Trial of Labor After Cesarean). It requires the right conditions, a supportive provider, and an understanding of what is involved.
Why go VBAC?
For many families, the "why" comes down to recovery, health, and personal empowerment. There are some big benefits when a VBAC is successful:
faster recovery: No abdominal surgery means a quicker return to normal life
fewer complications: lower risk of blood loss, infection, and surgical injuries
better for future pregnancies: Repeat cesareans increase the risk of placenta previa, accreta, and other complications.
emotional satisfaction: Many parents feel deeply empowered by achieving a VBAC.
What is the flip side?
VBAC is not without risk and it is smart to go in with your eyes open.
uterine rupture: Rare (less than 1%), but serious, the previous scar opening is the biggest concern.
emergency cesarean: If a TOLAC does not work out, an urgent c-section can carry more risks than a planned one. VBACs should only be done in hospitals equipped with an OR, anesthesia, and surgical staff available now, not "soon."
What does ACOG say?
Here are the American College of Obstetricians and Gynecologists recommendations:
People with one prior low-transverse incision (the standard horizontal one) are generally good candidates.
People with a classical (vertical) incision or a history of uterine rupture should NOT attempt TOLAC.
Prostaglandin medications for cervical ripening should not be used.
Induction and augmentation may be considered cautiously with other methods, like a Foley balloon or low-dose Pitocin.
VBAC should be supported in facilities capable of immediate emergency cesarean delivery.
Birth decisions should be individual and made with shared, informed discussion.
Will a VBAC work for you?
VBAC success rates hover around 60-80%, and your personal odds depend on a few factors:
More likely to be successful:
You've had a vaginal birth before, especially a prior VBAC.
Your first cesarean was for something non-recurring. like a breech baby or multiples.
You go into labor spontaneously.
It is trickier if: (None of these are hard "no's," just things to discuss with your provider.)
You had a cesarean for stalled labor or a big baby.
You go well past your due date.
You conceived within 18 months of your last birth.
Boost Your Odds of Success with a VBAC Game Plan
Talk early and often with your provider about your birth goals. Not every provider or hospital supports VBACs so ask at your first visit.
Get your operative report to confirm what kind of incision you had.
Choose a facility that supports VBACs, and ask about their success rates.
Build your support team. Doulas make a measurable difference in birth satisfaction and outcomes; a
supportive provider plus an experienced doula is a dream team!
Keep an open mind. The baby is not going to read your birth plan, but informed flexibility is empowering. Even if plans shift, you are still the main character in your birth story.
TL/DR
Whether you choose VBAC or repeat cesarean, the most important thing is that you feel informed, supported, and respected. VBAC is not about proving anything; it is about options, evidence, and ownership of your birth experience.
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