Vaginal birth after cesarean (VBAC) is a vaginal childbirth after a woman has previously delivered a baby by cesarean section.
When you go into labor with the plan to deliver vaginally, it is called a "trial of labor after a cesarean," or TOLAC.
Having a vaginal birth after having a C-section can be a safe choice for most women. But it can have risks for both the mother and the baby. Whether it is right for you depends on several things, including:
Benefits of VBAC include:
Risks of VBAC include:
No two births are alike. You and your doctor can't fully control labor and delivery. So no doctor can say for sure that you will be able to have a vaginal birth.
The risks of cesarean delivery include:
If you are planning to get pregnant again, it's important to think about scarring. After you have two C-section scars, each added scar in the uterus raises the risk of placenta problems in a later pregnancy. These problems include placenta previa and placenta accreta, which raise the risk of problems for the baby and your risk of needing a hysterectomy to stop bleeding.
Your doctor might recommend a C-section instead of VBAC if:
|Try VBAC||Have a C-section|
|What is usually involved?|
|What are the benefits?|
|What are the risks and side effects?|
Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
"I believe I had a more difficult time bonding with my first baby in the first week because of the cesarean delivery (she was a breech birth). A lot of my energy was taken up with recovering from the surgery, both physically and emotionally. I'm planning a trial of labor for my second baby. My husband and I are really hopeful that things go well, especially since we plan to have a big family. If I can, I want to avoid the risks of having a scarred-up uterus from several cesareans."
— Amber, age 29
"I had my first child by cesarean after more than 30 hours of hard labor and a lot of pain. I am willing to go through another cesarean to avoid that experience again. I know that recovering from the surgery isn't easy either, but I prefer that option. And this is our last baby, so I don't have to worry about the risks of pregnancy with multiple cesarean scars."
— Gretchen, age 27
"During my first pregnancy, I developed placenta previa and had to have a cesarean. I have talked to my doctor and my husband and read up on all the risks of a trial of labor for someone in my situation. My doctor tells me that as long as another placenta previa doesn't develop, there is no obvious reason why I shouldn't be able to try a vaginal birth this time. I hope it goes well, because if I have another cesarean, I won't have the option of trying a vaginal birth the next time!"
— Marcia, age 35
"My first cesarean was done because the baby was in distress. That experience was so scary for me that I don't want to repeat it. My doctor says there's no reason to expect that it will happen again this time, but she also can't say for sure that it won't happen. She says the decision is up to me, and I'm choosing to have another cesarean."
— Graciella, age 31
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to try VBAC
Reasons to have a C-section
I want to participate more in my baby's birth.
I'll feel like I'm involved in the birth no matter how my baby arrives.
I'm not concerned about the risk of a uterine rupture.
I'm worried about a uterine rupture with VBAC.
I'm worried about a risk to my baby from a C-section.
I'm more worried that something could happen to my baby with VBAC.
I want to have this baby vaginally so that I don't get another scar on my uterus.
If I want to have another baby, I won't mind how my baby is delivered.
I want a shorter recovery.
I don't mind a longer recovery.
My other important reasons:
My other important reasons:
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Having a C-section
1. Is it likely that you can give birth vaginally after having had a cesarean before?
2. If you try VBAC, might you still need to have a C-section?
3. Do all hospitals and doctors offer VBAC?
1. Do you understand the options available to you?
2. Are you clear about which benefits and side effects matter most to you?
3. Do you have enough support and advice from others to make a choice?
1. How sure do you feel right now about your decision?
2. Check what you need to do before you make this decision.
3. Use the following space to list questions, concerns, and next steps.
|Primary Medical Reviewer||Sarah Marshall, MD - Family Medicine|
|Specialist Medical Reviewer||Femi Olatunbosun, MB, FRCSC - Obstetrics and Gynecology|