Yes, You Can Have a VBAC: What to Know About Vaginal Birth After Cesarean
If you’ve had a cesarean birth and are now pregnant again, you may be wondering if a vaginal birth is possible—or safe—for you this time around. The answer for most people? Yes. Absolutely.
Vaginal birth after cesarean (VBAC) is not only possible—it’s often safer than repeat cesarean surgery for low-risk pregnancies. As doulas, many of us are trained, experienced, and fully confident in supporting VBAC families through this healing and empowering experience.
Let’s walk through what VBAC is, what the evidence says about safety and success, and how you can prepare for your best chance at a smooth and supported vaginal birth after cesarean.
What Is a VBAC?
VBAC stands for Vaginal Birth After Cesarean. It simply means you’ve had one or more cesarean births in the past and are now planning (or open to) giving birth vaginally.
The alternative to VBAC is an elective repeat cesarean section (ERCS), which comes with its own set of risks—especially as the number of surgical births increases over time.
Is VBAC Safe?
Yes, for most people it is.
According to the American College of Obstetricians and Gynecologists (ACOG):
“Most women with one prior cesarean delivery with a low-transverse incision are candidates for—and should be offered—a trial of labor after cesarean (TOLAC).”
Here are the key safety stats:
Success rate of VBAC:
~70–85% of people who attempt a VBAC have a successful vaginal birthRisk of uterine rupture:
Less than 1% (0.5–0.9%) for those with one low-transverse incisionMaternal outcomes:
VBAC is associated with less blood loss, lower infection rates, and quicker recovery than repeat cesareanFuture pregnancies:
Avoiding multiple cesareans can reduce the risk of placenta accreta, surgical complications, and fertility issues
Benefits of a Successful VBAC
Shorter recovery time
Lower risk of infection and blood loss
Increased bonding and early breastfeeding opportunities
Lower risk in future pregnancies
Emotional healing and empowerment after a traumatic or unexpected first birth
What Makes VBAC More Likely to Succeed?
1. Supportive Provider and Birth Location
Not every hospital or provider is VBAC-friendly. Some are bound by policy or are hesitant to attend VBACs, even when evidence supports them. Your best chance of success often starts with choosing:
A midwife or OB who has a strong record of VBAC support
A hospital or birth center with VBAC protocols in place
Some home birth midwives also offer HBAC (home birth after cesarean) for carefully screened clients
2. Understanding Your Previous Cesarean
Talk to your provider or doula about what led to your cesarean:
Was it due to baby’s position?
Labor stall or “failure to progress”?
Induction or fetal distress?
Was it planned without labor?
Knowing the context can shape how you plan this birth and which tools you bring to the table.
3. Optimal Positioning and Movement
Freedom of movement during labor supports healthy positioning and helps labor progress naturally. Spinning Babies techniques, Rebozo work, and upright positions can make a big difference—especially if your last birth involved baby being posterior or malpositioned.
How Doulas Support VBAC
Most trained doulas are fully equipped and deeply passionate about supporting VBAC clients. As doulas, we:
Understand the emotional complexity of having had a prior cesarean
Help you process fears and expectations
Offer hands-on physical tools like counterpressure, hip squeezes, positioning, and comfort measures
Work with your provider team to maintain your sense of agency and informed decision-making
Support you in advocating for evidence-based care
Stay calm and grounded—whether labor moves quickly or slowly
Support you through all possible outcomes, with compassion and skill
If you’re wondering whether your doula is comfortable supporting VBAC, ask! Many of us have special training in this area and love being part of these powerful stories.
Tips to Prepare for a Successful VBAC
1. Choose a Provider Who Believes in Your Body
Ask your provider:
What is your VBAC success rate?
Do you require a certain dilation speed or time limits?
What is your cesarean rate for VBAC attempts?
If you get vague, fearful, or dismissive answers—it may be time to switch.
2. Take a VBAC-Specific Childbirth Class
Look for classes that address:
Physiological labor
Movement and positioning
Emotional preparation
Navigating hospital policies
3. Hire a VBAC-Savvy Doula
Someone who:
Understands hospital dynamics
Knows comfort techniques
Has supported VBACs before
Will help you advocate without tension
4. Prepare Physically
Daily movement (walking, stretching, pelvic tilts)
Optimal fetal positioning exercises (Spinning Babies)
Bodywork like chiropractic or massage, especially if baby was previously malpositioned
5. Release the Fear
Many VBAC clients carry fear—of uterine rupture, of “failing again,” of not being believed. A doula, therapist, or VBAC support group can help you release this and reclaim your confidence.
What About Home VBAC (HBAC)?
Some families choose home VBAC (HBAC), especially if their local hospitals don’t allow VBACs or are highly medicalized. While controversial in some regions, research has shown that planned HBACs with skilled midwives have high success rates and low intervention rates, though transfers should always be an option.
Be sure to talk with your midwife about screening, transport plans, and individualized care if you are considering this route.
Final Thoughts: You Deserve Options and Respect
VBAC isn’t for everyone—but it is possible for most people. The key is knowledge, preparation, support, and advocacy.
If you’re exploring your options after a cesarean birth, know this: Your body is not broken. Your story isn’t over. You get to choose what comes next.
Whether your birth unfolds at home, in a birth center, or in a hospital, you deserve care that respects your hopes, honors your past, and supports your future.
Resources and References
American College of Obstetricians and Gynecologists (ACOG). Practice Bulletin No. 205: Vaginal Birth After Cesarean Delivery.
National Institutes of Health. (2010). NIH Consensus Statement on Vaginal Birth After Cesarean.
VBAC Facts. www.vbacfacts.com
Childbirth Connection. (2020). What Every Pregnant Woman Needs to Know About Cesarean Birth.
Birth After Cesarean (BAC) Facebook & online support groups
Spinning Babies: www.spinningbabies.com
Evidence Based Birth. Evidence on VBAC
International Cesarean Awareness Network (ICAN): www.ican-online.org
