You’ve probably heard that if you’ve given birth via C-section, you’ll never be able to have a vaginal delivery for subsequent pregnancies. “Once a C-section, always a C-section” is, after all, an old adage. The reality? VBAC — or vaginal birth after a cesarean — is a possibility (but not a certainty) for mothers who have delivered once via C-section and would like to deliver vaginally for subsequent pregnancies.
Here’s what you need to consider about VBAC success rates, safety, and more.
Your provider can help you determine whether you're a VBAC candidate
Certain factors make someone a good candidate for a VBAC. The type of incision you had during your C-section is an important piece to consider. According to Mayo Clinic, if you’ve had a low incision with your previous C-section, have had a vaginal delivery in the past, and it has been more than 18 months since your last delivery, you have a greater risk of being cleared for VBAC.
But if you’ve had a uterine rupture in the past, have had other surgeries (like fibroid removal), or have had more than two C-sections, you are likely not deemed a candidate for VBAC.
Rescripted’s co-founder, Kristyn Hodgdon, initially thought she’d have a repeat C-section when she delivered her third baby (“It felt like the safest, most controlled option after everything I had been through,” she explains). But based on feedback from her providers, she decided to rethink that stance.
“As my pregnancy progressed, different providers at my new practice kept telling me I’d be a great candidate for a VBAC since I had delivered my daughter vaginally,” she said. “That’s when I set my condition: if I went into labor naturally before my scheduled C-section at 39 weeks, I’d go for it.”
Being deemed a candidate for VBAC doesn't necessarily mean you'll deliver that way
If your doctor tells you they’re on board with you attempting a VBAC, remember that this doesn’t guarantee a vaginal delivery.
“I learned that a VBAC is technically called a TOLAC, or trial of labor after C-section because it doesn’t always work out,” Kristyn shares.
It's not 100%, but VBAC success rates are promising
When it comes to attempting a vaginal delivery after a C-section, the odds are in your favor.
According to the Cleveland Clinic, studies estimate that VBAC success rates are between 60 and 80 percent. There are even calculators that can estimate your odds of success based on your age, weight, and delivery history — though, to be clear, those calculators can only provide an estimate. Ultimately, those are important factors in determining your odds of being able to deliver vaginally after having a C-section.
Your preferences also matter
If the thought of attempting to deliver vaginally but needing an emergency C-section terrifies you, talk to your doctor about that. Ultimately, formulating a birth plan is about safely bringing your child into the world, but your experience matters as well — and you’re allowed to voice your concerns.
“My biggest fear was ending up in another emergency C-section,” Kristyn shares. “I had been through that before; I didn’t want to go through it again. I told my doctor straight up that I’d rather have a planned C-section than go through another emergency situation, and she really listened to me.”
That's such an important part of charting the course of your pregnancy and delivery — finding a provider who listens to you, advocating for your needs, and working with your medical team to create a plan that keeps you safe and honors your wishes.
Part of making decisions comes down to weighing VBAC risks and benefits
VBAC delivery is not without risks — but neither is a C-section delivery. Each person’s risk factors are unique and take into account so many variables. At the end of the day, only you and your doctor can really figure out what the best option is for you.
One major risk associated with VBAC delivery is the risk of uterine rupture. Since a C-section creates a scar, the pressure of laboring for a vaginal delivery could cause your uterus to open along that scar. According to the Cleveland Clinic, this is a rare complication, but a very serious one: It can be life-threatening. Other risks include blood loss, infection, and an emergency C-section, which carries more risk than a planned C-section.
Again, your doctor can work with a full picture of your risk factors to fully understand your personal risks associated with VBAC.
From there, deciding on a VBAC birth plan can be challenging
There’s no “right” way to get birth — it’s truly about piecing together all the variables that affect the safety and benefits of each option.
But even then, it can be a tough decision to make. There’s no formula for deciding what the right option for your pregnancy is, at the end of the day.
“It was a tough decision,” Kristyn shares. “After my traumatic first birth experience, I felt safer with a planned C-section. Even when I was in labor, I got cold feet. I told my doctor, ‘I’m just terrified of this ending in an emergency C-section.’ But she talked me through everything, and knowing she truly understood my history — IVF, miscarriages, failed transfers, my first delivery — helped me feel safe enough to move forward with the VBAC.”
No two births are the same
Even if you’ve delivered vaginally before, you may be surprised by how different a VBAC feels. After all, no two births are exactly the same, and that’s what was so surprising to Kristyn, who experienced both vaginal and C-section births before having her own VBAC.
“[I was surprised by] how emotional it was,” she shares. “Having a female provider who really saw me, who understood everything I had been through, made such a difference. And then, when my doctor said, ‘Kristyn, reach down,’ and I got to pull my son onto my chest myself — I can’t even put into words how healing that moment was. It was everything I had dreamed of but didn’t think I’d get to experience.”
“I’ve learned that no two births are the same,” she adds. “Just because I had a traumatic experience before didn’t mean I was doomed to have another one. And the biggest lesson? Find providers who listen. Who really see you. Who make you feel safe. It changes everything.”
Zara Hanawalt is a freelance journalist and mom of twins. She's written for outlets like Parents, MarieClaire, Elle, Cosmopolitan, Motherly, and many others. In her (admittedly limited!) free time, she enjoys cooking, reading, trying new restaurants, and traveling with her family.
