To VBAC or Not?

If you've had a cesarean birth, and find yourself pregnant again, you have options!

You may choose to have a repeat cesarean, which will be scheduled typically around 38 weeks of pregnancy. Your other option is to try for a vaginal delivery this time around. For many birthing people, exploring VBAC can feel empowering, emotional, and sometimes overwhelming. Let’s talk about what VBAC is, how to prepare, and the real risks and benefits, so you can make the decision that feels right for you.

What Is a VBAC?

A VBAC is when a person gives birth vaginally after having had a previous cesarean section. I

Many people are surprised to learn that VBAC is a safe and reasonable option for most people! Many medical professionals are actually recommending a trial of labour to have a vaginal delivery as the safer option compared to a scheduled cesarean delivery.

Benefits of a VBAC

There are several potential benefits to choosing a VBAC when it’s medically appropriate:

1. Shorter Recovery Time

Vaginal births generally come with:

• Less post birth pain

• Shorter hospital stays

• Faster return to daily activities. This can be especially important when you’re caring for older children at home.

2. Lower Risk in Future Pregnancies

Each cesarean increases the risk of complications like:

• Placenta accreta. (The placenta attaching too deeply into the uterine wall which has a risk of severe bleeding which could require a hysterectomy)

• Placenta previa. (low lying placenta which covers the cervix)

• Surgical complications

  A successful VBAC can reduce these risks if you plan more pregnancies.

3. Reduced Surgical Risks

Avoiding major abdominal surgery means a lower risk of:

• Infection

• Blood clots

• Excessive blood loss

• Injury to surrounding organs

4. Emotional Healing & Empowerment

For some, VBAC offers a chance to:

• Process a previous birth that felt traumatic or disempowering

• Reconnect with trust in their body

• Experience labor and birth in a new way

It’s important to note that healing does not depend on the mode of birth—but for many, VBAC can be deeply meaningful.

5. Immediate Newborn Benefits

Babies born vaginally may experience:

• Improved respiratory transition

• Exposure to beneficial bacteria during birth

• Immediate skin-to-skin and feeding opportunities

  
  

Risks of a VBAC

It’s equally important to talk honestly about the risks so you can make an informed choice.

1. Uterine Rupture

The most discussed risk of VBAC is uterine rupture, where the prior scar opens during labor. While this sounds scary, it’s important to understand the numbers:

• Risk is approximately 0.5–1% for those with a low-transverse incision (bikini line incision)

• When properly monitored in a supportive medical setting, outcomes are generally very good. VBACS require continuous fetal monitoring, which watches for this.

2. Emergency Cesarean

Not all VBAC attempts result in vaginal birth. Some labors may require a repeat cesarean due to:

• Labor not progressing

• Baby showing signs of distress

• Maternal health concerns

An unplanned cesarean after labor can be more physically demanding than a scheduled one, though many still feel the attempt was worthwhile.

3. Limited Provider or Hospital Support

Unfortunately, not all hospitals or providers are equally supportive of VBAC. Some impose restrictions that can impact:

• Freedom of movement

• Use of induction methods

• Continuous labor support

This isn’t a medical risk—but it can affect your experience.

Preparing for a VBAC: Mind, Body, and Support

Preparation matters.

Choose a VBAC-Supportive Provider

Ask providers:

• What is your VBAC success rate?

• What policies do you have around induction, movement, and monitoring?

• How do you support physiologic labor after cesarean?

Feeling respected and heard is essential. If your provider doesn't feel supportive. Find a new one!

Learn About Labor & Birth

Education builds confidence. Consider:

• VBAC-specific childbirth classes

• Understanding stages of labor

• Learning comfort measures and coping techniques

Prepare Your Body

Gentle movement and body awareness can help:

• Prenatal yoga

• Walking and pelvic mobility exercises

• Optimal fetal positioning practices

Always check with your provider before starting anything new.

Address Emotional Healing

Previous birth experiences can leave lasting impressions. Journaling, therapy, or talking with a doula can help you:

• Process fear or disappointment

• Separate past experiences from your upcoming birth

• Build trust in your body again

Build a Strong Support Team

A doula can improve your chance at a VBAC!

• Provide continuous emotional and physical support

• Help you navigate hospital systems

• Encourage informed decision-making

• Support both VBAC attempts and unexpected outcomes

VBAC is not about “proving” anything or earning a certain type of birth. It’s about choice, safety, and autonomy. Whether you choose a planned repeat cesarean or pursue a VBAC, you deserve respectful care, clear information, and support every step of the way.

Birth is not one-size-fits-all—and neither is healing.

If you’re considering a VBAC, know this: your body is not broken, your past birth does not define your future one, and you are allowed to choose the path that feels right for you and your family. 💛

Planning a VBAC birth in Winnipeg? We'd love to support you!

Book a free doula support consultation today!