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To VBAC or Not to VBAC?

Always speak to your doctor or midwife to get their professional medical advice. If you are anything like me you may also want to do your own research. When I was faced with this decision, I did as much research as possible so that I could make a truly informed decision. There is a lot to weigh. Some things to consider:

1. VBAC is possible.

Not every woman with a previous cesarean is a good candidate for VBAC. Not every woman who tries to have a VBAC will have one. But many women are and do. In fact, 75% of the time VBAC is successful.

I had a VBAC in 2012. After my emergency cesarean in 2006, I was told in no uncertain terms that I should never try to have a vaginal birth or even consider going to full term in pregnancy. Yet, I did both of these things and lived to tell about it and I am not alone.

2. Education and facts matter.

There is a lot of misinformation that exists on the topic of VBAC. Most people still think: “Once a cesarean always a cesarean.” This is not true.

In this article ACOG says the following: “In 2010, ACOG supported VBAC as a safe and suitable choice for women who have had a prior cesarean delivery and are appropriate candidates, including for some who have had two previous cesareans. Achieving a vaginal birth depends on individual circumstances, and the decision to attempt trial of labor should be made through shared decision-making between the patient and the ob-gyn.” –

An excellent resource for factual information is Jennifer Kamel has spent thousands of hours researching and compiling the facts into an easily accessible and digestible format. She is not pro-VBAC or anti-cesarean. She shares evidence-based information through her website, classes and webinars.

3. There are risks for both VBAC and repeat cesarean.

VBAC risks will vary depending on many things including: health history, whether labor starts spontaneously or is induced, type of cesarean incision, etc.

When labor begins spontaneously after one bikini cut cesarean, the uterine rupture (UR) rate is 0.4%. It can increase with labor augmentation or induction. Out of that number only a small percentage result in tragic outcomes. Read this article to learn more.

Let’s put this in perspective. This rate of UR is similar to other obstetrical emergencies in first-time moms, including placental abruption and cord prolapse. Let me repeat this: placental abruption and cord prolapse (which are serious matters) can happen to ANY first-time mom at a similar rate that UR can happen to a VBAC mother. Did this consideration give you pause when having your first baby? Probably not.

We hear a lot of talk about the risks associated with VBAC. Did you know that there are also risks associated with repeat cesarean? Some of the risks include: placenta accreta, placenta previa, surgical injuries, hysterectomy, blood transfusion and ICU admission. These risks increase with each subsequent surgery. In contrast, after a successful VBAC, the future risk of uterine rupture and other complications significantly decrease.

4. Your comfort and security is relevant.

Don’t let misrepresentation of the facts, social or family pressure sway you one way or the other. At the end of the day, you must be comfortable and feel safe and secure in whatever decision you make, whether it is a trial of labor for a VBAC or a repeat cesarean. Do what is right for you in coordination with your care provider.

5. Make peace with either outcome.

It’s a good idea to remain flexible while still aiming for whatever your preference is. A repeat cesarean can be an extremely healing birth when you choose it on your terms.

As you may have already experienced, we don’t have 100% control in childbirth. Even if you choose to try for a VBAC, things may not go as planned on the big day. Knowing that you were educated, prepared and advocated for yourself can help you to have a more satisfying experience no matter the birth outcome.

About Christie Collbran

Christie Collbran is the owner and founder of Buddha Belly. Christie believes in helping women recognize their own inner wisdom, strength and power and has more than ten years of experience serving families as a doula.

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