Vaginal Birth After Caesarean (VBAC)

British Columbia Specific Information

If you are thinking about options for your next birth after a caesarean, Perinatal Services BC has an online tool called My Next Birth to provide information about repeat C-sections and what the different choices may mean for you, your family and your health.

Topic Overview

What is a vaginal birth after caesarean (VBAC)?

If you have had a caesarean delivery (also called a C-section) before, you may be able to deliver your next baby vaginally. This is called vaginal birth after caesarean, or VBAC.

Most women, whether they deliver vaginally or by C-section, don't have serious problems from childbirth.

If you and your doctor or midwife agree to try a VBAC, you will have what is called a "trial of labour after caesarean," or TOLAC. This means that you plan to go into labour with the goal to deliver vaginally. But as in any labour, it is hard to know if a VBAC will work. You still may need a C-section. About 25 out of 100 women who have a trial of labour need to have a C-section. This means about 75 out of 100 women who have a TOLAC deliver vaginally.footnote 1

Is a trial of labour safe?

Having a vaginal birth after having a C-section can be a safe choice for most women. Whether it is right for you depends on several things, including why you had a C-section before and how many C-sections you've had. You and your doctor or midwife can talk about your risk for having problems during a trial of labour.

A woman who chooses VBAC is closely monitored. As with any labour, if the mother or baby shows signs of distress, an emergency caesarean section is done.

What are the benefits of a TOLAC and VBAC?

The benefits of a VBAC compared to a C-section include:

  • Avoiding another scar on your uterus. This is important if you are planning on a future pregnancy. The more scars you have on your uterus, the greater the chance of problems with a later pregnancy.
  • Less pain after delivery.
  • Fewer days in the hospital and a shorter recovery at home.
  • A lower risk of infection.
  • A more active role for you and your birthing partner in the birth of your child.

What are the risks of TOLAC?

The most serious risk of a trial of labour is that a C-section scar could come open during labour. This is very rare. But when it does happen, it can be very serious for both the mother and the baby. The risk that a scar will tear open is very low during VBAC when you have just one low caesarean scar and your labour is not started with medicine. This risk is why VBAC is often only offered by hospitals that can do a rapid emergency C-section.

If you have a trial of labour and need to have a C-section, your risk of infection is slightly higher than if you just had a C-section.

Media gallery