What is a 'Vaginal birth after Caesarean (VBAC)' and why have one?

A VBAC, (pronounced 'vee-back') is the acronym used for the term 'Vaginal Birth After (one or more) Caesarean' births. Other terms used to describe when women plan to labour and give birth vaginally after a previous Caesarean, include Trial of Labour (TOL), Trial of Scar (TOS) or the American term, Trial of Labour after Caesarean (or TOLAC).

Extensive medical research continues to support the safety of a VBAC, when compared to the possible risks involved in having a repeated Caesarean operation for non-medical reasons. Because of this, planning a VBAC has become more commonplace in recent years, as the practice becomes an increasingly more accepted option.

Many women choose to explore the option of planning a VBAC for various personal and / or health reasons. Or they may start to consider a VBAC if it is suggested to them by their caregiver.

Some reasons for planning a VBAC can include one or many of the following:

You'd prefer a vaginal birth next time

For some women, they feel that their previous Caesarean birth was necessary and the birth experience itself was acceptable and straight forward, but they would prefer to have a vaginal birth next time around, unless there is a medical reason to repeat the Caesarean again.

For other women the Caesarean may have been a negative experience and / or very unexpected. It may be that you or your baby experienced unwanted side effects or complications from the previous operation or anaesthetic that was used. Perhaps you were unconscious for the operation and missed out on having tangible memories of your child's birth.

All these factors and others can add to a woman's motivation to plan a VBAC for a subsequent child.

You felt that your previous Caesarean was possibly unnecessary

Or it could have been avoided. Sometimes a woman will feel unresolved or unsure about why she had her previous Caesarean. (If you feel unresolved with your first birth experience, then speaking with your caregiver or obtaining your medical records could help clarify the events leading up to the Caesarean and explain why it was necessary. Alternatively, you could work through the issues with a childbirth educator or counsellor).

Learning what happened the first time can possibly lead you to plan the next birth in a way that helps you to feel you are more in control and more of a participant in the process. It could play a role in making the decision to plan a VBAC for the next birth or prompt you to plan for ways to make a possible repeat Caesarean a more positive experience. This can often be facilitated by writing a birth plan.

You feel incomplete, unfulfilled or traumatised by your previous Caesarean experience.

Some women will feel 'incomplete or unfulfilled' after their Caesarean birth. This is often not acknowledged as important (compared to the 'healthy mother and healthy baby' argument) by friends, relatives and caregivers, although it can be very much a reality for the woman.

A few women will feel deeply affected by their Caesarean births, some to the point of feeling 'violated' or 'traumatised'. It may be that those women need to debrief their first birth with a counsellor to be able to move on and emotionally prepare for their next birth. Wanting to have another child but not wanting to revisit another Caesarean, motivates many women to plan a VBAC. For some women planning a VBAC can be part of their healing process.

Taking care of a toddler is much easier if you are recovering from a vaginal birth

Recovering from a major operation is hard enough with a new baby, let alone throwing a toddler into the equation. For many women the prospect of having a vaginal birth with a subsequent child is an attractive option, and possibly one way of making the parenting of two or more a little easier.

Find more:

• Advantages of a VBAC

• Disadvantages of a VBAC