What it is
Birth after c-section comes with two paths: a planned repeat cesarean, or a trial of labor, called TOLAC. When the trial ends in a vaginal birth, it is a VBAC. ACOG says most mothers with one prior low, side-to-side cut are good candidates, and many with two. Each repeat cesarean raises the risk of placenta problems next time.
What's typical
About 60 to 80 in 100 who try have a vaginal birth. Odds are higher if you have had a vaginal birth before, go into labor on your own, or your last cesarean was for a reason that does not repeat, like breech. The main risk is uterine rupture, a tear at the old scar. With one prior low cut it happens in fewer than 1 in 100 labors. Hospitals that offer VBAC keep an anesthesiologist and operating room ready.
What's known
Some hospitals do not offer TOLAC, and some providers quietly steer away from it. Fewer than 15 in 100 US mothers with a prior cesarean have a VBAC.
What helps
- Get your operative report from the last cesarean. The type of cut on the uterus is the key fact.
- Ask the hospital directly. Do you offer TOLAC? Is anesthesia in the building 24 hours?
- Find a doula who has supported VBACs.
When to call someone
- Nowin labor with a prior cesarean, sudden sharp pain that stays between contractions, bleeding, or a baby who moves less. Go in now.
- Todayyour provider says no to VBAC without a reason you understand. Ask for one, or for a second opinion.
- At your next visitask for your success estimate.
Who helps
Tools: Birth Plan Generator · Birthworker Directory
Related
- Planning a cesareanGetting Ready for Birth
- When birth didn't go to planBirth and the First Days
- OB or midwife: choosing who catches your babyGetting Ready for Birth
- Induction: why, how, and what to askGetting Ready for Birth
- Cesarean recovery, week by weekPostpartum: Your Body
What mothers here say
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Sources
- American College of Obstetricians and Gynecologists — Practice bulletin on vaginal birth after cesarean delivery
- American College of Obstetricians and Gynecologists — Patient FAQ on vaginal birth after cesarean delivery
- Cal Hospital Compare — VBAC rates by hospital
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