Planning a vaginal birth after a C-section

The medical term is vaginal birth after caesarean, often shortened to VBAC. The decision is about the scar on the uterus, not simply the visible skin scar. Clinicians review the reason for the earlier caesarean, the direction of the uterine cut, recovery, previous births and any operations involving the uterus.

The current pregnancy also matters, including the baby's position, placenta location, pregnancy complications and whether labour begins spontaneously or needs assistance. The chosen birth setting should be able to monitor labour and provide urgent caesarean birth if a complication develops.

Ask the maternity team to obtain the previous operation note if it is available; the skin scar does not reliably reveal the uterine incision type. Review the benefits and risks of planned VBAC and planned repeat caesarean in relation to your health, values and plans for future pregnancies.

Agree when to contact the unit once contractions begin or the waters break, what monitoring is recommended and how pain relief can be provided. If induction becomes necessary, the team should explain which methods fit a scarred uterus and how those methods change the monitoring plan.

During pregnancy, urgently contact maternity care for heavy bleeding, severe or persistent abdominal pain, faintness, breathing difficulty, reduced fetal movement or fluid leaking before labour is expected. Follow your maternity unit's instructions about contractions and waters breaking.

During labour, continuous or unusual pain between contractions, sudden scar-area pain, bleeding or feeling acutely unwell requires immediate assessment. The labour team will also watch the baby's heart rate and labour progress for signs that the plan needs to change.

Ask what the earlier operation record says about your uterine incision, whether the original reason for surgery could recur, and which current-pregnancy findings influence your options. Clarify the hospital's labour monitoring, induction approach, pain-relief choices and circumstances that would lead to repeat caesarean birth.