Successful VBAC: what to know

Your obstetric team reviews why the earlier caesarean happened, the type and position of the uterine incision, any other uterine surgery, and how this pregnancy is progressing. Labour after caesarean needs continuous assessment because the scar can rarely separate during labour. A suitable birth setting has staff who can monitor you and the baby and respond quickly if a caesarean becomes necessary. A previous vaginal birth may also be relevant to the discussion, but it does not decide the plan alone.

Bring your previous operative report if it is available, and discuss your preferred birth plan early. Ask how contractions, fetal heart monitoring, pain relief and movement will be managed. Talk through what happens if labour does not start, if induction is advised, or if the baby’s position changes. Make sure you know which hospital to attend and how to reach the maternity team at any time.

Contact the maternity unit immediately for labour contractions, vaginal bleeding, fluid loss, sudden persistent abdominal pain, faintness, or reduced fetal movement. During labour, tell staff about new scar-area pain, unusual tenderness, breathlessness or feeling unwell. These symptoms need assessment; they do not predict the cause by themselves. Follow the emergency plan given by your maternity team.

Ask: What type of uterine incision did I have? Is VBAC appropriate in this pregnancy? Where should I give birth? What monitoring will be used? How would induction change the plan? When would a repeat caesarean be recommended?