VBAC vs Repeat C-Section: How to Make the Right Choice for You
Updated: Oct 1
If you have had a previous caesarean birth and are pregnant again, one of the questions you may find yourself asking is: “Should I try for a vaginal birth this time, or have another C-section?”
It is a decision worth discussing early in pregnancy because your previous C-section, your current pregnancy and your future pregnancy plans can all play a role.
A VBAC (Vaginal Birth After Caesarean) may be an option for some women, while a repeat C-section may be recommended for others. Understanding what influences this decision can help you have a more informed conversation with your obstetrician.
What Is VBAC?
VBAC means having a vaginal birth after a previous caesarean delivery.
A previous C-section does not automatically mean that every subsequent baby needs to be delivered by C-section.
However, VBAC is not suitable for everyone. The decision depends on factors related to your previous surgery, your current pregnancy, and the circumstances surrounding your previous birth.
What Does Your Previous C-Section Tell Us?
Your previous delivery history is an important starting point.
Factors considered include:
Why your previous C-section was performed
The type of incision made on your uterus
Whether you have had a previous vaginal birth
The number of previous caesarean deliveries
Any complications during your previous pregnancy or surgery
Your previous medical and obstetric records, when available
For example, a previous C-section because your baby was in a breech position is different from one performed because labour did not progress. The reason for the earlier caesarean can therefore be relevant when discussing your options for the current pregnancy.
When Can VBAC Be Considered?
VBAC may be considered when the overall circumstances are favourable.
Your current pregnancy will also be assessed, including:
Your baby's position
Placental location
Baby's growth and wellbeing
Any pregnancy complications
Your overall health and obstetric history
Whether there are any concerns that could make vaginal birth unsuitable
The type of uterine scar from your previous surgery is particularly important because different uterine incisions carry different considerations during a subsequent labour.
This is why your previous C-section records can be useful when planning your delivery.
When Might a Repeat C-Section Be Recommended?
There are circumstances where attempting labour after a previous C-section may not be advisable.
A repeat C-section may be recommended depending on the type of previous uterine surgery, certain placental conditions, pregnancy complications, or other factors that make a vaginal birth less suitable.
In some situations, a repeat C-section may be planned before labour begins. In others, the delivery plan may need to change depending on how the pregnancy progresses.
The recommendation is therefore based on your current clinical situation as well as your previous delivery history.
VBAC: What Should You Know?
A successful VBAC allows you to have a vaginal birth without another abdominal surgery.
However, attempting VBAC does not guarantee that a vaginal delivery will happen. Labour may not progress as expected, or concerns may arise during labour that require a caesarean delivery.
This is why attempting VBAC requires appropriate monitoring and access to emergency obstetric care when needed.
Your obstetrician should also discuss what would happen if a C-section becomes necessary during labour, so that you understand the possible outcomes before going into labour.
Repeat C-Section: What Should You Know?
A planned repeat C-section can provide a more predictable delivery plan and may be the recommended option when attempting vaginal birth carries additional concerns.
At the same time, a caesarean is major abdominal surgery. Recovery generally involves surgical wound care and may take longer than recovery after an uncomplicated vaginal birth.
Having multiple C-sections can also be relevant when planning future pregnancies, as the risk of certain complications can increase with repeated uterine surgery.
This does not mean that a repeat C-section is unsuitable. It means that your current and future pregnancy plans are worth considering as part of the discussion.
What Are the Chances of a Successful VBAC?
The likelihood of a successful VBAC varies from woman to woman.
There are several factors that may influence it which differ from person to person. Rather than relying on a general percentage found online, your obstetrician can assess your individual circumstances and discuss what may influence your chances of a successful VBAC.
What If You Go Into Labour but Need a C-Section?
Attempting VBAC does not mean that you have to continue with vaginal delivery if circumstances change.
During labour, your health and your baby's wellbeing will be monitored. If there are concerns about the baby's heart rate, labour is not progressing or another obstetric concern develops, a caesarean may become the safer option.
The delivery plan should therefore include not only the possibility of a successful VBAC, but also what happens if a C-section becomes necessary.
How Do You Decide Between VBAC and Repeat C-Section?
This is where an individual consultation becomes important.
Instead of making the decision based on another woman's birth experience, social media stories or general information online, discuss your own history and pregnancy with your obstetrician.
The discussion should also cover the potential benefits and risks of attempting VBAC, the possibility of an emergency C-section and what a planned repeat C-section would involve.
If your previous birth was difficult or unexpected, you can also discuss those concerns openly. Understanding what happened previously can help you feel more prepared for your next delivery.
Making Your Delivery Plan
If you have had a previous C-section, your next delivery deserves a plan based on your previous experience, current pregnancy and individual circumstances—not simply what worked for someone else.
Start with a conversation with Dr. Dhwany Munshi. She will review your previous C-section, current pregnancy and medical history, and discuss whether VBAC or a repeat C-section may be suitable for you.
Take the next step towards a well-informed delivery plan with personalised obstetric care from Dr. Dhwany Munshi.
Have questions about your delivery options? How to Ask the Right Questions at Your Gynaecologist Appointment? can help you prepare for a more meaningful discussion with your doctor.
