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If you have had a caesarean before and you’re hoping for a vaginal birth this time, you are not alone. Many women feel strongly about wanting a vaginal birth, and in the right circumstances, that goal is achievable. Working with a VBAC specialist who understands both the evidence and your own situation is the foundation of safe VBAC planning.
This guide explains what a VBAC is, who is a good candidate, what affects your chances of success, and what to expect along the way.
What Is a VBAC?
VBAC stands for Vaginal Birth After Caesarean. It means trying for a vaginal birth in a pregnancy after a previous caesarean. It is also called a trial of labour after caesarean (TOLAC).
For women who fit the right criteria, VBAC can be safe and rewarding. The main concern in VBAC planning is a small but real risk of uterine rupture. This means the scar from the earlier caesarean tears open during labour. This risk is about 0.5 to 1 per 100 VBAC attempts. It is this small risk that makes careful patient selection and close watching during labour so important.
Who Is a Good Candidate for VBAC?
Not every woman is a good fit for a vaginal birth after caesarean in Melbourne. This is why a proper check-up by an experienced obstetrician matters so much.
| Supports VBAC | May Rule Out VBAC |
|---|---|
| One previous low, horizontal caesarean cut | A previous up-and-down (classical) cut |
| No other major scarring on the womb | More than one previous caesarean |
| No reason for a caesarean this time | A previous womb rupture |
| Hospital ready for an emergency caesarean | Womb shape issues that raise rupture risk |
| Baby head-down near full term | Placenta or baby position needing a caesarean |
| A past vaginal birth | — |
What Are the Benefits of VBAC?
For women who have a successful vaginal birth, the benefits are real.
– Faster recovery than repeat caesarean surgery
– Lower risk of surgery problems like heavy bleeding, infection, or injury to nearby organs
– Avoiding the extra risks that build up with each caesarean you have
– A birth experience many women find more empowering and easier to recover from
– Shorter hospital stay and quicker return to daily life
What Improves Your Chance of Success?
Success rates for VBAC vary a lot from woman to woman. Working with a safe VBAC specialist who can assess your risk profile is the best way to understand your real chances.
Things linked to higher success:
– A past vaginal birth, either before or after your caesarean
– Labour starting on its own, rather than being started with medicine
– A cervix that is already softening and opening a little at the start of labour
– The past caesarean being for a reason unlikely to repeat, such as a breech baby, rather than labour not progressing
Things linked to lower success:
– Labour being started with medicine (induction)
– A higher body weight at the time of birth
– A past caesarean because labour did not progress
– A short gap since the last caesarean, less than about 18 to 24 months
What to Expect During a VBAC Labour
Labouring with a scar from a past caesarean needs closer watching than a normal first labour. This is not something to feel alarmed about. It is simply part of keeping you and your baby safe.
During a VBAC labour, you can expect:
– Constant monitoring of your baby’s heart rate through active labour, to spot any changes early
– A drip in your arm as a just-in-case measure
– Close checks on how your labour is going, from your midwife and obstetrician
– Fast access to an operating theatre if an emergency caesarean is needed
Warning signs of uterine rupture include a sudden change in the baby’s heart rate, pain between contractions, contractions suddenly slowing or stopping, and the mother feeling unwell or faint. Your care team will be watching for all of these.
Choosing the Right Obstetrician for VBAC
The relationship between a woman planning a VBAC and her obstetrician really matters. It takes trust, honest talk about risks, and a doctor who genuinely supports your choice while keeping safety front and centre.
Dr Steven Hatzikostas is a VBAC-friendly obstetrician in Melbourne with over 30 years of experience managing complex births, including vaginal births after caesarean. As a VBAC obstetrician in Melbourne, he strongly believes in supporting women who want to try for a vaginal birth, as long as they meet the right medical criteria and understand the process fully.
Dr Hatzikostas runs his own solo practice. This means the same doctor who plans your VBAC through pregnancy is the one there with you in labour. This kind of continuity really matters when you’re aiming for a birth that requires an experienced doctor to be close by.
He offers 24/7 access via a private phone line to all his obstetric patients, which is especially reassuring as a VBAC labour progresses.
If a VBAC Attempt Does Not Work Out
Not every VBAC attempt ends in a vaginal birth. If labour does not progress safely, or if warning signs show up, a caesarean will be done. This is not a failure. It is your care team doing exactly what they should.
Many women who do not end up with a vaginal birth still find the experience meaningful. Being supported to labour, making an informed choice, and knowing the birth was managed safely all add up to a positive experience, even if the way baby arrives changes.
Conclusion
VBAC is a real and often achievable goal for women who have had a past caesarean. The key is careful patient selection, a natural birth after c-section plan built on full medical checks, and close watching during labour by an experienced, available team.
Dr Steven Hatzikostas offers personal VBAC planning and labour support for women in Melbourne committed to trying for a vaginal birth safely, with full and honest information. If you’re hoping to explore VBAC in your next pregnancy, starting that chat early with a specialist obstetrician is the right first step.
Frequently Asked Questions
How soon after a caesarean can I try for a VBAC?
Most obstetricians suggest waiting at least 18 to 24 months between the birth and your next pregnancy before trying VBAC. A shorter gap raises the risk of uterine rupture. Your obstetrician can advise based on your own situation.
Can I have a VBAC after two caesareans?
Two or more past caesareans raise the risk linked to VBAC. In some carefully chosen cases, it may still be considered, but it requires a thorough review of your specific risks. Most guidelines say each case should be judged on its own.
Will I need constant monitoring during a VBAC labour?
Yes. Constant electronic monitoring of your baby’s heart rate is recommended through active labour for VBAC attempts, since changes in heart rate can be an early sign of stress on the scar. This is standard practice and an important safety step.
Is starting labour with medicine (induction) safe with VBAC?
Induction, especially with certain medicines, carries a higher risk of uterine rupture compared to labour starting naturally in VBAC attempts. This doesn’t mean induction is never used, but it is approached carefully and needs a proper talk with your obstetrician about the balance of risks.
What is the success rate for VBAC?
For women who are well suited to it, VBAC success rates typically range from 60 to 80 out of 100 attempts. The rate is higher for women who have had a past vaginal birth, and lower when labour is induced. Your obstetrician can give you a more personal estimate based on your own history.
