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13 Myths About VBAC

Many women believe that the only safe choice after a cesarean is another cesarean. Social pressure plays a huge role in a woman’s decision making process and the prevailing American conventional wisdom is greatly influenced by persistent and pervasive myths about vaginal birth after cesarean (VBAC). The result is a 86% repeat cesarean rate in America (1) despite the fact that most women are candidates for VBAC and most VBACs are successful.  Let’s draw a clear line between myth and fact.

According to the National Institutes of Health (NIH), “VBAC is a reasonable and safe choice for the majority of women with prior cesarean.” (2) The American College of Obstetricians & Gynecologists (ACOG) concurred when they said “most” women with one prior cesarean and “some” women with two prior cesareans are candidates for VBAC. (3)

Power to Push VBAC Booklet

BC Women’s Cesarean Task Force Power to Push 2010 VBAC Booklet

Myth:  VBAC after one cesarean has a 60-70% risk of uterine rupture.

The risk of uterine rupture after one low transverse (bikini) cut cesarean is about 0.5% – 1% depending on factors. (2) (Keep in mind that this refers to the incision on the uterus, not on the abdomen.) First time moms are at risk for complications that are equally serious to uterine rupture and occur at a similar rate such as placental abruption, (4) cord prolapse, (5) and shoulder dystocia. (6)

Myth: Hospitals ban VBAC because it’s such a serious and unusual complication that they cannot manage it appropriately.

Hospitals with labor and delivery units have protocols in place to respond to obstetrical emergencies. The guidelines used to manage the complications from first time moms and repeat cesarean moms are also used to address uterine rupture in VBAC moms.

Myth: To expedite an emergency cesarean, epidurals are required in VBAC moms. VBAC moms can’t have epidurals because it will obscure the pain of uterine rupture.

Per ACOG, epidurals may be used in a VBAC (3) and evidence suggests that epidurals do not mask uterine rupture-related pain. (7, 8) Additionally, only 26% of women who experience a uterine rupture report abdominal pain, so it is an inconsistent and unreliable symptom. (9)

Myth: There is a 25% chance that either baby or mom will die during a VBAC.


ACOG 2010 VBAC Guidelines

The risk of maternal mortality is very low whether a woman plans a TOLAC (0.0038%) or an elective repeat cesarean (0.0134%). (2) Limited evidence suggests that there is a 2.8 – 6.2% risk of infant mortality after a uterine rupture with many factors contributing to this range. (2, 10)

The most serious cesarean-related complications become more likely as an individual woman has more cesareans. (11) These complications include placental abnormalities such as placenta accreta which carries an up to 7% maternal mortality rate (12) and a 71% hysterectomy rate. (13) After two cesareans, the risk of accreta is 0.57%, (11) similar to the risk of uterine rupture after one cesarean.

Myth: I can’t have a VBAC in my state because it’s illegal.

VBAC is legal throughout America and in some states, it’s legal for a midwife to attend an out-of-hospital VBAC.

Farah Diaz-Tello of the National Advocates for Pregnant Women clarifies, “I have never heard of a situation in which a physician has lost their license for adhering to a woman’s wishes after providing them will full informed consent, and attending them in a manner that is consistent with the standard of care. Even physicians who have been found liable for medical malpractice do not automatically lose their license.”

Myth: VBACs can’t, or shouldn’t, be induced.


NIH 2010 VBAC Conference

When a mom or baby develops a complication that requires the baby be born sooner rather than later, but not necessarily in the next ten minutes, induction can make the difference between a VBAC and a repeat cesarean. This is why ACOG maintains that medically indicated Pitocin and/or Foley catheter induction “remains an option” during a VBAC. (3, 14)

Myth: Hospitals ban VBAC because they can’t meet ACOG’s “immediately available” requirement.

Some hospitals interpret ACOG’s “immediately available” recommendation to be a mandate that an anesthesiologist must be in the hospital 24/7. Some hospitals that cannot provide that level of coverage have banned VBAC. However, “immediately available” does not have a standard definition and various hospitals implement the guideline in different ways. (15)

Myth: Hospitals that do not have 24/7 anesthesia coverage ban VBAC.

There are motivated hospitals that offer VBAC without 24/7 anesthesia. The rural hospitals that serve the Navajo Nation in New Mexico are an example and they report a 38% VBAC rate. (16)  The American VBAC rate is 14%. (1)



Myth: The evidence shows that 24/7 anesthesia coverage creates a safer environment for VBAC.

ACOG confirms that the data is not available: “Although there is reason to think that more rapid availability of cesarean delivery may provide an incremental benefit in safety, comparative data … are not available.” (3, 15) In the absence of empirical evidence, the “immediately available” recommendation is based on the lowest level of evidence which is “consensus opinion.” (3) Hospitals without 24/7 anesthesia implement a variety of policies to make VBAC safer including fire drills and cesarean under local anesthesia. (15)

Myth:  If your hospital doesn’t offer VBAC, you have to have a repeat cesarean.

As Howard Minkoff MD said at the 2010 NIH VBAC Conference, “Autonomy is an unrestricted negative right which means a woman, a person, anybody, has a right to refuse any surgery at any time.” (16) ACOG affirms that “restrictive VBAC policies should not be used to force women to undergo a repeat cesarean delivery against their will.” (3)

There are real risks and benefits to VBAC and elective repeat cesarean section.  Make the right decision for yourself: understand your options, discern truth from fiction, know your legal rights, and get down to the facts.

 DSC_0111 head Jennifer Kamel is the Founder & Director of VBAC Facts whose mission is to close the gap between what the best practice guidelines from ACOG and the NIH say about VBAC and repeat cesarean and what people generally believe. VBAC Facts is an advocate for accurate and fair information and does not promote a specific mode of delivery, type of health care professional, or birth location. Ms. Kamel presents her class “The Truth About VBAC: History, Politics, & Stats” throughout the United States. Provider approved by the California Board of Registered Nursing, Continuing Education Provider #16238.

1. Curtin, S. C., Gregory, K. D., Korst, L. M., & Uddin, S. F. (2015). Maternal Morbidity for Vaginal and Cesarean Deliveries, According to Previous Cesarean History: New Data From the Birth Certificate, 2013. National Vital Statistics Reports, 64(4). Retrieved from http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_04.pdf

2. Guise, J.-M.; Eden, K.; Emeis, C.; Denman, M. A.; Marshall, N.; Fu, R. (.; Janik, R.; Nygren, P.; Walker, M.; McDonagh, M. Vaginal Birth After Cesarean: New Insights; Agency for Healthcare Research and Quality (US): Rockville (MD), 2010. http://www.ahrq.gov/clinic/tp/vbacuptp.htm

3. American College of Obstetricians and Gynecologists. Practice Bulletin No. 115: Vaginal Birth After Previous Cesarean Delivery. Obstetrics and Gynecology 2010, 116 (2), 450-463, http://www.acog.org/Resources_And_Publications/Practice_Bulletins/Committee_on_Practice_Bulletins_–_Obstetrics/Vaginal_Birth_After_Previous_Cesarean_Delivery.

4. Deering, S. H.; Smith, C. V. Abruptio Placentae, 2013. Medscape. http://emedicine.medscape.com/article/252810-overview#a0199.

5. Beall, M. H.; Chelmow, D. Umbilical Cord Complications, 2012. Medscape. http://emedicine.medscape.com/article/262470-overview#a30.

6. Allen, R. H.; Chelmow, D. Shoulder Dystocia, 2011. Medscape. http://emedicine.medscape.com/article/1602970-overview#a03.

7. Johnson, C.; Oriol, N. The role of epidural anesthesia in trial of labor. Reg Anesth., Nov-Dec 1990, 304-308.

8. Kamel, J. Can you feel a uterine rupture with an epidural?, 2012. VBAC Facts. http://vbacfacts.com/2012/06/22/can-you-feel-a-uterine-rupture-with-an-epidural/.

9. Nahum, G. G. Uterine Rupture in Pregnancy , 2012. Medscape Reference. http://emedicine.medscape.com/article/275854-overview#aw2aab6b6.

10. Kamel, J. Confusing fact: Only 6% of uterine rutpures are catastrophic, 2012. VBAC Facts. http://vbacfacts.com/2012/04/03/confusing-fact-only-6-of-uterine-ruptures-are-catastrophic/.

11. Silver, R. M.; Landon, M. B.; Rouse, D. J.; Leveno, K. J. Maternal Morbidity Associated with Multiple Repeat Cesarean Deliveries. Obstetrics & Gynecology 2006, 107, 1226-1232. http://journals.lww.com/greenjournal/fulltext/2006/06000/maternal_morbidity_associated_with_multiple_repeat.4.aspx

12. American College of Obstetricians and Gynecologists. Placenta accreta. Committee Opinion No. 529. Obstet Gynecol 2012, 201-211. http://www.acog.org/~/media/Committee%20Opinions/Committee%20on%20Obstetric%20Practice/co529.pdf?dmc=1&ts=20120623T1523006523

13. Shellhaas, C. S.; Gilbert, S.; Landon, M. B.; Varner, M. W.; Leveno, K. J.; Hauth, J. C.; Spong, C. Y.; Caritis, S. N.; Wapner, R. J.; Sorokin, Y.; Miodovnik, M.; O’Sullivan, M. J.; Sibai, B. M.; Langer, O.; Gabbe, S. The frequency and complication rates of hysterectomy accompanying cesarean delivery. Obstet Gynecol 2009, 114 (2, Part 1), 224-229. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2771379/

14. Kamel, J. Myth: VBACs should never be induced, 2012. VBAC Facts. http://vbacfacts.com/2012/05/27/myth-vbacs-should-never-be-induced/.

15. Birnbach, D. J. Impact of Anesthesiologists on the Incidence of Vaginal Birth After Cesarean in the United States: Role of Anesthesia Availability, Productivity, Guidelines, and Patient Safety (video), 2010. Vimeo. http://vimeo.com/10808838.

16. National Institutes of Health. NIH VBAC Conference, Day 2, #04 – Discussion, 2010. Vimeo. http://vimeo.com/10898005.

17. Office of Statewide Health Planning and Development. Utilization Rates* for Selected Medical Procedures in California Hospitals, 2011. http://oshpd.ca.gov/HID/Products/PatDischargeData/ResearchReports/Hospipqualind/vol-util_indicatorsrpt/ (accessed June 12, 2013).

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157 comments to 13 Myths About VBAC

  • Paula

    Hi! I have had 2 c-sections, I agree that it is possible to have a VBAC but I also think that it is horrible for us, women who have never had a natural childbirth, to feel guilty about our C-sections, as if we were absolutely responsible for what happened. And, most of the time, we feel guilty because many women support natural birth. Even though it is important to support it, they shouldn’t make us feel guilty for the very simple fact that we couldn´t have a natural childbirth

    • Jen Kamel

      I absolutely agree with you Paula.

    • Hi Paula, I read your post with interest because it shows to me yet again, the impact a positive or negative birth experience has on women. Childbirth shapes how we feel about ourselves as a woman and mothers and impacts on our relationship with our children, partners, family and society as a whole – it’s as profound as that! Caesarean section can be a life saving operation and I am sure that your doctors offered for the very best clinical reasons for you and your baby’s wellbeing. You have no reason to feel guilt therefore and I hope you made a good recovery. The evidence strongly supports normal birth and VBAC; to ignore this evidence, we do so at our peril.

  • Patricia

    My Son was breech so I had to have a section right away with him.
    With my daughter we were all set to do Vbac. There were so many things that went wrong that night. My contractions started to slow after 13hrs, so the Dr decided to give me the drip. Then my uterus tore and I was in so much pain for 4hrs and no one would believe me. They kept giving me more epidural to stop the pain. However the pain got worse and I couldn’t feel my legs anymore. Finally the anesthesiologist came in and advised there was something wrong.
    Thanks to this my daughter was born by section and rushed to ICU. She swallowed my blood and it was in her lungs. After a week stay for both of us and a few blood transfusions for me we were both ready to go home.
    We are both doing well now and she’s a happy healthy 4m old.
    I really didn’t think I would be the 1% but I guess it can happen.

  • Sally Green

    I was a VBAC and am glad I didn’t cave in to the myths. It was amazing to experience that primal urge to push, just incredible. No judging; do what’s best for you! But I wouldn’t be afraid to be a VBAC if the doc thinks it’s fine.

  • Brenda Dotson

    I had my first child c-section due to her being breach. I then had 3 more children all VBAC without any issues. I never even considered having scheduled C sections for my other children. And I’m so glad my husband and I got to have the experience of labor.

  • Tiffany

    My first child was born by C-section, my next was a VBAC without an epidural and Pitocin, my next was another VBAC with an epidural and Pitocin, and my last was a C-section (Dr did not want to induce due to my first C-section and I had a tubal). The second child (1st VBAC) was with a midwife through a Dr’s office. I chose this because I knew that they would be more willing to allow a VBAC. My second VBAC, my Dr was supportive I believe because I was successful with the 1st VBAC. My last child, the Dr was not comfortable with the idea of inducing with a previous C-section. All of my pregnancies, I had trouble with “failure to progress” with labor. I honestly could not give birth without the aid of Pitocin. My first child was 2 weeks past due date and they induced me every other day for an entire week with no results. I think that VBACs are dependent on your situation. I don’t think there is any shame in having C-sections. Sometimes, it is beyond our control. If I had not had the first C-section, I would have lost my child, my placenta had started to shut down and she was not getting proper nourishment.

    • Jen Kamel


      I agree that there is no shame in having a cesarean. Unfortunately, so much of the conversation about VBAC and repeat cesarean has become so dogmatic. VBAC Facts seeks to counter that. If there is a medical reason, or if a mom just wants a cesarean, she should have one! No shame!



  • Dr. OB


    What is your source of these “myths”. I do not know one OB around who has ever, for example, quoted a uterine rupture rate of 60%. It is insulting to imply that we as a Profession are behaving in such an un-ethical manner on any scale. It is not an “us vs. them” problem as you and your sites imply. I really do think that you are NOT being fair to the vast majority of OB/GYN’s that absolutely support “natural birth” which, unfortunately, does not always go so naturally.


    • Jen Kamel

      Some of these myths (such as the 60% uterine rupture statistic) are directly from the mouths of OB/GYNs who, apparently, do not know better. However, they absolutely do not represent all doctors as I personally know many wonderful, ethical doctors. It’s unfortunate that many take the “us vs. them” mentality. I do not and the practitioners, including OBs, who have taken my seminar can attest to that.

      Just like when people “shop doctors” when they need knee surgery – because we acknowledge that not all doctors are equal – I encourage women do to the same if they want to plan a VBAC as philosophies, protocols, and knowledge can vary greatly between practitioners.



      • Jen, as an independent midwife, practising in the UK, I can add a whole list of stuff and nonsense, lies and shroud waving statements that pregnant women I have worked with, have be subjected to. And often coming from midwives, I hasten to add!

  • Marlene

    I never believed any of these… except that VBACs USUALY should not be augmented or induced. I read uterine rupture was 12 times higher when VBACs were induced, but I forget where I read that; could have been the NIH 1982 study on C/S safety.

  • The surgical birth rate is so very high now that more and more women are dying!! This is real. Not to mention that the mothers and babies have serious breastfeeding problems and often quit.

  • Lea

    My first was a c-section. Then I had six children VBAC. I never had any problems. Of course I was warned each time of the risk but didn’t seem risky to me. I also breastfed them all. Did have some difficulty with the first. It was all worth it!

  • JudyC

    It is such a shame that so many women are denied a chance at VBAC. I had two CS which I hated and that turned me into a passionate midwife. I have attended so many VBAC over the years, at home an in hospital as well as several HBA2C. So far no trouble with any. If a woman wants it she should be given every opportunity to labour and birth normally as there is enough science out in the big wide world to prove it safer.

  • Jennifer Z

    Hi Jen,

    I am an RN working on my BSN and am currently in a Nursing Research class. I have to analyze a study and I have been trying to find a VBAC study and have come up empty handed. It needs to be within the past 5 years ~ any chance you know of any?

    Thanks so much!

  • Tamara

    I have a friend who has had an emergency c-section, and so listened to the advice of a fear-weilding physician and had an operative c-section, due to fear of uterine rupture. I remember the stats she told me were pretty high! So, this is a different view. If she were to have a V-bac for baby #3, would that be safe? Could a midwife assess this possibility? What could allay her fears? Any tests? Ultra sound of her uterus? Thanks for any advice!

    • Jen Kamel


      It’s best for her to consult with providers (doctors or midwives) in her area with whom she can review her operative report to get information on her individual situation. In general, yes, most women are candidates for VBAC and most VBACs are successful.

      Here’s an article on finding a provider and questions to ask them.

      In terms of allaying her fears, have her talk to a VBAC supportive provider, read any of the resources at VBAC Facts, attend a workshop, and connect with other women. One place to do that is my page on Facebook.



  • I’ve been told outright by the ONLY hospital within an hour of my home that I will “absolutely not be allowed to deliver there” if I choose a VBAC! I’m devastated! Is there anything I can do to legally fight this without being a total jerk?

    I want the right to choose. I was forced into a c-section first time. The second time I was coerced into a repeat cesarean. This will be my third baby. If at any time during my pregnancy or labor, it becomes obvious to my doctor that a repeat cesarean is medically necessary, then I will have no issue agreeing to one, however, I’d at least like the option to discuss VBAC until that point. Being told that it’s absolutely not an option seems illegal and unethical to me. With my second, I fully believe my body would’ve been successful in a VBAC situation. Because my OB/GYN had a patient coming to her office within a few hours, she coerced me into a repeat cesarean even though my water ruptured spontaneously and labor was progressing normally, confirmed in hospital by OB and EFM. Needless to say, I was devastated at being denied that right to choose.

  • Shaylee

    My daughter was an emergency Csection after 4 days of being in the hospital laboring. My doctors were very patient with me, I however never progressed past a .5 and even though contractions were off the charts I was going no where. My baby started on day 2 to slow down and have very very minimal movement. On day 3 my water finally broke on its own and I thought for sure we would have our baby. After 24 hours of no water she was in distress and I still never reached 1cm. I finally had to have a Csection. Come to find out she was very tangled. She had her leg over her head and the cord wrapped around that, then her elbow was infront of her face with the cord wrapped around her neck once again. She was in complete limbo. I am so glad we ended up where we did because I think we both would have died if it would have continued. I am now pregnant with baby 2 and my doctor has asked me what I would like to do. I am torn between doing a Vbac or a repeat CS. I feel there are many pros and cons to both. But the unknown and the chance of losing my baby scares me. Any advice would be great!! Thanks!

    • Jen Kamel


      I hear you. There are risks and benefits to both VBAC and repeat cesarean. As you walk this journey, you will find people who feel very strongly that VBAC or repeat cesarean was the best choice for them and thus, they reason, it must be the best choice for everyone else. But you know what? It doesn’t matter what anyone else decided. It matters which risks and benefits are acceptable to you as everyone is entitled to an individualized risk assessment. Which is why you may make a different decision than family members, friends, or people you encounter on-line.

      There are many resources for women evaluating their options. As you can see above, I link to several different documents on the right hand side of the article. I also invite you to check out the VBAC Facts Page on Facebook where conversations are on-going (I’ve posted your question there to get more feedback.) Also consider enrolling in the Winter Webinar Series of “The Truth About VBAC” which is a 6 hour program reviewing the history, politics, and stats of VBAC vs. repeat cesarean. I do offer discounts for couples and WIC recipients.

      If you have any other questions, don’t hesitate to ask.



    • Krisztina

      I had a VBA2C just 2 months ago. My 1st child, 17 years ago was vaginal, my 2nd was c-section because she was breech, I hated the thought but come to find out once she was born that she had the umbilical cord wrapped around her neck twice. My 3rd child 11 years later had to be a repeat c-section done by the same doctor I had my previous 2 with just because I already had a prior c-sec. He did not give me the choice of doing a VBAC even though my pregnancy and baby were healthy and he was in position to be born the way God intended. At the time I was not strong and confident enough to pursue having a VBAC and now I feel like I was pushed and pressured into a repeat c-sec. To this day I regret not doing all I could to avoid that 2nd c-section. When I became pregnant with my 4th child in December of last year I went with a new OB doctor but this doctors office once again did not give me a choice to do a VBAC. On my 1st visit they already informed me that I would have a scheduled repeat c-sec. As my pregnancy progressed I was starting to accept the fact that I would have another c-sec until I came across an artical about VBAC’s through a facebook page when I was about 30 weeks. Women were commenting about having succesful VBAC’s even after multiple c-sections with no previous vaginal births. So my mind started turning and all of a sudden I was not ok with another c-section! I did not want to be cut once again and have a major surgery just to have my baby. I started researching and came across the ICAN-online.org website and through there I found an office of a group of midwives in my area that support VBAC’s so I sent them an email explaining my situation. After I was emailed to make an appointment to have a consultation with one of the midwifes to see if I would be a good candidate. At my appointment she looked over my medical records and asked me some questions and she told me confidently that I could absolutely have a VBAC and if I transfer over to their office for care they would let me go into labor on my own and let me have a vaginal delivery because their is no need for me to have a c-sec. Of course I was informed of the possible small risk of a uterine rupture and the risks of a repeat c-sec. They also told me that they have an 86% VBAC success rate. When I left their office the day of my consultation I was on cloud nine and so ecstatic. I transfered care to them right away and I had my baby at 41 weeks with a successful vaginal delivery. My baby boy was a very healthy baby weighing 10lbs 3oz. My delivery went smoothly and quick. I became one of their offices success stories for VBAC’s. My midwife who delivered was extremely proud of me and said this is the reason they do what they do. I am so extremely happy I gave vaginal delivery a chance! I myself was willing to take the small risk with a VBAC because I hated the thought of another c-section and the painful recovery. The recovery with the VBAC was way less painful. With my midwife and the hospital I was at they were prepared for any and all kinds of emergencies just incase need be. But thank God everything went perfect and I am so happy I was able to birth the way I wanted to and the way a doctor wanted me to.

  • Marta Kurtz

    I had my first c-section for fetal distress in 1970. Had 2 VBACS 1976 and 1980 at a time when it was not a common thing. I was probably one of the first. I was lucky my doctor (found before I got pregnant) was head of high risk clinic at a teaching hospital. Only one shot of Demerol both times. Lamaze and Gentil Birth for Baby. I really hate that the system fell apart.
    I knew I would have no help after my children were born in 76 AND 80 so recovery from a surgery and care for children was not an option. When I had the first VBAC my doctor was not available and the resident tried to scare my husband into signing for C-SEC. I had prepared my husband well before we went to the hospital. Had worked in a women’s clinic that was influenced by the women’s movement of the time. I had told my husband that signing for me was grounds for divorce and he knew I meant it. To this day 40+ years later he does not sign for me if I have to go to the ER for any reason. My Body, My Choice.
    Marta K.

  • sertap

    Hello! I wanted so resist I too cried, but here d I ignorant because it is cruel my first pregnancy, normal birth did not know anything about cs’ve built a caesarean section three months ago deceived I turkeyd but dr insisted yet 37 hurried to flow make first weeks of age if the beer is no pain in my pains I also did not I went to check baby properly, I do not even defend my right to health can not think of pregnancy, I was ripped off again because nobody listens I do not know what I want to do jumps to birdaha cs çoksinirl of VECO miserable: ((

  • I keep referring back to this article, and I forward it on to my clients quite frequently. Thank you Science and Sensibility!


  • Eguolo

    I have had 3 C – sections, no vaginal birth . The reason for the first was a previa, the 2nd, was the baby had the umbilical cord tied round the neck thrice and on one arm so I labored for hours and ended up with an emergency c – section(baby became distressed), my third baby came in so quick, I never had the opportunity to opt for a vaginal birth because my doctor wont let me, so I had the 3rd C – section. Now, I’m pregnant again, how possible is it for me to have a VBAC . I’m dieing to have a vaginal birth; what should I do? What’s your take?

    • Jen Kamel


      I’m so sorry for the delay in my response. Somehow your comment got buried and I’m just seeing it now!

      Evidence is pretty limited on the risks of VBA3C. You can read more information here.

      The toughest part will be finding a provider in your area. I list some tips here.

      What area are you in? Perhaps I can post on my Facebook page to see if anyone has any referrals in your area.



  • Mary

    I had my first baby via csection in May 2011. When I got pregnant with my second, I knew I wanted to try for a vbac! My original doctor was a jerk when it came down to giving me information, so I took it upon myself to research & find a doctor who supported vbacs. I ended up at my local hospital at 37 weeks because I had a bladder infection & they admitted me to the ob & had me stay overnight. The doctor who checked up on me the next day was my oldest’s doctor & he tried to scare me out of having the vbac, telling me how I could die on the drive (the hospital I was planning on going to was 100 miles away), but I still said I was going. They didnt seem impressed. I was so worried they’d try to convince me to stay & deliver there but thankfully I asked questions & knew what my rights were. I went home & about 3 weeks later I went into labor & we left the house several hours later once my labor was progressed. About half way to the hospital, my water broke in our car & I knew we wouldnt make it much farther. I called 911 & they had us pull over. By the time they got there, baby was crowning. I got into the ambulance & the emt helped pull down my pants & with once push, my sweet little princess was born. It was the most intense, crazy experience ever, but thankfully we were both safe & I got my vbac! My doctor was so supportive of me since day one & I think that’s the most important part of trying for a vbac! Good luck to all other mommies trying for one!

  • Trying for VBAC

    My first child was a c-section because he was breech. Now we’re pregnant with our second child (6 years later) and I am going for a VBAC. I have 4 weeks until my due date. I am excited, but also a little nervous because I’ve never labored before. For those of you who have had a VBAC, is there any advice, insight or tips you can share with me to help me make this a successful VBAC?

    Thank you in advance for sharing!

  • Sarah

    I had an absolutely HORRIFIC 1st birth via cesarean. Worst experience of my life hands down. It was so bad that my husband and I are unsure if I should ever become pregnant again. I am researching VBAC because this is really the only feasible option for me. I have to find an OB team who will be supportive of VBAC and who will respect my wishes for NOTHING like what happened before to happen.

    I believe VBAC will be feasible for me, the main concern is that I produce children with very large heads and that they won’t fit through my pelvis. This will be my greatest obstacle. Do you have any information about this? I have heard that progesterone therapy can enable the pelvis to widen more.

    Also, is it true that you have to wait at least 18 months to become pregnant again after a cesarean in order to even be a VBAC candidate?

    • Jen Kamel

      Hi Sarah!

      I posted your question here and got a lot of great responses.

      Every baby and labor is different. Just because you had a baby with a large head in the first pregnancy doesn’t mean that will repeat. And there are women who have babies with average heads that just aren’t positioned optimally for a vaginal delivery. So perhaps the issue wasn’t so much a large head, but a large head that wasn’t positioned correctly. Either which way, there are many factors that impact how a labor plays out and it’s impossible to know how your next labor will play out until you are in the moment.

      You can also use this head circumference calculator to see how your child’s head compares to the averages.

      The range 18 – 24 months between pregnancies (delivery to conception) is the general recommended interval regardless of mode of delivery. It’s not just about the physical recovery from delivery (vaginal or cesarean.) It’s about the general stress and strain that our bodies and minds experience during pregnancy, delivery, breastfeeding, and then caring for an infant.

      Pregnancies that are too close together, or too far apart, are associated with higher complication rates. You can learn more via these articles from WebMD and the Mayo Clinic.

      While ACOG states that short interpregnancy intervals are associated with lower VBAC rates, they do not “risk out” women with short interpregnancy intervals from planning a VBAC. Read more on uterine rupture and birth intervals.

      Hope this helps!



  • Rosalyna

    I had to have an emergency c section with my first daughter because I went into labor 36-1/2 weeks and she was breech. Now 3 years later 33 weeks pregnant with baby #2. Iam being forced to have another c section. The hospitals in my area don’t allow it and my dr won’t do it. I’ve already scheduled the date and registered with the hospital but every single day it bothers me to think I’m being forced into this. If I wanted to try a vbach I’d have to find a new dr about 30 miles away. I don’t know what to do. Iam a petite women I’m only 4-9 so people keep saying they don’t think I would be able to have a normal birth anyways. So that’s what’s holding me back too. Sooo confused

    • Jen Kamel


      Many petite women plan a VBAC and many women find that they have to travel in order to have a VBAC supportive provider attend their birth. So the question is, do you want a VBAC? If so, 30 miles is not far to drive and being petite doesn’t “risk you out” of a vaginal delivery.

      I posted your comment here and got a lot of responses from petite women who had VBACs. Check it out and best wishes!


  • Eva

    Hi am about 11 weeks pregnant and I am going to pursue a vbac! Only cath is I just had my son October 8th 2014 so that would put this baby being born at 14 months post partum cesarean. Of course I was denied a vbac from all the doctors at our ob practice and our only hospital does not allow it either. I had a csection with my first because he was stuck coming face first and I was told there was nothing that could be done and I needed an immediate csection. I feel like I should have pushed a little and maybe his head would have straightened out but they told me I could brake his neck if I tried. My recovery was awful. I could have done a better job at caring for myself and my son if I were paralyzed. The only risks my doctors have told me are the risk of uterin rupture which is 1%. That is not enough to scare me into a repeat csection. They can schedule it all they want but I will not be showing up for it. 1. Because I truly believe I can handle a vbac! 2. Because I am absolutely terrified to go under the knife another damn time and never know if j could have delivered vaginally. I am due December 26th 2015. I’ve researched everything and honestly I don’t believe most of it. If no one is ever given a chance of vbac then of course the statistics for them are going to be awful low success rates. I asked my doctor what if I waited and labored at home for a little while. He said if you came to the hospital and you were 5cm dialated, then you would have already ruptured by then if it was going to happen. Then he said “but it would be a terrible thing to bleed out at home” this to scare me! I wasn’t scared cus I really don’t think it’s going to happen. Am I not considering the risks enough? Am I being too optimistic? There are so many success vbacs I’ve read wit woman pp under 18 months. Do you think I can do it? Do you have any advice for me?

  • Bonnie

    Hi! I am currently 11 weeks pregnant with twins. My first pregnancy was a singleton and was a c-section. I am considering a VBAC with this pregnancy. I would really like to have one. I was wondering if there were any statistics or advice you could share on a VBAC with twins. My doctor has not told me that we couldn’t do it. Thanks so much!

    • Jen Kamel

      Hi Bonnie,

      Here is a collection of information that I have assembled. I hope it’s helpful in either starting a discussion with your provider or finding someone in your area who attends breech births (which can be the sticking point with twin deliveries.)

      ACOG says expecting twins should not prevent a mom from planning a VBAC. Evidence is limited on uterine rupture rate with multiples. The main barrier to twin delivery is finding a provider trained in vaginal breech delivery.

      Read a summary on ACOG’s VBAC recommendations here: http://vbacfacts.com/2010/07/21/acog-issues-less-restrictive-vbac-guidelines/.

      Read the actual ACOG recommendations (and check out its biblio for specific studies) here: http://dhmh.maryland.gov/midwives/Documents/ACOG%20VBAC.pdf

      News report on vaginal twin deliveries: http://www.ctvnews.ca/mobile/health/c-sections-not-better-for-twin-births-canadian-study-says-1.1160754

      ACOG’s 2012 Committee Opinion on Breech, “There are no recent data to support the recommendation of cesarean delivery to patients whose second twin is in a nonvertex presentation, although a large multicenter randomized controlled trial is in progress (www.utoronto.ca/ miru/tbs).” http://www.acog.org/~/media/Committee%20Opinions/Committee%20on%20Obstetric%20Practice/co340.pdf?dmc=1&ts=20130709T1331299729

      ACOG 2010 VBAC guidelines: “The studies of women with twin gestations who attempt VBAC have consistently demonstrated that their outcomes are similar to those of women with singleton gestations who attempt VBAC (85–90). In two analyses of large populations, women with twin gestations had a similar chance of achieving VBAC as women with singleton gestations and did not incur any greater risk of uterine rupture or maternal or perinatal morbidity (89, 90). Women with one previous cesarean delivery with a low transverse incision, who are otherwise appropriate candidates for twin vaginal delivery, may be considered candidates for TOLAC.”

      Mescape also provides some great insight and additional studies that one can review:

      “A study by Cahill et al revealed that whereas women with twin gestations are less likely to undergo a trial of labor after prior cesarean, they appear to be at no increased risk for uterine rupture.[18]

      Other smaller studies examined the rate of uterine rupture in patients with twin gestation undergoing a trial of labor after cesarean delivery, and none of them demonstrated a frank rupture—though when their data were combined, 5 asymptomatic dehiscences in 151 patients were identified.[19, 20, 21]

      The rate of asymptomatic uterine dehiscence in patients undergoing a trial of labor after cesarean delivery is difficult to assess because it is not commonly investigated. Thus, although the overall statistical power of the studies examining this issue in twins is not overwhelming, there is certainly no evidence suggesting a higher risk of uterine rupture in these women.

      The 2010 ACOG guidelines state that TOLAC may be considered in women with 1 previous cesarean delivery with a low transverse incision who are otherwise appropriate candidates for twin vaginal delivery.[2]”
      Read more here: http://emedicine.medscape.com/article/272187-overview

      FB thread looking for more info: https://www.facebook.com/vbacfacts/posts/4596360478664?notif_t=like

      More studies: http://naturallyparentingtwins.net/wp/?p=46



    • Megan

      I have never replied to any comments like this, but felt compelled to this time since I know it’s a little harder to find info on twin VBACs compared to singleton VBACs. I had a c-section with my singleton and really wanted a VBAC with my next pregnancy. It ended up being twins and was so hard to find a provider that was willing to have a TOLAC with twins but I did, and it was worth it. I had a successful VBAC of my twin boys in August, and it was absolutely amazing. I know I’m not giving statistics, but I just wanted to share that it is possible and is so wonderful! Good luck with your pregnancy and labor and delivery.

  • Jen

    I had to have an emergency c-section with my first child due to his position and head getting stuck. My incision opened up after a week once I came home and once it finally healed I developed a hernia at incision site. I am pregnant again, after only 6 months postpartum, and asked about whether VBAC is feasible with said hernia. One Dr. said yes and another Dr. said not likely or only if you have your heart set on it. Any info or other Moms that have been in the same situation? I was induced 2 weeks early with the first due to my blood pressure elevating the last month of pregnancy. And though I know what risk that makes for mother and baby, I feel like my body just wasn’t ready. 4 days of laboring to get to 10 cm, including Cervidil and the balloon catheter, only to push for 3 hours and told he is stuck. I did everything to make this child appear without surgery but ended up still having the section. I really feel like I missed out on “going into labor on my own”, so I wanted to VBAC unless the hernia makes it out of the question. They also said they will repair hernia at time of c-section again. Just need some extra advice, please!!!!

    • Jen Kamel

      Hi Jen!

      Unfortunately, I do not have any information on whether a hernia makes a difference in planning a VBAC. I posted your question here, but didn’t get any responses. Perhaps a third opinion will help break the tie?

      Sorry I can’t be more help!



  • Amber

    My first child was CS. 9 days over due with preeclampsia. I was induced and in labor for 23hrs. Her heart rate started dropping which resulted in emergency CS. She is now 10trs old. I am now 37wks pregnant with my second and will be attempting a VBAC. My doctor is very supportive of my choice. Does anyone know if the risks are less when the first CS was years ago?

    • Jen Kamel

      Hi Amber!

      This is a good question that I don’t have the answer for. I’ve shared your question here. Perhaps someone else can point you in the right direction.



  • kayla


    So I am worried I can’t have a VBAC. I have 3 children. First 2 naturally and my 3rd born January 12, 2015 was c section. I am pregnant again and possible due date of may 3, 2016. When I mentioned VBAC my Dr said it’s under 18 months and we can try but she highly doubts it will be success. If nothings wrong why not? I would love to know your thoughts. I am 26 and fit, active and in healthy eating. I’m terrified for another c section. When I mean terrified I mean I wake up sweating and in tears some nights.

    Do you know anyone or have any sites that show the rate of success VBAC before 18 months? I feel I’m so close how does 3 months make a difference?

    Thank you !!!

    • Jen Kamel


      Above anything else, the single factor that will impact how your birth plays out is who you hire to attend your birth. While some providers feel very strongly that there should be 18 months between pregnancies, others don’t. So, the question is, how much do you want to VBAC? There may be other providers in your area who are more supportive. It’s always worth looking. Here’s a list of questions that may be helpful to you.



  • Kristin

    I would to know if there is any evidence to support that a woman can have a successful vbac, after C-section with j-extension into the contraction part of the uterus?

    • Jen Kamel

      Hi Kristin!

      The most accurate answer to your question is, “We don’t know the rate of rupture in an special scar, but it’s likely higher than a low transverse scar. How much higher, we don’t know.”

      The evidence we have on classical, T and J incision, and low vertical uterine rupture rates is of low quality because the number of women included in these studies are very small.

      Remember when looking at ANY study on VBAC that you need at least a few thousand women in order to capture and accurately measure the event of uterine rupture which occurs about 0.5% of the time. With only 0.5% of cesareans going into the fundus (contracting part of the uterus), we don’t have a lot of women available to study.

      We do know that the rate of rupture is higher when an incision goes into the fundus. This is because the fundus does all the work during labor.

      The few studies that have been completed group classical, T and J incisions together and include extremely few women – 130 or less.

      Spong 2007 quoted a 1.59% rate for classical, T and J incisions, but there were less than 50 women included.

      Landon 2004 quoted 1.9% for classical, T and J incision, but again, there were 106 women.

      In 2004, ACOG quoted a 4-9% rupture rate for classical incisions, but I don’t see the same stat in the 2010 guidelines.

      Bottom line: we don’t have a good idea of what the rupture rate is in classical, T and J incisions. The conventional wisdom states, if the incision goes into the fundus, the rate of rupture is higher.

      Thus, ACOG states that women with classical, T or J incisions are not “generally” considered candidates for VBAC. Per the latest (2010) ACOG VBAC recommendations:

      The preponderance of evidence suggests that most women with one previous cesarean delivery with a low transverse incision are candidates for and should be counseled about VBAC and offered TOLAC. Conversely, those at high risk for complications (eg, those with previous classical or T-incision, prior uterine rupture, or extensive transfundal uterine surgery) and those in whom vaginal delivery is otherwise contraindicated are not generally candidates for planned TOLAC.

      They do leave the option open by using the word “generally.”

      Read a summary on ACOG’s VBAC recommendations here.

      Read the actual ACOG recommendations here.

      There are health care providers who attend “special scar” VBACs in the hospital and at home, however, not in every community. There are risks and benefits to each birth location which you can read more about here.

      Your best bet is to review your operative report with 2-3 VBAC supportive providers and see what they say.

      You can connect with other women who have special scars online. Here is one group.

      I hope this helps!


  • Gena

    My 1st child was born via c-section due to being partially paralized on my left side. My hubby and I want to try a VBAC, but I’m scared that I’ll be denied the chance or if I do try something will go wrong. with our ds , 38-39weeks I could hardly feel contractions…I’m guessing do to the paralysis.

    Any info on this wild be greatly appreciated


    • Jen Kamel

      Hi Gena!

      I recommend talking to VBAC supportive providers in your area. Here is a list of questions that will help you determine if your provider is supportive.

      I also recommend that you connect with other paralyzed women who have birthed to see how care varies, if it does at all, depending on where you live or who you hire to attend your birth.



  • Ashleigh Turgeon

    Hi I had an emergency c section with my son who is now going to be 4 and I’m now 12 weeks and 5 days pregnant with my 2nd child and I was given the option for a VBAC and I’m a little confused as to what I should go with when I was in labor with my son for 22hours I pushed for 4 hours and his head got stuck in my pelvic bone so I had to have a c section he was 9lbs 6oz and born at 36 weeks My Dr. Said that since I had such a big baby the 1st time I’m bound to ha e a big child the 2nd time. So my main worry is if I do try the VBac Will my child just get stuck again ?

    • Jen Kamel

      Hi Ashleigh,

      There is really no way to accurately predict how large this baby will get or how your labor will play out. What you need is a provider who supports your option to VBAC, if that is what you want to do, unless something arises that would risk you out.

      I recommend getting a second or even third opinion for VBAC supportive providers in your area. Here is a list of questions to ask.

      I also posted your question here to continue the conversation.


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