Can I Have Normal Delivery After a Previous C-Section?

By Ambuj Shrivastava
Updated: 24 Sept 2025, 11:30 am

Many women in India are told that once you deliver by C-section, all future births must also be surgical. The truth is more nuanced. Vaginal birth after caesarean (VBAC) can be safe and successful for many, though awareness and hospital readiness in India are still limited. Understanding the medical factors, risks, and cultural realities helps you decide if VBAC is an option for you.

Pregatips
Your first birth may have ended in a caesarean for reasons beyond your control: stalled labour, fetal distress, or simply hospital policy. With your second pregnancy, you may be asking: Is a vaginal delivery still possible for me?
In this article:
The answer is yes, in many cases. A vaginal birth after caesarean (VBAC) is supported by strong global evidence. But in India, doctors and families often hesitate because of concerns about safety, hospital preparedness, and lack of training. Here’s what you need to know.

What VBAC Really Means

VBAC refers to delivering vaginally after a previous caesarean. Doctors usually call this a “trial of labour after caesarean” (TOLAC). If labour progresses well, you will give birth vaginally. If not, or if risks arise, an emergency C-section may still be required.
VBAC isn’t about proving strength. It’s about whether your body, your scar, and your medical situation make it a safe option.

Why VBAC Matters for Mothers

Compared with a planned repeat C-section, a successful VBAC offers clear advantages:
  • Faster recovery: Vaginal delivery typically results in a shorter hospital stay, quicker mobility, and easier initiation of breastfeeding.
  • Lower surgical risks: No incision means lower chances of infection, blood loss, or anaesthesia complications.
  • Future pregnancy safety: Each additional C-section raises the risk of placenta previa, placenta accreta, and adhesions. VBAC reduces this burden.
  • Emotional empowerment: Many women feel more in control when they achieve a vaginal birth after being told it wasn’t possible.

The Risks You Must Understand

VBAC is not risk-free. The main medical concern is:
  • Uterine rupture: The scar from your previous C-section can rarely tear open during labour. This happens in about 0.5–1% of cases (1 in 200 women). While rare, it is life-threatening for both mother and baby and requires immediate surgery.Other risks include:
  • Failed trial of labour: Around 20–40% of VBAC attempts may end in emergency C-section, which can be more complicated than a planned one.
  • Neonatal risks: If rupture or severe distress occurs, the baby may need NICU support.
  • Maternal strain: Long labour ending in surgery can mean more blood loss, infection, and longer recovery.

Who Is a Good Candidate for VBAC?

Doctors assess the VBAC safety on a case-by-case basis. You may be suitable if:
  • Your earlier C-section was with a low transverse (horizontal) incision.
  • You’ve had only one previous C-section (some hospitals may allow two if scars are healthy).
  • There are no complications this time, no placenta previa, no major fibroids, and the baby is head-down.
  • At least 18–24 months have passed since your last delivery, allowing the scar to heal well.
  • Your current pregnancy is low risk, with normal blood pressure, sugar control, and healthy growth.

When VBAC Is Not Recommended

VBAC may be discouraged if:
  • Your previous surgery involved a vertical or classical incision (higher rupture risk).
  • You’ve had three or more C-sections.
  • You have conditions like uncontrolled hypertension, diabetes, or severe pelvic problems.
  • You’re carrying twins or triplets with complications.
  • The hospital lacks a round-the-clock NICU, operation theatre, and anaesthetist facilities.

Now, VBAC may also be difficult owing to the following factors:
  • Hospital preparedness: Many hospitals, especially smaller nursing homes, are not equipped for immediate emergency surgery if a rupture occurs.
  • Doctor’s caution: Gynaecologists often prefer a repeat C-section to avoid medico-legal risks if complications arise.
  • Family pressure: Families may insist on a planned C-section for convenience or fear of labour pain.
  • Cultural beliefs: Choosing an “auspicious date” for surgery often overrides consideration of VBAC.
  • Insurance policies: Some insurance providers cover only C-section costs fully, influencing choices.
This doesn’t mean VBAC isn’t possible in India. Large tertiary hospitals in metros like Delhi, Mumbai, and Bengaluru are more likely to support VBAC, but women often need to ask directly.

What to Ask Your Doctor

To be safe and informed, ask your doctor the following questions:
  • “Was my previous incision low transverse?”
  • “What is your hospital’s VBAC success rate?”
  • “Will there be continuous fetal monitoring?”
  • “How quickly can you perform an emergency C-section if needed?”
  • “What pain relief options are available for VBAC?”

Recovery After VBAC vs Repeat C-section

It’s also important to inquire about recovery options and what to expect:
  • VBAC recovery: Faster mobility, less pain, lower chance of infection, and earlier return to routine.
  • Repeat C-section recovery: Longer hospital stay, abdominal pain, delayed walking, and more limitations on lifting or driving.
  • Future pregnancy risk: With each repeat surgery, the risks of placenta problems and surgical complications rise.

Emotional and Cultural Layers

You may feel pressured to agree to another C-section. Remember:
  • Wanting a normal birth is not irresponsible. It is evidence-based and medically valid in many cases.
  • Emotional support is crucial. If possible, take your partner to appointments and ensure both of you understand the risks and benefits.
  • Joining communities of women who have had successful VBACs can reduce fear and stigma.
One previous C-section does not mean every future birth must be surgical. VBAC is a safe and evidence-backed option for many women, provided your scar and pregnancy conditions allow it. In India, low awareness and hospital hesitancy make it less common, but by choosing the right care setting and asking informed questions, you can keep VBAC on the table. What matters most is that you and your baby are safe, whether the birth is vaginal or surgical.
Whether you’re pregnant, a new mom, or navigating postpartum, you don’t have to do it alone. Join our support group to connect, share, and support one another.

FAQs on Can I Have Normal Delivery After a Previous C-Section?

  1. What is the success rate of VBAC in India?
    Globally, 60–80% of women attempting VBAC succeed. In India, success depends on hospital support and monitoring, but similar rates are possible in well-prepared centres.
  2. Can I get pain relief (epidural) during VBAC?
    Yes. Epidural analgesia is safe during VBAC, though close monitoring is essential.
  3. Is VBAC safe after two C-sections?
    Some international guidelines allow it if both scars are transverse and healing is healthy, but very few Indian hospitals currently support this.
  4. Does VBAC put my baby at higher risk?
    The overall risk is small. The chance of uterine rupture is under 1%, but because it can be serious, VBAC should only be attempted in a hospital with emergency surgical readiness.

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