How Doctors Decide If You’re a Good Candidate for a VBAC

BySamradni Pradhan
Updated: 3 Dec 2025, 12:30 pm

You may have delivered via a C-section before, but now you may wonder whether a vaginal delivery is possible. The answer is yes, vaginal birth after Cesarean (VBAC) is not only possible, but also safe. However, there are some considerations. Your doctor may assess your health, pregnancy and birth-related factors before suggesting a VBAC. You can prepare yourself by understanding the several aspects of VBAC to make an informed decision for a positive birthing experience.

Pregatips.com
The stories about delivering vaginally after a cesarean are true. You may have heard them, and now you are considering it yourself. You may feel encouraged to avoid another surgical procedure to deliver your baby, or you just want to experience a natural birth. However, the decision of a VBAC is never all yours. The doctor needs to check your medical history, pregnancy details and risk factors before deciding if you are an ideal candidate for a VBAC.
In this article:

What Is a VBAC and Why Does It Matter?

VBAC stands for Vaginal Birth After Cesarean, which is a type of delivery where you give birth vaginally after delivering via a C-section previously. VBAC has a shorter healing period, and the pain is also considerably less. You will undergo a more natural experience.

You may find it surprising, but almost 60-80% of the VBAC cases are successful worldwide. However, your health and the reason for the cesarean delivery earlier decide whether you can go for a VBAC.

What Do Doctors Look At Before Suggesting VBAC?

Several factors determine if VBAC is a safe option for you and your baby.

What Type of Uterine Cut Did You Have Earlier?

The main factor is the type of cut you had in your previous surgery.
  • Low transverse incision (side-to-side cut): This is the safest and most common type of scar, so if you have this scar type, you are usually a good candidate for VBAC.
  • Vertical incision (up-and-down cut): It is riskier because of a higher chance of uterine rupture, so VBAC is not usually recommended.

Why Did You Have a C-Section Before?

Your next delivery type is based on the reasons for your previous C-section.
  • VBAC might be a good choice now, if previously it was due to temporary issues, such as the baby’s position or fetal distress.
  • If it were because of permanent or repeated issues like a narrow pelvis, VBAC may not be safe.

How Much Time Has Passed Between Pregnancies?

Doctors recommend a gap of at least 18–24 months between your cesarean and next pregnancy. It allows your uterus to heal properly and reduces the risk of uterine rupture. It is a severe complication in which the scar from the previous surgery reopens during labour.

What Is the Condition of Your Current Pregnancy?

VBAC is considered safe under some circumstances, as mentioned below.
  • Your baby’s head is down and ready for vaginal delivery
  • You have normal blood pressure and no signs of complications
  • The baby’s weight is under 3.8-4 kg

What Are the Chances of Uterine Rupture?

The most common concern with VBAC is uterine rupture, but it is quite rare. If you have a low-transverse scar, the chances are as little as 0.5% to 1%. Your doctor will make the judgment considering your medical and surgical history.

How Do Doctors Prepare You for a Possible VBAC?

Your doctor will ensure that all necessary provisions are in place for a safe delivery if you are a suitable candidate for a VBAC. They will take the following steps:
  • Monitor your labour closely
  • Avoid using excessive medications to speed up contractions
  • Keep surgical and neonatal teams on standby for safety

What Can You Do to Increase Your Chances of a Successful VBAC?

You can improve your success rate by preparing your body and mind.
  • Maintain a healthy weight during pregnancy
  • A simple exercise routine can prepare your pelvis for birth
  • Iron, calcium, and protein are essential, so try to get them through the foods you eat
  • Learn breathing and labour techniques in prenatal classes
  • Discuss your birth plan with your doctor and partner openly

When Might a Doctor Recommend Against VBAC?

The chances of a VBAC may be lower in the following situations:
  • More than two C-sections in the previous pregnancies
  • A vertical uterine scar
  • Multiple babies (twins or triplets)
  • Medical issues like placenta previa or uncontrolled diabetes
  • The baby is in a breech (bottom-first) position

What to Expect Emotionally During the VBAC Decision?

Trying for a VBAC can make you nervous. It is completely normal. You may feel anxious if your family or friends have strong opinions about your birthing choice. However, the important thing is that it is about your experience and your body. You can discuss your fears and hopes about the delivery with your partner or doctor. Emotional support from your loved ones can make the journey smoother and help you stay calm during labour.

VBAC Preparation Checklist

  • Check your previous surgery records
  • Discuss the healing time and type of scar with your doctor
  • Ask if your hospital has 24-hour surgical support
  • Maintain your weight by eating a balanced diet and managing stress effectively
  • Keep a birth plan ready, but be flexible with it
A VBAC provides a good chance to experience a natural birth after a cesarean, but it depends on your health and medical factors. Doctors assess all the possible risks of your case before giving you the clearance for a VBAC. Remember, your and your baby’s health is what matters the most, whether it’s a VBAC or another cesarean.

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FAQs on How Doctors Decide If You’re a Good Candidate for a VBAC?

  1. Can I choose a VBAC even if my doctor suggests a C-section?
    Your doctor will suggest a C-section based on your medical conditions to deliver the baby safely. However, you can still discuss your preference with them.
  2. How can I know if my hospital supports VBAC deliveries?
    The only way to know it is by asking your doctor directly during your prenatal visits. Also, consider a hospital with a team of obstetric specialists and 24/7 emergency facilities.
  3. How painful is a VBAC compared to a C-section?
    VBAC involves labour pain, but heals faster. On the contrary, a C-section may have less pain during delivery, but a longer healing period.
Disclaimer: Medically approved by Dr. Akhila C, Obstetrician and Gynaecologist, Apollo Hospitals, Bangalore

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