Written by Aisha Saleem, Pharmacist & Health Writer at PharmaHealths.com
Last Updated: August 7, 2026
If you had a c-section with your last baby and you are wondering whether a normal delivery is possible this time, the honest answer is that for most women, yes, it is. This is called VBAC, vaginal birth after cesarean, and it has become one of the most researched areas in modern obstetrics.
What Is VBAC and who is it for?
VBAC stands for vaginal birth after cesarean, and it simply means going into labor and delivering vaginally after having had a previous c-section. When a woman attempts this, doctors call the labor itself a trial of labor after cesarean, or TOLAC. Not every attempt ends in a vaginal birth, but the International Federation of Gynecology and Obstetrics good practice recommendations published in 2025 report success rates between 60% and 80% for women who attempt it, which means three to four out of five women who try do go on to deliver vaginally.
Am I a candidate for VBAC?
You are most likely to be a good candidate if you had a single previous c-section with a low transverse incision, a spontaneous start to labor, and a gap of at least 18 months between deliveries. The FIGO recommendations list the strongest predictors of success as a prior vaginal birth, a non-recurring reason for the earlier c-section, a body mass index under 30, and labor that starts on its own rather than through induction. Women with two prior c-sections may still be considered in carefully selected cases, though the decision requires more individual counseling.
What Is the risk of uterine rupture during VBAC?
Uterine rupture is rare, and for most women attempting VBAC after one prior low transverse c-section, the risk sits between 0.2% and 0.7%, according to the FIGO guidelines. That risk roughly doubles for women attempting VBAC after two prior c-sections, rising to around 1.6% based on a 2019 review in Best Practice and Research Clinical Obstetrics and Gynaecology, compared with 0.7% after a single prior c-section. A separate population-based study following over 200,000 deliveries found the overall incidence of uterine rupture across all births, VBAC and non-VBAC combined, was just under 2 in 10,000. These numbers matter because they show the risk is real but small, and it becomes part of an informed conversation rather than an automatic reason to rule VBAC out.
Does the type of c-section incision affect whether I Can try VBAC?
Yes, and this is one of the most important factors your doctor will check. A low transverse incision, the horizontal cut used in the vast majority of c-sections, carries the lowest rupture risk and makes VBAC much more likely to be offered. A classical incision, which runs vertically on the uterus itself and is far less common, is a contraindication to VBAC because it carries a substantially higher rupture risk. If you are not sure which type you had, your surgical notes from the previous delivery will confirm it.
Can I be induced during a VBAC attempt?
Induction is possible but it changes the risk profile, particularly if prostaglandins are used on a cervix that is not yet favorable for labor. Clinical teaching consistently identifies prostaglandin induction as the single biggest risk factor for uterine rupture in women attempting VBAC, which is why many doctors prefer to let labor start naturally when possible, or use more mechanical methods of induction if induction becomes necessary.
What Happens if VBAC fails during labor?
About one in four women who attempt VBAC end up needing an unplanned c-section during labor, most often because labor stalls or the baby shows signs of distress, while roughly three in four go on to deliver vaginally. If your labor does not progress as expected, your medical team will move to a c-section, and this is exactly why VBAC is only recommended in hospitals equipped to perform an emergency c-section quickly if it becomes necessary.
How do I find a doctor or hospital that supports VBAC?
Look specifically for a doctor and hospital that manage VBAC regularly, not just one that says it is technically willing. A facility needs round the clock access to anesthesia and an obstetric team ready for emergency delivery, so smaller hospitals without that staffing often cannot safely offer it even if a woman is otherwise a good candidate. Ask directly how many VBACs the practice manages each year, since a team with real ongoing experience will counsel you more precisely on your own odds.
Conclusion
VBAC is a safe, well-studied option for most women who have had one prior c-section with a low transverse incision, and it deserves a real conversation with your doctor rather than being ruled out by default. Knowing your own risk factors, the type of incision you had, and what your hospital can offer puts you in a much stronger position to make the choice that is right for you. For many women, the decision is not about choosing what is safest in general, but what is safest for their specific situation.
Disclaimer
This article is for educational purposes only and is not a substitute for professional medical advice. Always consult a qualified healthcare provider about your specific pregnancy history and delivery options.
References
• Barnea ER, et al. “FIGO good practice recommendations for vaginal birth after cesarean section.” International Journal of Gynecology & Obstetrics, 2025. https://obgyn.onlinelibrary.wiley.com/doi/10.1002/ijgo.70406
• Uterine scar rupture: Prediction, prevention, diagnosis, and management.” Best Practice & Research Clinical Obstetrics & Gynecology, 2019. https://pubmed.ncbi.nlm.nih.gov/30837118/
• Uterine rupture, associated factors and its maternal and perinatal outcomes.” BMC Pregnancy and Childbirth, 2022. https://link.springer.com/10.1186/s12884-022-04415-6
• Vaginal Birth After Cesarean Delivery.” StatPearls, NCBI Bookshelf, 2025. https://www.ncbi.nlm.nih.gov/books/NBK507844/
