Nottingham University Hospitals
Vaginal Birth After Caesarean
This leaflet will explain what a VBAC is, what the risks and
benefits are, and will answer some of your questions.
What is a VBAC?
‘VBAC’ is short for ‘Vaginal Birth After Caesarean’. Many
women who have previously had a Caesarean will be able to
give birth vaginally the next time around. VBACs are offered
at both the City Hospital campus and the Queen’s Medical
• Many women want to avoid further major surgery
• VBAC gives you the opportunity of a less ‘medicalised’
and more natural approach to labour and birth
• Avoiding a Caesarean section often results in a quicker
return to normal everyday activities, and following
normal birth you can usually go home as soon as you
• There is less chance of infection, thrombosis (blood
clots), or the need for a blood transfusion if you have a
vaginal birth than if you choose to have a planned
• When babies are born normally their breathing may
settle more quickly
• Mothers report a greater satisfaction after a vaginal
Risks or disadvantages
• The main risk is that during your labour it could become
apparent that you will be unable to give birth vaginally
and so require another Caesarean section
• There is a small risk of the scar on the womb from the
previous Caesarean section separating during your
labour. Many large studies have suggested this risk is
less than 1%, but that it may even occur if you are not
in labour. If this occurs then an emergency Caesarean
section will be necessary. Very rarely the scar may
rupture, which is more serious. If this happens, there is
a risk that you may need a hysterectomy following the
birth of your baby.
What will happen during my VBAC?
If you have had a previous Caesarean section it is advisable to
have your labour and birth in the hospital. This is because if
you need another Caesarean section it can be arranged
• Because there is a chance of another Caesarean section,
we advise that you have a venflon (small plastic needle
placed in the back of your hand). This means that the
midwife or doctor can attach a drip should it be
necessary. We also suggest taking a blood sample. This
gives us the most up to date blood count and means we
can prepare a blood transfusion should that be necessary
• We also advise that we check your baby is coping well
during your labour by using continuous electronic fetal
monitoring. There is a separate leaflet ‘Fetal Monitoring
in Labour’ which your midwife can give you. However
this can easily be done if you wish to remain upright and
mobile, choosing whatever position you find helpful
• You can have whatever pain relief you would like. There
is a separate leaflet ‘Positive ways to manage pain in
labour’ which your midwife can give you
Can I decide my method of birth?
For some women, there are very good reasons why deciding
on another Caesarean section is very sensible for either you
or your baby’s safety. However, VBAC is a very reasonable
choice for most women. If you have had one vaginal birth
already, you are more likely to have a successful VBAC. It is
important to make your decision with the help of your
midwife and doctor. When you discuss with your midwife
and doctor about your labour and birth, these are the points
you need to consider:
• Why did you have your first Caesarean section?
• Have you had more than one Caesarean section?
• What sort of scar was made?
When you have made your decision, a plan will be made
which will be written into your hand-held notes, and also in
the hospital records.
Will I go into labour naturally?
Yes – it is very likely that you will. However, in some
circumstances it is possible that your labour may need to be
induced (started off). As there are risks with an induction
when you have had a Caesarean section before, your doctor
and midwife will have further discussion with you.
Will the midwife still look after me?
Yes – you will be ‘booked’ under the care of the Consultant
obstetrician, but you will always have a midwife to look after
you during your labour and birth.
The information in this leaflet is gained from guidelines
which midwives and doctors use all the time. They are from
local and national guidelines, and are produced from
research. Your midwife or doctor can give you more
information should you require it.
Fetal monitoring in labour (NUH leaflet)
Positive ways to manage pain in labour (NUH leaflet)
Types of birth (NUH leaflet)
Queen’s Medical Centre Campus labour suite: 875 4672
City Hospital Campus labour suite: 962 7710
City Hospital campus
Queen’s Medical Centre campus
0115 969 1169
0115 924 9924
This leaflet is produced by the Leaflet Review Group,
© Nottingham University Hospitals NHS Trust
Review date: September 2008