A VBAC (pronounced “vee-back”) is a vaginal birth after cesarean, meaning you deliver a baby vaginally after having had a C-section in a previous pregnancy. The process of attempting this is called a trial of labor after cesarean, or TOLAC. Not every attempt succeeds, but overall VBAC rates fall between 60% and 80% for those who try.
For decades, the standard approach was “once a cesarean, always a cesarean.” That thinking has shifted significantly. Major medical organizations now support VBAC as a safe option for many people, with the decision guided by your individual history, risk factors, and personal preferences.
How VBAC Differs From a Standard Vaginal Delivery
In most ways, a VBAC looks and feels like any other vaginal birth. You go through labor, push, and deliver. The key difference is that your uterus carries a scar from the prior C-section, and that scar creates a small but real risk of the uterus tearing open during labor contractions. Because of this, VBAC deliveries should take place in a hospital equipped to handle an emergency cesarean quickly if needed.
Your care team will monitor you more closely than in a typical vaginal delivery, watching for signs of distress in you or the baby. If labor stalls or complications arise, the plan can shift to a repeat C-section at any point.
Who Can Try for a VBAC
The single most important factor is the type of incision made on your uterus during your previous C-section. A low transverse incision, which is a horizontal cut across the lower, thinner part of the uterus, carries the lowest risk of rupture and makes you the strongest candidate. This is the most common type of uterine incision used today.
Vertical or T-shaped incisions on the upper part of the uterus are considered high risk for rupture, and VBAC is generally not recommended with those scar types. It’s worth noting that the scar on your skin doesn’t always match the scar on your uterus. A horizontal skin incision could still hide a vertical uterine cut underneath. Getting your surgical records from your previous delivery is the only reliable way to confirm what type of incision was made.
Other factors your provider will consider include: how many prior C-sections you’ve had, your reason for the first cesarean, whether you’ve ever had a successful vaginal delivery before (which significantly boosts your odds), and whether there are any current pregnancy complications.
Benefits Compared to a Repeat C-Section
A successful VBAC offers several advantages over scheduling another cesarean. Recovery is typically faster, since you’re healing from a vaginal delivery rather than major abdominal surgery. You avoid the risks that come with any surgical procedure, including heavier blood loss, infection at the incision site, and longer hospital stays.
The long-term benefits matter too, especially if you plan on having more children. Each additional C-section increases the risk of surgical complications like scarring, injury to nearby organs such as the bladder or bowel, and placental problems in future pregnancies. Conditions like placenta previa (where the placenta covers the cervix) and placenta accreta (where the placenta grows too deeply into the uterine wall) become more likely with each repeat surgery. A successful VBAC breaks that cycle.
The Main Risk: Uterine Rupture
The most serious concern with VBAC is uterine rupture, where the scar from the prior C-section tears open during labor. This is a medical emergency that can endanger both you and your baby, potentially requiring an immediate cesarean and, in rare cases, a hysterectomy.
The actual numbers, though, are reassuring for most candidates. For people with a prior low transverse incision, the incidence of uterine rupture during a trial of labor ranges from about 0.5% to 1%. By comparison, the rupture rate during a planned repeat cesarean is roughly 0.03%. So the risk is higher with VBAC, but still low in absolute terms. This is why hospital setting and continuous monitoring matter so much.
What Affects Your Chances of Success
The overall 60% to 80% success rate is a broad average. Your individual odds depend on a mix of factors. Having had a previous vaginal delivery, whether before or after your C-section, is one of the strongest predictors of success. Going into labor spontaneously rather than being induced also improves your chances, as does being younger and having a lower BMI.
Some providers use a VBAC calculator to estimate your personal likelihood of success based on these variables. These tools tend to be more accurate when they predict a 60% or higher chance, and less reliable at the lower end. The American College of Obstetricians and Gynecologists has been clear that a calculator score alone should not be used as a barrier to attempting VBAC. Some people and providers find the calculator helpful as a conversation starter, while others prefer a broader discussion of the options without anchoring to a single number.
Making the Decision
Choosing between a trial of labor and a scheduled repeat cesarean is deeply personal. Medical guidelines emphasize that your values and preferences should drive the conversation, not just clinical risk scores. Some people feel strongly about experiencing a vaginal birth. Others prioritize the predictability and control of a planned surgery. Neither choice is wrong.
What helps most is having an honest conversation with your provider about your specific history, your goals for this pregnancy and any future ones, and what support is available at your hospital. If your provider or birth facility doesn’t offer VBAC, it’s reasonable to seek a second opinion or look into hospitals that do, since access varies widely by region.