VBAC: My story, the evidence, and the empowering truth about birthing after Caesarean

For a long time, the term VBAC felt both electrifying and terrifying to me.

“VBAC” stands for Vaginal Birth After Caesarean - and the term will continue to be applied no matter how many times you birth after c-section(s). For instance, you would be a 2VBAC after a single c-section then two VBACs, or if you’d had multiple c-sections you could be a VBA2C or a 2VBA2C (and so on).

Behind the seemingly simple definition sits a whole world of emotion, history, fear, hope, and possibility.

For many women, VBAC represents not just a mode of birth, but a reclamation of agency, trust, and confidence after an experience that may have felt disempowering, unexpected, or traumatic.

This was certainly true for me.

My first VBAC: the birth that changed me

After my first birth ended in an unwanted caesarean, I carried a complicated mix of grief, confusion, and determination into my next pregnancy. I knew I wanted a VBAC — not because vaginal birth is “better,” but because I needed to know what my body could do when supported, informed, and trusted. And I knew there were clear benefits to VBAC for both my baby and I.

Since there are a myriad of circumstances that could exist in a pregnancy, and for post-partum recovery, I do not suggest that there’s a clear path indicating VBAC will be best for every mother to attempt, but it’s worth discussing with healthcare providers as an option. Informed choice is what I do advocate as being the best.

How I went about birthing was completely different this time:

• Before pregnancy I sought out scar release through natural health modalities – I found a Bowen therapist and felt I got good results. I have since observed many other forms of massage and bodywork that could be equally helpful.
• I did yoga throughout pregnancy, not just for strength and mobility, but for nervous system regulation and emotional steadiness.
• My husband and I completed independent birthing classes (via Calmbirth) together, which ended up being one of the most grounding and connecting experiences we’ve had – giving us tools not just for empowered birth, but for a loving and united pregnancy, labour and recovery (side note - until it was highlighted in these classes what an asset my husband could be as my advocate, to speak for me when I needed to stay “in the zone”, and to meet the needs I had a chance to express in advance, I hadn’t even realised what a huge role he could fulfil).

• I joined a VBAC support group on Facebook, where I learned more from other women’s stories than I ever had from antenatal classes.
• I learned all I could about how to best influence optimal foetal positioning, including what I could do before and during labour – now I had options and an openness to new possibilities.

Most importantly, I entered this birth with knowledge — real, embodied, practical knowledge — something I didn’t have anywhere near enough of the first time.

I’d thought ‘go with the flow’ would be best for a ‘chill’ and ‘natural’ birth experience, but I learned that preparation isn’t restrictive – it’s liberating. It was no longer a case of “you don’t even know what you don’t know”. It gave me confidence and direction - I knew what I most wanted and needed to advocate for.

But even with all that preparation, I was nervous.

I knew how deeply my mental health had been affected after my first birth.

I knew how fragile I had felt in the fog of postnatal depression.

I knew how much I wanted this VBAC — not for a “perfect birth,” and not to “outrun” postnatal depression, but …

to reclaim the sense of ownership I’d lost the first time.

I wanted to birth in a way that felt loving, connected, and deeply mine.

I was realistic – I had a chance, but no guarantees, and I might have to make my peace with another c-section if that turned out to be necessary. And still, the idea of not achieving my dream scared me more than I wanted to admit.

And then labour began.

I will remember the moment for the rest of my life: the midwife leaning close, her voice warm and certain, saying, “I can see the head. Baby will be coming vaginally.” In that instant, something inside me cracked open — relief, joy, disbelief, pride, all flooding in at once. I felt the last kicks on the inside as 3.96kg of baby boy (with a hand on the side of his giant 39cm head) slid out of my body. And the raw, powerful truth of having been the one to do that — myself — is something I will carry forever.

And it was undeniable proof that the care provider who once told me my ‘narrow pelvis’ could never birth a baby had been wrong. There was nothing wrong with my anatomy. There was nothing wrong with having a big baby. It was mostly about getting the right combination of positioning, determination, and a dose of luck. Though my birth choice hadn’t been about proving someone else wrong, finding out that it wasn’t that anything was wrong with me, and being provided fodder to empower other women who are given the same baseless assumption, just added to the sense of victory and elation.

It was one of the most primal, beautiful and empowering moments of my life.

The part we don’t talk about enough: postpartum reality

My physical recovery after that VBAC was harder in some ways than my c‑section recovery — something I wasn’t expecting. I had a mild postpartum haemorrhage and a deep second‑degree tear which had been extremely painful during suturing (even with pudendal nerve block). My pelvic floor muscles felt heavy in a way I had never experienced before. I couldn’t sit without pain for weeks. And I couldn’t walk far without wondering if it was possible for everything to just fall out through said pelvic floor. There were moments where I wondered, quietly and guiltily, whether the VBAC had been “worth it.”

But every time I returned to that moment — hearing the midwife’s words, feeling my baby move from inside to outside, knowing I had birthed him with my own strength, being the first one ever to hold him — the answer was always yes. Absolutely yes.

Birth is never just physical. It’s emotional, psychological, spiritual. And for me, the emotional healing of that VBAC outweighed every physical challenge that followed.

My second VBAC: bigger baby, bigger emotions, bigger lessons

My next VBAC brought its own complexities. Labour was beautiful, though it was intense, it went faster than last time, I felt good going totally unmedicated, and it was just what I’d wanted. Another loving and deeply connected birth. Another big baby — 4.45kg this time (same off-the-charts head circumference) — and unfortunately another postpartum haemorrhage, this one significant and requiring theatre and general anaesthesia for repair. Retained placenta and uterine inertia.

It was intense, and yes, it was scary.

There was a lot of painful “uterine massage” to try to improve contractility and help stem the haemorrhage, in conjunction with cord traction, until I passed out from the pain (I will note here that all uterine massage stories I’ve heard are painful, but not all are so extreme they cause fainting).

I was separated from my baby for hours, which was not ideal (but at least I’d expressed colostrum and my husband had been sure to bring it in, so he was well fed in my absence).

I did experience what I’d describe as mild adverse emotional effects as a result, but it was all manageable with the tools I had in my toolkit from my prior pregnancies, psychologist visits and most of all, my recent yoga teacher training (I was nearly finished the baseline 200-hour level at the time of the birth, so had spent a long time immersed in yogic philosophy, with fortuitous timing).

Even with the complications, it was a risk I had been willing to take for the benefits of VBAC, and I would make the same choice again. Because I could just as easily not have haemorrhaged. And the empowerment, clarity, and connection I felt in birthing him vaginally were worth it to me.

The physical recovery amazed me this time – even with a total estimated loss of 1.2L and another second-degree tear, I barely noticed any perineal pain by day two and my pelvic floor was no different to what it was in pregnancy (which was quite good, through excellent care - and strengthening exercises - between babies and through pregnancy).

I found that what they say about every birth and recovery being different is indeed the truth. And that perspective is everything – though my complications were significant, remaining focussed on the positives and the empowered choices I’d made throughout had helped me process my emotions and let go of anything that did not serve me. Nothing got stuck. Thoughts didn’t loop. The love and joy remained as a highlight.

VBAC in Australia: what the numbers actually say

VBAC is often framed as risky – unfortunately even by some in medical professions - but the evidence paints a far more balanced picture.

• Caesarean rate in Australia: ~37% of all births
• VBAC attempt rate: ~20–30% of women
• VBAC success rate: 70–80% for women who attempt it

Now let’s talk uterine rupture risk:

• VBAC: 0.5–0.9%
• First vaginal birth: similar at ~0.7%
• Second vaginal birth: slightly lower at ~0.4%

This is important — the risk of rupture is not dramatically higher for VBAC compared to a first vaginal birth (or even a second), despite how often it’s used as a deterrent. And if you are worried – as my husband was, as a nurse or two in my family was – flip it and consider again. That VBAC uterine rupture risk there translates to 99 (or more) out of 100 labours with a c-section scar not resulting in any rupture.

And of the ruptures that do occur, around 10% are categorised as catastrophic (i.e. immediate and severe harm to mother and/or baby). So that means that 99.9% of labours and births where there is a c-section scar present do not result in catastrophic outcomes.

All of this is not to say that there is no risk to VBAC. But in reality, every birth carries some risk. Every pregnancy carries some risk. In fact, we can’t live without some risk of harm in every activity we do. Keeping a balance to the perspective is incredibly important for maternal mental and physical health outcomes, and it is well worth knowing these statistics when speaking to your doctor or midwife about your specific situation. If it turns out your health care provider is more risk averse than you would like, you can always consider looking for an alternative provider.

The risks no one talks about enough: placenta accreta & placenta previa after Caesarean

One of the most frustrating parts of VBAC counselling is how often the conversation focuses on uterine rupture — a small risk — while completely overlooking the risks that increase with repeat caesareans.

Two of the most significant are placenta previa and placenta accreta spectrum (PAS).

Placenta previa

A previous caesarean increases the risk of placenta previa because scar tissue creates a less optimal environment for implantation.

• Before you’ve had a caesarean: 0.3-0.5% risk

• After one caesarean: ~1–2% risk
• After two: ~3 risk
• After 3 or more: ~3-10% (depending on exactly how many c-sections – essentially, it keeps increasing with the number of surgeries)

Placenta Accreta Spectrum (PAS)

Placenta accreta is far more serious. It occurs when the placenta grows too deeply into the uterine wall, sometimes invading the muscle or beyond. It can lead to life‑threatening haemorrhage, emergency hysterectomy, preterm birth, and ICU admission.

The strongest risk factor is a prior caesarean scar.

And the risk rises with each additional caesarean — especially when placenta previa is also present:

• With no prior caesareans: ~0.03% risk of PAS – and it does not increase meaningfully with additional pregnancies*.

• After one caesarean: ~0.2% risk (+ previa → ~3% risk of PAS)
• After two: ~0.3–0.6% risk (+ previa → ~11%)
• After three: ~0.6–0.8% risk (+ previa → ~40%)
• After four or more: ~2–2.1 up to 6.7% risk (+ previa → 60–67%)

*After 3-4 births accreta risk does start to rise slightly, sitting at 0.04-0.05%, or at 0.06-1% for 5+ prior births. It is also possible to have PAS without a prior c-section scar. Other risk factors include placenta previa, maternal age, IVF, uterine anomalies, prior uterine surgery (D&C, myomectomy, etc.)

So although some of the risks associated with repeat c-section are significant, many women are never even told about them in the discussion about the preferences for next birth after c-section. I know I wasn’t, when repeat c-section was recommended to me due to “narrow pelvis” and big baby.

Benefits of VBAC for mothers and babies

VBAC can offer important benefits:

For mothers

• Shorter recovery, usually less time in hospital
• Lower infection risk
• Reduced surgical complications
• Lower risk of placenta accreta in future pregnancies
• Lower risk of chronic pelvic pain and adhesions
• Labouring triggers a powerful hormonal cascade — oxytocin for bonding and calm, beta‑endorphins for pain relief and emotional resilience, catecholamines for the baby’s transition and the mother’s alertness, and prolactin for breastfeeding and nurturing behaviours
• Greater likelihood of immediate skin‑to‑skin and early breastfeeding
• Potential for lower rates of post-natal depression and anxiety (compared to emergency c-section).

For babies

• Lower risk of respiratory complications at the birth
• More stable transition after birth
• Reduced NICU admissions compared to elective repeat caesarean
• Exposure of the infant gut with beneficial bacteria (noting there is increased interest in manually ‘seeding’ after a c-section, and I have not investigated whether there’s data on how outcomes compare to vaginal birth)
• Allowing labour to commence (whether it results in vaginal birth or not) may boost oxytocin and beta-endorphins in babies, supporting bonding, calm alertness and sensory integration
• Babies born vaginally may have lower rates of respiratory illness, asthma, allergies, and certain metabolic conditions later in childhood.

As you can see, an important theme within is that spontaneous labour itself can have benefits for mother and baby, even though vaginal birth is not guaranteed even if you choose to proceed with VBAC as your birth preference.

Why VBAC matters: it’s more than the statistics

VBAC is not just about risk profiles or percentages. It’s about:

• reclaiming trust in your body
• healing after a traumatic or unexpected first birth (noting that this is still possible with or without another birth, and with or without a vaginal birth – it’s likely the empowerment of informed choice and the quality of emotional processing and support that makes the most impact)
• experiencing birth in a way that aligns with your values
• feeling informed, supported, and empowered
• knowing you have real and viable options

For me, VBAC was a turning point in my motherhood. It reshaped my confidence, my relationship with my body, and my understanding of birth. It taught me that knowledge is power, that support is essential, and that birth can be profoundly healing even when it’s messy, intense, or complicated.

If You’re Considering a VBAC…

Here’s what helped me most:

• Education — Calmbirth, Spinning Babies and other birth physiology resources, VBAC‑specific journal articles, blogs and other resources
• Support — the VBAC Facebook group I joined was invaluable
• Movement — yoga kept me grounded, mobile, and connected
• Advocacy — asking questions, understanding policies, knowing my rights
• Trust — in my body, my baby, and my intuition

And here’s what I want you to know:

You are not “risky.” You are not “less safe.”

You are a woman with a scar and a story — and you deserve care that honours both.

VBAC is safe for most women. VBAC is empowering for many women. And VBAC is a valid, evidence‑supported option that should be offered without bias, pressure, or fear.

Birth Is Never One‑Size‑Fits‑All

Whether you choose VBAC, repeat caesarean, pain relief or all natural, induction or spontaneous labour…or have unexpected complications necessitating quick decisions you may not like but have to make anyway (another story, another day)…you deserve informed consent, compassionate care, and support that respects your history and your hopes.

My VBACs were two of the most transformative experiences of my life — not because they were perfect, but because they were mine. They taught me that birth can be healing, that strength can look like softness, and that motherhood is built not just on how we birth, but on how we rise after.

If you’re walking this path, I’m cheering for you. If you ever want to share your story, I’ll meet you gently. And if you’re preparing for your own VBAC journey, I hope you find the same liberty and joy that I did — in whatever form your birth takes. If you’d like more support from me, I have a lot more on birth preparation through yoga (including two full-length yoga classes, and separate meditations for vaginal birth and c-section prep) in the Prenatal Presence online course – find out more here.