TL;DR: If you’ve had a previous C-section and are pregnant again, you have a choice: attempt a vaginal birth after cesarean (VBAC) or schedule a repeat cesarean. Both are safe options for the right candidates. The decision depends on factors like your reason for the previous C-section, the type of uterine incision, your current pregnancy, and your personal preferences. Your OB/GYN is your best resource for navigating this decision.
Navigating a pregnancy after a previous C-section? Schedule a prenatal visit at Lona Sasser OB/GYN.
VBAC vs. Repeat C-Section: Understanding Your Options for Birth After a Cesarean
If you’ve had a C-section before, you may have assumed that all future births would be cesareans too. But that’s not necessarily the case. Many women are good candidates for a vaginal birth after cesarean (VBAC) — and for some, it’s actually the lower-risk option. At the same time, a planned repeat cesarean is the right choice for others.
The key is making an informed decision — one that weighs your medical history, your current pregnancy, and your personal values. Here’s what you need to know.
At Lona Sasser Obstetrics and Gynecology, your health is our top priority. We offer comprehensive obstetrics services for patients in Coral Springs, FL. To make an appointment, you can easily book online or give us a call at (954) 340-1050.
What Is a VBAC?
VBAC stands for vaginal birth after cesarean. It simply means attempting to deliver vaginally in a subsequent pregnancy after having delivered by C-section in a previous one. A successful VBAC is called a TOLAC (trial of labor after cesarean).
According to ACOG, about 60 to 80 percent of women who attempt VBAC are successful. It’s more common than many people realize.
Potential Benefits of VBAC
- Shorter recovery time — vaginal delivery typically means a faster return to normal activity
- No surgical risks — avoiding a repeat cesarean means no risk of surgical complications like infection, blood clots, or injury to surrounding organs
- Fewer risks in future pregnancies — each additional C-section increases the risk of placenta complications and other surgical complications in subsequent pregnancies
- Potentially better outcomes for baby — vaginal birth is associated with certain respiratory and immune benefits for newborns
Potential Risks of VBAC
The most serious risk of VBAC is uterine rupture — a tear at the site of the previous uterine incision. This is rare (occurring in less than 1% of VBAC attempts in appropriate candidates) but can be life-threatening for both mother and baby when it occurs. It’s why VBAC should only be attempted at a hospital equipped to perform an emergency C-section if needed.
Other potential risks include the need for an unplanned C-section during labor, which carries a higher risk than a planned one.
Who Is a Good Candidate for VBAC?
Not everyone is a good candidate. Factors that generally favor VBAC include:
- A low transverse (horizontal) uterine incision from the previous C-section — the most common type
- A clear reason for the previous C-section that is unlikely to recur (e.g., breech position, fetal distress)
- No more than one or two prior cesareans
- No other uterine surgeries that could affect uterine integrity
- A pelvis and fetal size that are compatible with vaginal delivery
Factors that generally favor a repeat C-section include:
- A prior classical (vertical) uterine incision, which carries a higher rupture risk
- Three or more prior cesareans
- A recurring reason for C-section, such as a narrow pelvis
- Certain placenta conditions like placenta previa
- Your hospital or provider does not support TOLAC
What to Consider When Making Your Decision
Beyond the clinical factors, there are personal considerations that matter too. How do you feel about labor? How important is recovery time to you — especially if you have other children at home? Do you have strong feelings about birth experience? There’s no wrong answer, and a good OB/GYN will help you think through all of it.
This conversation should ideally start early in your pregnancy, during prenatal care, so there’s time to review your records from your previous delivery, assess your current pregnancy, and make a plan that works for you.
Let’s Make This Decision Together
At Lona Sasser Obstetrics & Gynecology, your health is our top priority. We offer comprehensive obstetric care for patients in Coral Springs, FL, and we believe every woman deserves a birth experience that reflects her values and priorities. Our team — Dr. Lona Sasser, Dr. Mary Squire-De Leon, and Dr. Cherelle Leslie — will take the time to review your history, explain your options clearly, and support whatever decision is right for you.
We serve women in Coral Springs, Tamarac, Parkland, Coconut Creek, Deerfield Beach, North Lauderdale, and Boca Raton.
Book your prenatal appointment online through Zocdoc or call us at 954-340-1050.
Frequently Asked Questions About VBAC vs. Repeat C-Section
Is VBAC safe?
For appropriately selected candidates, yes. ACOG supports VBAC as a safe and reasonable option for most women who have had a prior low transverse cesarean. The key is being at a facility equipped for emergency response and having a care team experienced in managing TOLAC.
Can I choose to have a repeat C-section even if I’m a VBAC candidate?
Absolutely. Being a VBAC candidate means you have the option — it doesn’t mean you’re required to attempt it. Your preferences matter, and a repeat C-section is a completely valid choice.
Does my previous C-section scar affect my options?
Yes, the type of uterine incision (not the external skin incision) is one of the most important factors. A low transverse incision is associated with the lowest rupture risk and is the most VBAC-favorable. If you’re unsure about your incision type, your OB/GYN can review your previous operative notes.
How many C-sections can you have?
There’s no universal limit, but each subsequent cesarean increases the complexity of the surgery and the risk of complications, particularly involving the placenta. Your OB/GYN will discuss the implications of your specific history.
What if I start labor and change my mind?
You can always change your mind about attempting VBAC and request a C-section during labor (barring emergency circumstances). The goal is for you to feel informed, supported, and in control of your birth experience.
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