VBAC in the UK: Benefits, Risks and What the Evidence Says

If you have previously had a caesarean birth, you may be wondering what your options are for your next birth.

The reassuring news is that a Vaginal Birth After Caesarean (VBAC) is a safe and supported option for many people in the UK. National guidance recommends that parents are given balanced, evidence-based information to help them decide between a VBAC and a planned repeat caesarean.

As a doula, I support families to feel informed, confident and in control of their birth decisions. This article brings together the latest UK guidance to help you understand VBAC benefits, risks and success rates in the UK.

What is VBAC?

VBAC stands for Vaginal Birth After Caesarean. You may also see the term TOLAC (Trial of Labour After Caesarean) used in medical settings.

If you are wondering “can I have a vaginal birth after C-section UK”, the answer is: in many cases, yes.

According to the Royal College of Obstetricians and Gynaecologists (RCOG), around 72–75% of people who plan a VBAC in the UK will have a successful vaginal birth.

Benefits of VBAC

Faster recovery after birth

One of the main reasons people research VBAC vs repeat C-section is the question of recovery.

A vaginal birth usually means:

• Shorter hospital stay

• Faster physical recovery

• Less pain after birth

  
  

Avoiding surgery also reduces risks such as infection, blood clots and heavy bleeding (NICE, 2021).

Reduced risks in future pregnancies

If you are searching multiple C-sections risks, it’s important to consider that each caesarean increases the likelihood of complications such as:

• Placenta praevia

• Placenta accreta

  
  

A successful VBAC avoids another uterine scar, which may reduce these risks in future pregnancies (RCOG, 2015).

Potential benefits for babies

Many parents wonder Is VBAC safer for baby?

Babies born vaginally may have a lower risk of respiratory problems compared with babies born by planned caesarean before labour begins (RCOG, 2015).

Risks of VBAC

Understanding VBAC risks is an important part of making an informed decision.

Uterine rupture

The risk of uterine rupture with a previous lower-segment caesarean scar is approximately

1 in 200 (0.5%) in the UK (RCOG, 2015).

Although rare, this is the most serious risk associated with VBAC and requires immediate medical care.

Emergency caesarean birth

What happens if VBAC fails?

It’s important to know that:

• Not all VBACs result in a vaginal birth

• Some people will need an emergency caesarean

  
  

Emergency caesareans can carry slightly higher risks than planned procedures.

Who is not suitable for a VBAC?

VBAC may not be recommended if you have had:

• A classical (vertical) uterine incision

• A previous uterine rupture

• Certain uterine surgeries

• Specific pregnancy complications

  
  

Always discuss your individual situation with your midwife or obstetrician.

Factors That Increase VBAC Success

Research highlights several important factors on how to increase VBAC success:

• Previous vaginal birth

• Previous successful VBAC

• Only one previous caesarean

• Labour starting naturally (spontaneous labour)

• No additional complications

  
  

People who have had a previous vaginal birth may have success rates of 85–90%.

Birth Setting for VBAC in the UK

If you are wondering where can I have a VBAC or what are the VBAC NHS guidelines?

Current UK recommendations state that VBAC should take place in a maternity unit where:

• Emergency caesarean birth can be performed quickly

• Continuous fetal monitoring is available

  
  

This ensures that if complications arise, care can be provided without delay (NICE, 2021).

VBAC vs Repeat Caesarean - Making Your Decision

This is a personal decision; both VBAC and planned repeat caesarean are valid options.

The right choice depends on:

• Your medical history

• Your previous birth experience

• Your preferences and feelings about birth

  
  

The most important thing is that you feel informed, supported and confident in your decision.

Support with Your VBAC Journey

Having the right support can make a big difference to how you feel during pregnancy and birth.

If you would like personalised, continuous support throughout your journey, you can contact me for a FREE no-obligation call to discuss my services and the packages I offer.

I support families to feel calm, informed and nurtured as they prepare for birth - whatever path they choose.

Contact

References

National Institute for Health and Care Excellence (NICE) (2021) Caesarean birth (NG192). London: NICE.

Royal College of Obstetricians and Gynaecologists (RCOG) (2015) Birth after previous caesarean birth (Green-top Guideline No.45). London: RCOG.

Right Decisions NHS Scotland (2024) Vaginal birth after caesarean section clinical guideline. NHS Scotland.

Tommy’s (2024) Giving birth after a caesarean section. London: Tommy’s PregnancyHub.