5 Things I Wish People Knew About VBAC (vaginal births after caesarean)
Content Warning: mention of birth trauma
Vaginal Birth After Caesarean (VBAC) has become more widely discussed in recent years, but many of the conversations around it are still incomplete, oversimplified, or framed in ways that unintentionally place pressure on parents.
For parents exploring VBAC in Singapore or learning about birth options after a previous caesarean, the information online can sometimes feel confusing or contradictory.
Over time, I’ve noticed a few common misunderstandings about VBAC and TOLAC (Trial of Labour After Caesarean) that can make the journey harder than it needs to be.
If you’re considering a VBAC after C-section, supporting someone who is, or simply trying to understand your options, here are five things I wish more people knew.
1.VBAC is not about course correction.
I always ask clients what’s motivating their desire for a VBAC.
Because we live in a culture that often frames caesarean birth as failure, VBAC is sometimes positioned within a redemptive narrative rather than as an informed choice. But here’s the truth: birth doesn’t need redeeming, and people don’t need fixing.
It’s okay to want something different for your next birth. It’s also okay to honour what came before.
A caesarean birth is not a mistake that our bodies made. It is not something that needs to be erased or undone. For many families, choosing vaginal birth after caesarean is simply about having another option for how their next birth might unfold.
Sometimes the motivation is:
a smoother postpartum recovery
planning for future pregnancies
personal birth preferences
medical considerations
One way I often frame it with clients is this:
VBAC is not about fixing the past. It’s about making an informed, evidence-based decision for the present pregnancy.
When we remove the pressure of redemption, parents can approach the decision with greater clarity rather than carrying the emotional burden of needing to “redeem” their previous birth.
2.Before VBAC, there is TOLAC.
When someone says they’re planning a VBAC, what they’re actually planning is TOLAC — Trial of Labour After Caesarean. TOLAC simply means giving the body the opportunity to labour after a previous caesarean birth. If that labour results in a vaginal birth, then it becomes a VBAC.
TOLAC is not about “proving” anything.
Sometimes labour leads to a vaginal birth. Sometimes another caesarean becomes the safest or most tenable path. Both are valid and possible outcomes.
We need to move away from the success/failure binary when it comes to VBAC — and birth in general. What I try to work towards instead is helping clients feel grounded in informed choice. Understanding the difference between TOLAC and VBAC helps set realistic expectations and shifts the focus toward preparation and decision-making rather than a fixed birth outcome.
Interestingly, some emerging evidence suggests that attempting labour before a caesarean can actually support better postpartum recovery outcomes compared to a fully elective repeat caesarean. Some parents even choose to schedule a repeat caesarean only once early labour begins. Understanding the difference between TOLAC and VBAC helps set realistic expectations and shifts the focus toward preparation and decision-making rather than a fixed birth outcome.
3.VBAC carry risk, so do repeat caeserean sections.
When it comes to VBAC vs repeat caesarean, risks vary from person to person. We need to stop making blanket statements that VBAC is safe for everyone who wants one.
There are many factors that may make attempting a VBAC more complex. At the same time, we also need to acknowledge that repeat caesareans carry risks too — something that is often missing from the broader narrative.
This conversation isn’t about proving one option is right or wrong. It’s about informed decision-making.
Risks associated with repeat caesarean sections may include:
Surgical complications
Infection
Adhesions and scar tissue
Longer recovery periods
Increased risk in future pregnancies (such as placenta previa or placenta accreta)
Risks associated with VBAC or TOLAC may include:
Uterine rupture
Emergency caesarean during labour
Possible fetal distress requiring intervention
For people who are good candidates for VBAC, obstetricians usually evaluate several factors to determine risk levels. These may include:
scar thickness from the previous caesarean
the time interval between pregnancies
overall maternal health
the reason for the previous caesarean
Good care means these factors are discussed clearly so parents can make evidence-informed choices about VBAC or repeat caesarean birth. For evidence-based information on VBACs, I highly recommend VBAC Facts, a wonderful resource for parents and birth professionals alike.
4.Birth prep for VBAC needs to be different.
Preparing for a VBAC birth is not the same as preparing for a first vaginal birth. Many parents carry physical, emotional, or informational gaps from their previous birth experience. Some may still be processing grief or birth trauma even during this pregnancy.
Taking time to reflect on the first birth with soft eyes, and working alongside therapists when needed, can be an important first step in VBAC preparation.
As a physiology-driven doula and Spinning Babies® Certified Parent Educator, I also focus on physical preparation and body literacy. This includes:
understanding the cardinal movements of baby during labour
pelvic balancing exercises
bodywork to support optimal fetal positioning
scar tissue release after a previous caesarean
Because certain interventions — such as chemical inductions or external cephalic version (ECV) — may be contraindicated after a prior caesarean depending on individual circumstances, it becomes even more important to prepare the body for TOLAC and create conditions that support physiological labour.
In my prenatal yoga classes, I also take VBAC plans into consideration. Movement recommendations can be different when there is a previous caesarean scar. We pay closer attention to scar tissue mobility, pelvic balance, and movements that encourage favourable fetal positioning — all of which may help labour begin spontaneously.
This matters because spontaneous labour is often the preferred pathway for VBAC, as many forms of medical induction are restricted or used with greater caution after a previous caesarean.
VBAC preparation, therefore, is not just about hoping for a different outcome. It’s about supporting the body and nervous system so that physiological labour has the best chance to unfold.
5.Find a Provider Who Advocates for VBAC — Not Just Someone Who Tolerates It
Finding the right provider is crucial when planning a VBAC after a previous caesarean. Ideally, you want someone who actively advocates for VBAC, not just someone who tolerates it.
Unfortunately, some parents experience what can feel like a “bait and switch.” Early in pregnancy, a provider may appear supportive of VBAC. But as the pregnancy progresses — or once labour begins — restrictive protocols suddenly appear, TOLAC may be discouraged, or there may be pressure to move toward a repeat caesarean.
This can be incredibly disorienting for parents who believed they had supportive care in place.A provider who truly advocates for VBAC and TOLAC approaches things differently. They understand the current evidence around vaginal birth after caesarean, support physiological labour when it is appropriate, and communicate risks with clarity and transparency.
Most importantly, they create an environment where your informed choices are respected first. VBAC advocacy does not mean guaranteeing a vaginal birth. Labour is unpredictable, and sometimes a repeat caesarean may still become necessary. What advocacy does mean is ensuring that parents are supported with balanced information, respectful care, and genuine support for TOLAC.
Having this kind of provider support can make a profound difference in how confident, safe, and empowered you feel throughout your VBAC journey.
Planning for a VBAC or know someone who is?
I’m happy to speak to you about my doula and childbirth education services I provide if you’re planning for a VBAC. I run a monthly childbirth preparation course for couples called Together in Birth at Maia House. For more information, schedule a 30min discovery call here.
