How to Increase Your Chances of a Successful VBAC
How to Increase Your Chances of a Successful VBAC
This content is for educational purposes only and is not medical advice. Always consult your licensed healthcare provider regarding your individual health history and circumstances.
If you've had a C-section and you're hoping for a vaginal birth next time, the question usually isn't "Is VBAC possible?" It's: "What can I actually do to improve my chances?"
After my first birth ended in a C-section following induction and multiple interventions, I didn't know what was within my control. When I prepared for my second birth — which became a successful unmedicated VBAC — I approached it differently with more intentionality.
Here's what the evidence says actually increases your likelihood of a successful VBAC — and what that looked like in practice.
First: What Are the Odds?
Planned VBAC success rates range from 60–80% among women attempting a Trial of Labor After Cesarean (TOLAC) (ACOG, 2019; Guise et al., 2010). That means most women who attempt labor after one prior low transverse C-section deliver vaginally.
Certain factors increase those odds. And many of them are within your influence.
1. Choose a VBAC-Supportive Provider
This is the single most foundational decision you will make.
Provider philosophy directly shapes induction decisions, labor time limits, cesarean threshold, mobility policies, and monitoring requirements. ACOG (2019) states that most women with one prior low transverse incision are candidates for TOLAC — but being a candidate and being genuinely supported are two different things entirely.
The questions worth asking: What is your personal VBAC rate? How do you define labor arrest? How long do you allow labor to progress? What is your induction philosophy for VBAC patients?
If you want a full breakdown of what to ask and what red flags to watch for:
→ Choosing a VBAC-Supportive Provider: What to Look For (And What to Ask)
Your environment shapes your outcome. The provider you choose is part of that environment.
2. Aim for Spontaneous Labor When Possible
Spontaneous labor is consistently associated with higher VBAC success rates compared to induced labor (Guise et al., 2010). Induction can still result in a successful VBAC — many women are induced and deliver vaginally — but statistically, spontaneous labor improves the odds.
This is not an argument against medically indicated induction. It is an argument for understanding why induction is being recommended, which methods are being proposed, and how long labor will be allowed to unfold before other decisions are made.
If induction is part of your history or your current plan:
→ The Truth About Cytotec for Labor Induction (From a Mom Who's Been There)
→ Foley Bulb for Labor: Pros, Cons & What It Felt Like
→ The Difference I Noticed Between Natural and Induced Contractions
3. Understand the Reason for Your First C-Section
Not all C-sections carry the same likelihood of repeating.
VBAC success tends to be higher when the prior cesarean was for breech positioning, placenta previa, or fetal distress unrelated to labor progress — all of which are typically situational and do not automatically recur. Success may be slightly lower when the prior surgery was for arrest of dilation or arrest of descent, but even those diagnoses do not make a successful VBAC impossible (ACOG, 2019).
What matters more than the label is whether the same conditions are likely to be present again. That is a conversation worth having directly with your provider — using your actual surgical records, not a one-sentence summary from a previous appointment.
Context matters more than the diagnosis alone.
4. Prepare for Physiologic Labor
VBAC success increases when labor is allowed to progress the way the body actually works. That often means staying home through early labor when safe to do so, moving freely, avoiding lying flat on your back, using upright and gravity-assisted positions, and allowing time for dilation to unfold at its own pace.
Labor progression is not linear, and many repeat C-sections happen because labor is judged against a timeline that doesn't account for normal variation. Research suggests that active labor may begin later than previously thought, and longer labor durations can still be entirely normal (ACOG, 2019).
Before your birth, ask your provider: When do you consider dilation stalled? How long do you allow the pushing stage? What criteria would prompt a recommendation for surgery? Clarity before labor reduces pressure during it.
5. Strengthen Emotional Readiness
This part is rarely discussed in clinical settings, but it is not clinically irrelevant.
If your first birth involved trauma — feeling unheard, rushed, pressured, or anxious — that experience does not stay in the past when you walk into your next birth. Anxiety can lead to earlier hospital arrival than is ideal. Fear can increase the likelihood of requesting interventions. Unresolved trauma can quietly undermine the confidence and communication you need most in that room.
Healing does not guarantee a vaginal birth. But emotional readiness improves clarity, communication, and your ability to advocate for yourself when it counts.
What happened in your first birth is not irrelevant to your second. Your nervous system recorded it — and processing what happened before you labor again is part of preparation, not separate from it.
If trauma is part of your story:
→ You're Allowed to Have a Vaginal Birth After a C-Section. Here's the Truth
6. Optimize What You Can Control
Certain health factors are associated with lower VBAC success rates, including obesity, diabetes, and hypertensive disorders (Guise et al., 2010). You cannot control everything — and this is not about blame or shame. It is about identifying where there is room to prepare intentionally.
Where it is medically appropriate, prioritizing balanced nutrition, staying physically active, spacing pregnancies thoughtfully, and managing chronic health conditions with your provider's guidance are all factors that can support a healthier labor. These are preparation tools, not judgments.
7. Build a Support Team
Continuous labor support has been associated with lower cesarean rates overall (Bohren et al., 2017). That support can come from a partner who is prepared and present, a doula, a midwife, or any combination of people who know your goals and can help you stay grounded when labor gets hard.
Support improves confidence, encourages mobility, and gives you someone in the room who is focused entirely on you — not on managing the institutional environment around you. That matters more than most people realize until they are in the middle of labor.
8. Keep Risk in Perspective
The risk of uterine rupture in women with one prior low transverse incision is approximately 0.5–0.9% (ACOG, 2019). Most TOLAC attempts do not result in rupture.
It is also worth knowing that repeat cesarean deliveries are not without risk. Each additional surgery increases the likelihood of placenta accreta spectrum — a condition where the placenta attaches too deeply into the uterine wall and can cause serious complications during delivery — as well as surgical adhesions and other complications in future pregnancies (Silver et al., 2006).
The decision is not VBAC risk versus no risk. It is an honest, balanced comparison of two options that both carry real considerations. That is what informed consent actually requires — and you deserve both sides of it.
What the Research Consistently Shows
When studies look at what predicts a successful VBAC, the same factors appear repeatedly: spontaneous labor, a prior vaginal birth, a supportive provider, physiologic labor management, informed preparation, and patient-centered counseling (Guise et al., 2010).
You cannot control everything. But you can influence many of these variables — and that influence matters more than most women are told.
Final Thoughts
A successful VBAC is not random.
It is shaped by the provider you choose, the environment you labor in, the preparation you bring, and the support surrounding you. Most women who attempt TOLAC deliver vaginally (ACOG, 2019). The evidence is not a guarantee — but it is not discouraging either.
Understanding how to increase your chances does not mean controlling every variable. It means walking into the birth room having done everything within your power — and knowing the difference between what you can influence and what you cannot.
That clarity alone changes the experience.
References
American College of Obstetricians and Gynecologists. (2019). Vaginal birth after cesarean delivery: ACOG Practice Bulletin No. 205. Obstetrics & Gynecology, 133(2), e110–e127.
Bohren, M. A., Hofmeyr, G. J., Sakala, C., Fukuzawa, R. K., & Cuthbert, A. (2017). Continuous support for women during childbirth. Cochrane Database of Systematic Reviews, (7), CD003766.
Guise, J. M., Eden, K., Emeis, C., Denman, M., Marshall, N., Fu, R., & McDonagh, M. (2010). Vaginal birth after cesarean: New insights. Evidence Report/Technology Assessment No. 191. Agency for Healthcare Research and Quality.
Silver, R. M., Landon, M. B., Rouse, D. J., et al. (2006). Maternal morbidity associated with multiple repeat cesarean deliveries. Obstetrics & Gynecology, 107(6), 1226–1232.
Disclaimer: The Nurture Nook is an educational resource, not a medical practice. Nothing on this site constitutes medical advice, diagnosis, or treatment. All content is intended to support informed conversations with your healthcare provider — not to replace them.
