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Labour and Delivery

VBAC: Vaginal Birth After Caesarean in the UK

Published 8 April 2026
This content is for informational purposes only and does not replace professional medical advice. Always consult your midwife or GP.
At a glance

Medically reviewed content. Last updated: April 2026.

In this article

VBAC: Vaginal Birth After Caesarean in the UK

Medically reviewed content. Last updated: April 2026.

If you have had a previous caesarean, you may be wondering whether you can have a vaginal birth next time. For most people, the answer is yes. VBAC stands for vaginal birth after caesarean, and RCOG supports offering it to most people with one previous lower-segment caesarean section.

What are the success rates?

VBAC is successful in approximately 72 to 75% of cases. Your chances are higher if you have had a previous vaginal birth (pushing success above 85 to 90%), go into labour spontaneously, had your previous caesarean for a non-recurring reason like breech position, have a BMI under 30, and are under 40.

What are the benefits?

Compared to a repeat caesarean, a successful VBAC offers shorter recovery, lower infection risk, less blood loss, shorter hospital stay, and lower risk of placenta complications in future pregnancies. Each additional caesarean increases the risk of placenta praevia and accreta.

What are the risks?

The main VBAC-specific risk is uterine rupture, where the previous scar opens during labour. This is rare, occurring in approximately 2 to 7 per 1,000 VBACs. When it occurs, it requires immediate emergency caesarean. Risk is higher with induction (particularly prostaglandins), more than one previous caesarean, or a very short gap between pregnancies.

Around 25 to 28% of attempted VBACs end in emergency caesarean if labour does not progress.

How is VBAC managed?

Your care will include consultant-led management, birth in a hospital obstetric unit, continuous fetal monitoring, and immediate access to an operating theatre. You can still use gas and air, TENS, opioid pain relief, and epidurals. An epidural does not reduce your chances of success.

What about induction?

Induction is possible but carries slightly higher uterine rupture risk. Mechanical methods (balloon catheter) are generally preferred over prostaglandin medications. Your consultant will advise on the safest approach.

How do you decide?

This is personal. Consider how important vaginal birth is to you, the reason for your previous caesarean, your individual success factors, and whether you are planning more pregnancies. RCOG recommends balanced information and support for either choice.

Key takeaways

  • VBAC is successful in approximately 72 to 75% of cases and is a safe option for most people with one previous lower-segment caesarean
  • The main risk is uterine rupture (0.2 to 0.7%), which is rare but serious
  • Previous vaginal birth is the strongest predictor of success
  • Labour is managed in hospital with continuous monitoring
  • The decision between VBAC and repeat caesarean is personal

Sources

  • RCOG. Birth after previous caesarean birth. Green-top Guideline No. 45. 2015
  • NICE Clinical Guideline CG132. Caesarean birth. 2011, updated 2021
  • NHS. Vaginal birth after caesarean. nhs.uk
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Frequently asked questions

What are the success rates?

VBAC is successful in approximately 72 to 75% of cases. Your chances are higher if you have had a previous vaginal birth (pushing success above 85 to 90%), go into labour spontaneously, had your previous caesarean for a non-recurring reason like breech position, have a BMI under 30, and are under 40.

What are the benefits?

Compared to a repeat caesarean, a successful VBAC offers shorter recovery, lower infection risk, less blood loss, shorter hospital stay, and lower risk of placenta complications in future pregnancies. Each additional caesarean increases the risk of placenta praevia and accreta.

What are the risks?

The main VBAC-specific risk is uterine rupture, where the previous scar opens during labour. This is rare, occurring in approximately 2 to 7 per 1,000 VBACs. When it occurs, it requires immediate emergency caesarean. Risk is higher with induction (particularly prostaglandins), more than one previous caesarean, or a very short gap between pregnancies.

How is VBAC managed?

Your care will include consultant-led management, birth in a hospital obstetric unit, continuous fetal monitoring, and immediate access to an operating theatre. You can still use gas and air, TENS, opioid pain relief, and epidurals. An epidural does not reduce your chances of success.

What about induction?

Induction is possible but carries slightly higher uterine rupture risk. Mechanical methods (balloon catheter) are generally preferred over prostaglandin medications. Your consultant will advise on the safest approach.

How do you decide?

This is personal. Consider how important vaginal birth is to you, the reason for your previous caesarean, your individual success factors, and whether you are planning more pregnancies. RCOG recommends balanced information and support for either choice.

Sources

  1. RCOG. Birth after previous caesarean birth. Green-top Guideline No. 45. 2015
  2. NICE Clinical Guideline CG132. Caesarean birth. 2011, updated 2021
  3. NHS. Vaginal birth after caesarean

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