Vaginal birth after caesarean (VBAC): your chances, the risks and who can try
In this article
Vaginal birth after caesarean (VBAC) means giving birth vaginally when you had a caesarean in an earlier pregnancy. KKH doctors say it can still be an option and put the chance of success at 50 to 60%, higher if you have had a vaginal birth before. The main risk is the old scar on the womb tearing, about 0.5% after one caesarean, so a VBAC labour is closely watched in hospital.
| Success rate | 50 to 60%, KKH says; 3 in 4 when labour starts naturally, the RCOG says |
|---|---|
| After a previous vaginal birth | About 8 to 9 in 10, the RCOG says |
| Scar rupture | About 0.5% after one caesarean |
| Emergency caesarean in labour | Around 1 in 4, the RCOG says |
| Epidural | Allowed, KKH says |
Who can try for a VBAC
The NHS says most women who have had a caesarean can safely have a vaginal birth next time, with some extra monitoring in labour. The type of cut on your womb matters most. ACOG says a low transverse cut, side to side across the lower womb, is the most common and carries the least chance of rupture. A low vertical cut carries more, and a high vertical or classical cut carries the highest. You cannot tell which you had from the scar on your skin, so ask for the records from your last C-section.
The Royal College of Obstetricians and Gynaecologists (RCOG) says your chances are better if you have had a vaginal birth before, if labour starts on its own, and if your BMI was under 30 at your first antenatal check. If you have had more than one caesarean, it says you will get advice for your own situation. ACOG says VBAC should not be tried if your risk of rupture is high.
Your chances and the risks, in numbers
Sources give different success rates. KKH doctors, writing on HealthXchange, put it at 50 to 60%. The RCOG says three in four women who have had one caesarean and whose labour starts naturally give birth vaginally. The RCOG says your healthcare team should help you work out what these numbers mean for you.
KKH puts the risk of scar rupture at only 0.5% after one caesarean, but says a rupture is life-threatening for mother and baby when it happens. The RCOG puts it at up to 1 in 200, and says warning signs include unexpected vaginal bleeding or changes in your baby's heart rate. Around 1 in 4 women planning a VBAC end up with an emergency caesarean, the RCOG says, compared with about 1 in 5 in a first labour.
How a VBAC labour is managed
KKH says that if you want a VBAC and your doctor finds you suitable, you are closely monitored through a trial of labour, and an emergency caesarean is done if labour stops progressing or your baby shows distress. ACOG says a VBAC should happen in a hospital that can handle emergencies.
Pain relief is open to you; KKH says an epidural is safe for a VBAC. Starting labour artificially is more delicate. ACOG says induction can lower the chance of a vaginal birth and raise the chance of complications, and that some prostaglandin medicines are avoided after a caesarean because of the rupture risk.
VBAC or a planned repeat caesarean
The RCOG says a straightforward vaginal birth usually means a quicker recovery, a shorter hospital stay and a better chance of vaginal birth next time. It also says the risks rise with each caesarean, so it may be better to avoid another one if you plan more children. ACOG lists bowel or bladder injury, hysterectomy and placenta problems among the issues linked to several caesareans.
A planned repeat caesarean is usually done after 39 completed weeks, the RCOG says, because babies born by caesarean earlier are more likely to need help with their breathing. Our VBAC in Singapore guide sets the two options side by side.
Frequently asked questions
What does VBAC mean?
VBAC stands for vaginal birth after caesarean. It is a vaginal birth, including one helped by forceps or vacuum, in a woman who had a caesarean before.
What is my chance of a successful VBAC?
KKH says 50 to 60%, and higher if you have had a vaginal birth before. The RCOG says three in four women succeed after one caesarean when labour starts naturally.
Can I have an epidural during a VBAC?
Yes. KKH says an epidural is safe for a VBAC.
Can I have a VBAC after two caesareans?
It depends on you. The RCOG says women with more than one caesarean get individual advice on the benefits and risks, so raise it with your gynae early in the pregnancy.
Related terms
- C-section (Caesarean Section): An operation to deliver your baby through a cut in your tummy and womb, planned ahead or done in labour.
- Epidural: Labour pain relief given through a fine tube in your lower back by an anaesthetist, numbing the womb and birth canal.
- Induction of Labour: Starting labour with medical help, such as a pessary, balloon or drip, instead of waiting for it to begin.
- Contractions: The tightening and relaxing of your womb that opens the cervix and pushes your baby down in labour.
- KKH via HealthXchange - VBAC (Vaginal Birth After C-Section): What You Need to Know (read 9 November 2026)
- RCOG - Birth options after previous caesarean birth (read 9 November 2026)
- ACOG - Vaginal Birth After Cesarean Delivery (read 9 November 2026)
- ACOG - Labor Induction (read 9 November 2026)
- NHS - Caesarean section (read 9 November 2026)
