What is VBAC and How to Know If You’re a Candidate

The rate of cesarean deliveries has been on a constant upswing in the United States for decades. As recently as 2005, the Centers for Disease Control reported that more than 25% of all births in the United States came by way of C-Section deliveries. Despite this, popular opinion is beginning to move back towards more natural, vaginal births. The result is that more women who have had previous C-sections are starting to ask their doctors about attempting something known as a “VBAC.”


Some women who have previously delivered a baby by means of a cesarean section may still be able to consider a vaginal birth in the future. This scenario is called a vaginal birth after cesarean section, or VBAC for short. In this procedure, doctors assess the risk to you as well as the fetus that you’re carrying and, if conditions look good, approves a trial of labor. According to the American Pregnancy Association, as many as 90% of women who have previously delivered via C-section are considered to be good candidates to attempt a vaginal birth after caesarian.


In general, most doctors will allow you to consider a VBAC if you meet the following minimum guidelines:


  • No more than 2 low, transverse C-sections prior to attempting a VBAC.
  • No history of additional uterine distress, including rupture, abnormality, or scarring.
  • Your hospital of choice has staff and equipment on hand to safely switch to an emergency C-section birth plan if needed.


Other factors that can help improve your case for attempting a VBAC include:

  • A head down fetus
  • A normally sized fetus vs. a large one
  • No major medical issues
  • The original reasons for cesarean are not repeated


By far, the scariest risk of attempting a VBAC delivery is the risk of a uterine rupture. This is a very small risk but represents a serious complication with severe implications for the health of the fetus as well as yourself. According to the American College of Obstetricians and Gynecologists, women who have had a previous C-section with a low transverse incision have only a .2-1.5% chance of a uterine rupture. These rates continue to drop if the succeeding labor is spontaneous as opposed to induced.


Some doctors may refuse to even entertain the idea of a vaginal birth following a C-section. Other doctors are willing to consider allowing the process on a case by case basis. In these cases, doctors will look at a number of variables including the reason for your prior C-section deliveries, the number of C-section deliveries that you’ve had, and how you recovered following each birth.


Deciding whether to attempt a vaginal birth following a C-section should be given an appropriate amount of thought and discussion with your doctor. If you have additional questions about how this choice may impact your surrogacy journey, feel free to reach out to your case specialist. They will be able to address any concerns that you have, and also help you discuss the option with your intended parents.

Kim Bergman, PhD, a licensed psychologist of 26 years, has specialized in the area of gay and lesbian parenting, parenting by choice and third party assisted reproduction for over two decades. Dr. Bergman has created a comprehensive psychological screening, support and monitoring process for intended parents, surrogates and donors. She is the co-owner of Growing Generations and is a member of the American Society for Reproductive Medicine, the American Psychological Association, the Los Angeles County Psychological Association, the Lesbian and Gay Psychotherapy Association, and the Gay and Lesbian Medical Association. She is on the national Emeritus board of the Family Equality Council. Dr. Bergman writes, teaches and speaks extensively on parenting by choice. Along with co-authors, she published “Gay Men Who Become Fathers via Surrogacy: The Transition to Parenthood” (Journal of GLBT Family Studies, April 2010). Dr. Bergman’s is the author of the book, Your Future Family: The Essential Guide to Assisted Reproduction (Conari Press 2019) as well as the children's book You Began as a Wish (Independent Press 2019). Dr. Bergman created her own family using third party assisted reproduction and she lives with her wife of 35 years. She has two adult daughters.