How to Choose Between a Repeat Caesarean Section and a Vaginal Birth after Caesarean (vbac).

I’m often working with clients who are trying to work out whether or not they will choose to have a repeat caesarean or ‘try’ for a vaginal birth after a previous caesarean section (VBAC).  I was faced with this same predicament when I became pregnant with my third baby as I had had  a caesarean with my second child (but not with my first) due to placenta previa.  This is when the placenta is across the cervix instead of toward the top of the uterus and there is a much higher risk of haemorrhaging that normal pregnancies.

This article will give you some key ways to help you to make a decision that is right for you and to prepare for your birth.  I have had this discussion a few times this week already, as it makes women extremely anxious and they really do need some loving support and guidance, especially when they feel they are being  pressured one way or another.

There is a lot of fear and misunderstanding around VBACs, and this in itself can add to women’s anxiety when faced with this decision.  It can make you feel anxious, confused and overwhelmed.  So you need to start by getting your facts straight.  This means becoming  well informed.  The biggest myth is that if you’ve had  a previous caesarean, you have to have a repeat caesarean.  This is simply not true.  You need to be reassured that for most women, with the right knowledge, preparation and support a VBAC IS ABSOLUTELY POSSIBLE.  Here’s some questions to help you get clear on this point:

  1.   Do you have the same presenting problem / risk as your last pregnancy?  For example, I did not have placenta previa with my third pregnancy, therefor the previous presenting problem was not present with my third baby as it was with my second for which I had a caesarean.
  2. Can you perceive the possibility that things could be different this time?  Ask yourself questions such as: What set off the sequence of events that lead you to having a caesarean, can you change this and would you make different decisions this time around? (for example, being induced, high blood pressure)
  3. Is there any reason besides the fact that you had  a previous caesarean that is indicating that a caesarean is currently the safer option for you and your baby?

Once you’ve established that there is a possibility, not matter how slight it may feel to you right now, of a vaginal birth rather than a caesarean then there are steps you need to take to help you to come to a clear decision about what is right for you.

Here are 7 Steps to help you make a decision about having repeat caesarean or a VBAC.

  1.  De-brief your caesarean birth.  Even you don’t feel it was a ‘negative’ experience, de-brief it.  You need to heal and release any negative residue from your previous experience.  Release and heal stuck emotions and thoughts, trauma and stories.  A birth debrief with a doula or birth educator is a great way to process your experience.  Energy Healing is an even more effective way to release these thoughts, stories, emotions and beliefs.  You will feel lighter and clearer and a deep sense of relief as you integrate your experience.  It will also help you to separate this pregnancy from the previous one.
  2. Become informed about normal birth.  Knowledge is power!  Many women choose another caesarean out of fear – fear of the unknown.  It is much better to make a choice from an empowered place than one of fear.  Learn about normal birth and learn about VBAC so you have the information you need to make an informed choice.
  3. Learn from hindsight.   Knowing that you did your absolute best last time with the situation you were in, ask yourself, what would I do differently this time?
  4. Connect with this baby and this pregnancy.  Yoga, meditation and relaxation are extremely helpful in connecting with the baby.  Remind yourself that this is a different pregnancy, different baby and different circumstances.  If you quieten your mind and listen, you will be able to hear yourself think and hear your baby, too.
  5. Learn to trust your gut feeling and take action to follow it.
  6. Find a mentor and a tribe.  Pull in your tribe!  Surround yourself with people you can confide in and who will guide you and support you to make an informed decision, no matter what you choose.  This takes the pressure off so you can hear and feel what you think.
  7. Make your own choice when you are ready.  There is no rush to make a choice early on.  Remain open minded until you feel sure about what you want to do.  Practice self-empathy by giving yourself the time and space to make a choice.

If you follow these steps, you will surely feel better about making a choice.  The process of making a decision and the decision itself will feel lighter and easier.

So overall, you need to decide to be proactive at the same time as be patient and kind to yourself.  It may feel extremely overwhelming to get started on the process and to allow yourself to entertain the idea of a vaginal birth, but once you get started you feel more and more at ease…. and if in the end you choose a repeat caesarean, you will feel good about that, too.

To help you get started, choose the one thing that you will start with and please share in the comments the first step that you are going to take towards making an informed and empowered choice about your next birth.


If you would like me to help you with this process, including Energy Healing, please book a free Pregnancy Clarity Session with me here:


Tara x

Ps Recieve our video Series on the 7 Secrets of Childbirth here.