VBAC Birth Plan

VBAC Birth Plan (Vaginal Birth After Cesarean)

A birth plan for attempting vaginal birth after previous cesarean section, balancing safety monitoring with VBAC-supportive practices.

About This Birth Plan

VBAC (Vaginal Birth After Cesarean) gives you the opportunity to experience vaginal birth after a previous cesarean. Many women are candidates for VBAC with proper screening and support.

This plan acknowledges the need for additional monitoring while still supporting your efforts for a vaginal birth. Success rates are 60-80% depending on various factors.

VBAC Candidacy & Preparation

  • Previous C-section reason: [specify]
  • Type of uterine incision: [low transverse preferred]
  • Number of previous cesareans: [specify]
  • Time since last cesarean: [specify]
  • Reviewed VBAC risks and benefits with provider
  • Confirmed as good VBAC candidate
  • Hospital capable of emergency cesarean
  • Provider supportive of VBAC attempt
  • Anesthesia and surgical team available 24/7

Labor Support Team

  • Partner/spouse for continuous support
  • Doula experienced with VBAC
  • Provider who is VBAC-supportive
  • Support team to provide encouragement
  • Positive mindset and confidence in my body
  • Understanding that repeat cesarean may be necessary

Monitoring Requirements

  • Continuous fetal monitoring required (standard for VBAC)
  • Wireless monitoring if available to allow movement
  • Regular vital sign checks
  • Assessment of uterine activity
  • Watch for signs of uterine rupture (rare but serious)
  • IV access required (hep lock acceptable)
  • Remain at hospital after admission (no home early labor)

Movement & Positioning

  • Freedom to move and change positions within monitoring requirements
  • Use of birth ball, peanut ball
  • Upright positions when possible
  • Access to shower/tub for comfort (check hospital policy)
  • Position changes to help labor progress
  • Squatting bar or rebozo for positioning
  • Avoid flat on back position

Pain Management

  • Open to all pain management options
  • Start with non-medical comfort measures
  • Epidural available if desired
  • Pain relief does not equal failure
  • IV pain medication option
  • Nitrous oxide if available
  • Supportive atmosphere regardless of pain relief choice

Labor Management

  • Allow spontaneous labor to begin (no elective induction if possible)
  • Avoid or minimize Pitocin (increases rupture risk)
  • If induction necessary, careful monitoring required
  • No misoprostol/Cytotec (contraindicated for VBAC)
  • Mechanical methods for induction if needed (Foley bulb)
  • Allow adequate time for labor progression
  • Patience with labor timeline
  • Position changes before interventions
  • Discuss all interventions before implementing

Pushing & Delivery

  • Push when I feel the urge
  • Choose effective pushing position
  • Allow time for perineum to stretch
  • Avoid episiotomy unless necessary
  • Slow, controlled delivery
  • Encourage and support during pushing phase
  • Understanding that prolonged pushing may prompt cesarean evaluation

Signs Requiring Cesarean

  • Fetal distress not responsive to position changes
  • Signs or symptoms of uterine rupture
  • Failure to progress despite adequate contractions
  • Abnormal bleeding
  • Immediate explanation of reason for cesarean decision
  • Quick but calm transfer to OR if needed
  • Understanding this is not failure but safe birth prioritization

Successful VBAC - Immediate After

  • Immediate skin-to-skin contact
  • Delayed cord clamping
  • Partner cuts cord
  • Celebration of VBAC success
  • Breastfeeding within first hour
  • Deliver placenta naturally
  • Check incision site from previous cesarean
  • Photos and quiet bonding time

If Repeat Cesarean Needed

  • Clear explanation of medical reason
  • Time to process decision if not emergency
  • Partner present in OR
  • Family-centered cesarean approach
  • Skin-to-skin in OR if possible
  • Positive support from team
  • Acknowledgment of effort and courage
  • Understanding that safe delivery is priority

Newborn Care

  • Rooming-in regardless of birth method
  • Immediate skin-to-skin (even after repeat cesarean)
  • Breastfeeding support
  • Vitamin K, eye ointment as per standard preferences
  • Delay routine procedures during bonding
  • All newborn care explained

⚠️ Important Considerations

  • •VBAC success rate is 60-80% for appropriate candidates
  • •Risk of uterine rupture is less than 1% but serious
  • •Continuous monitoring is required
  • •Must deliver in hospital with emergency surgical capability
  • •Some hospitals and providers don't offer VBAC
  • •Pitocin and certain induction methods increase rupture risk
  • •Previous vaginal delivery increases VBAC success rate
  • •Multiple previous cesareans decrease success rate
  • •Emotional preparation for possible repeat cesarean important
  • •VBAC is not "all or nothing" - trying is valuable even if cesarean needed

❓ Questions to Ask Your Healthcare Provider

Discuss these questions at a prenatal appointment to ensure your provider supports your birth plan:

  • 1.Am I a good candidate for VBAC?
  • 2.What is your VBAC success rate?
  • 3.What factors might require a repeat cesarean?
  • 4.Is continuous monitoring required?
  • 5.Can I move around during labor?
  • 6.What pain relief options are available?
  • 7.Do you support spontaneous labor start, or would you recommend induction?
  • 8.What induction methods are safe for VBAC?
  • 9.How long will you allow labor to progress?
  • 10.At what point would you recommend cesarean?
  • 11.Can I try VBAC if I go past my due date?
  • 12.Is your hospital equipped for emergency cesarean?
  • 13.How will you monitor for uterine rupture signs?
  • 14.Will my previous cesarean scar be checked during labor?

Related Birth Plans

Hospital Birth Plan (Standard Medical) →C-Section Birth Plan (Planned Cesarean) →Natural Birth Plan (Unmedicated) →

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This birth plan template is a general guide. Always discuss your birth preferences with your healthcare provider to ensure they align with your specific medical situation, facility capabilities, and safety requirements. Birth plans are flexible guidelines - medical necessity may require changes.

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