Pregnant woman holding her son's hand who is kissing her belly

So, you had a caesarean birth with your first baby and now you’re thinking about having another baby. Here’s what you need to know about giving birth naturally after a c-section. You may be wondering what are your options? Many people believe the myth of “once a caesarean, always a cesarean”. While for some women this is true, but for many people it doesn’t have to be.

What makes me different?

The thing that makes someone who has had a caesarean birth different from someone who hasn’t is the fact that she has a scar on her uterus. This scar needs time to heal so that it can stay strong through a future pregnancy and birth. This is why most health care providers will recommend spacing at least two years between births after you have had a caesarean. This allows your body the optimal time to heal and ensure a safe delivery. In very rare circumstances, this scar can tear open during a future pregnancy or birth (this complication is called a “uterine rupture”).

DID YOU KNOW? Women who have had a previous caesarean birth can be cared for by midwives or an OB regardless of what type of birth they plan to have.

What is a VBAC?

pregnant woman sitting on a couch with a toddler

VBAC stands for Vaginal Birth After Caesarean.  VBAC is a safe option for most women. Women who achieve a successful VBAC benefit from a:

  • faster recovery time
  • shorter hospital stay
  • less painful postpartum recovery
  • lower risk of serious infection and bleeding complications that come along with major surgery

Their babies also benefit from earlier skin to skin contact and breastfeeding. The research shows that babies born by VBAC, compared to elective repeat caesarean section, have higher rates of exclusive breastfeeding at 3 and 6 months of age. For women who are planning a large family, a VBAC drastically reduces their risk of serious complications with the placenta that can complicate pregnancies in women who have had multiple caesarean births.

The research tells us that women who plan a VBAC have approximately a 75% chance of having a successful vaginal birth, which is about the same rate as a first time mother. 

What about an Elective Repeat Caesarean Section?

pregnant woman sitting on the couch with her older children

Anyone who has had a caesarean before has the choice of planning an elective caesarean with their next baby. This option offers the benefit of being able to plan the timing and staffing of your baby’s birth. It also lowers the chances of a uterine rupture happening. You will always have the option to choose an elective c-section at any time, even if you change your mind and decide to have a c-section when you are in labor.

So what is the best choice for me?

That answer will be different for everyone!  Each choice comes with benefits and risks and only you know the best answer for you and your family.  The Association of Ontario Midwives has a great tool that can help you understand how you can increase your chances of a safe outcome, that can be found at https://www.ontariomidwives.ca/sites/default/files/Thinking-about-VBAC-English_1.pdf

You can also speak with your midwife or OB about your particular circumstances and how your health and history might impact a future birth.


Melissa Nowell is a Registered Midwife with the Midwives of Headwater Hills in Orangeville, Ontario.  She has been practicing as a Registered Midwife for almost 5 years and was a birth doula before becoming a midwife. 

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