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Vaginal Birth After Cesarean (VBAC): Resource Overview

It was once thought that if a woman had one cesarean delivery, all future babies should be born that way. Today, we know that many women can undergo a trial of labor after a cesarean delivery (TOLAC), and many will be able to give birth through the vagina—called a vaginal birth after cesarean delivery (VBAC).

It is important to understand the risks and benefits when deciding to attempt a VBAC. Ob-gyns, physicians whose primary responsibility is women’s health, are best suited to help a woman determine if a VBAC is the right choice for her.

Here are the key publications and resources for ob-gyns, other women’s health care providers, and patients from the American College of Obstetricians and Gynecologists (ACOG) and other sources.

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Resources for Ob-Gyns and Women’s Health Care Providers
Resources for Women and Patients
External Resources

Resources for Ob-Gyns and Women’s Health Care Providers

Practice Bulletin: Vaginal Birth After Cesarean Delivery  (members only)

“Vaginal Birth After Cesarean Delivery,” issued by ACOG in November 2017, issues less-restrictive guidelines for vaginal birth after cesarean (VBAC) delivery. It discusses the benefits and risks of VBAC that ob-gyns should discuss with patients, and states that attempting a VBAC is a safe and appropriate choice for most women who have had a prior cesarean delivery, including some women who have had two previous cesareans.

Obstetric Care Consensus: Levels of Maternal Care 

“Levels of Maternal Care,” issued by ACOG in February 2015 (reaffirmed 2016), provides uniform designations for levels of maternal care, standardized definitions and nomenclature for facilities that provide each level of maternal care, and guidelines according to level of maternal care for use in quality improvement and health promotion.

Committee Opinion: Planned Home Birth

“Planned Home Birth,” issued by ACOG in April 2017, advises that women inquiring about planned home birth should be informed of its risks and benefits based on recent evidence. It examines available research and outlines specific risks, appropriate candidates and health care professionals for this type of delivery, and other procedures to help reduce perinatal mortality rates and achieve favorable home birth outcomes.

Committee Opinion: Elective Surgery and Patient Choice

“Elective Surgery and Patient Choice,” issued by ACOG in November 2013 (reaffirmed 2016), provides an ethical framework to guide a physician’s responses to patient requests for surgical treatment that is not traditionally recommended.

Patient Safety Checklist: Appropriateness of Trial of Labor After Previous Cesarean Delivery (Antepartum Period)

“Appropriateness of Trial of Labor After Previous Cesarean Delivery (Antepartum Period),” issued by ACOG in November 2012, is a safety checklist to be completed by the health care provider early in the course of prenatal care. It is to be used with patients for whom a trial of labor after previous cesarean delivery may be appropriate.

Patient Safety Checklist: Trial of Labor After Previous Cesarean Delivery (Intrapartum Admission)

“Trial of Labor After Previous Cesarean Delivery (Intrapartum Admission),” issued by ACOG in November 2012 (reaffirmed 2016), is a safety checklist to be completed by the health care provider upon the patient’s hospital admission for labor and delivery.

Committee Opinion: Informed Consent

“Informed Consent,” issued by ACOG in August 2009 (reaffirmed 2015), describes the history, ethical basis, and purpose of informed consent and identifies special ethical questions pertinent to ob-gyns. It reviews two major elements in the ethical concept of informed consent—comprehension (or understanding) and free consent—and addresses limits to informed consent.


Resources for Women and Patients

Patient FAQ: Vaginal Birth After Cesarean Delivery—Deciding on a Trial of Labor After Cesarean Delivery

“Vaginal Birth After Cesarean Delivery–Deciding on a Trial of Labor After Cesarean Delivery,” issued by ACOG in August 2011, is a list of questions and answers to guide a woman’s decision to attempt a vaginal birth after cesarean delivery. It explains VBAC and TOLAC, risks and benefits, factors in choosing a delivery procedure, and how to prepare for possible changes in the delivery plan.


External Resources

National Institute of Child Health and Human Development Maternal-Fetal Medicine Units (MFMU) Network

The National Institute of Child Health and Human Development Maternal-Fetal Medicine Units (MFMU) Network provides two VBAC calculators to help identify the chance of having a vaginal birth after cesarean.

Perinatal Quality Foundation Preterm VBAC Calculator

The Perinatal Quality Foundation’s VBAC calculator uses a patient’s medical and delivery history to help predict vaginal birth after cesarean in the preterm period.


The American College of Obstetricians and Gynecologists (ACOG), a 501(c)(3) organization, is the nation’s leading group of physicians providing health care for women. As a private, voluntary, nonprofit membership organization of more than 58,000 members, ACOG strongly advocates for quality women’s health care, maintains the highest standards of clinical practice and continuing education of its members, promotes patient education, and increases awareness among its members and the public of the changing issues facing women’s health care.

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American Congress of Obstetricians and Gynecologists
409 12th Street SW, Washington, DC  20024-2188 | Mailing Address: PO Box 70620, Washington, DC 20024-9998