Maybe your first birth didn’t go the way you planned. Labor stalled, the baby’s heart rate dropped, or the baby was breech, and you ended up in the operating room. You and your baby were safe, and that’s what mattered most.
But now you’re pregnant again, and you’re wondering: does this baby have to be a C-section too?
For many women, the answer is no. You may be able to have a VBAC, and it’s more possible than many people are told. The hard part is often finding a doctor in Los Angeles who will support it.
This guide explains what a VBAC is, who’s a good candidate, the real risks on both sides, whether a VBAC is possible after two C-sections, and how Dr. David Seil Kim approaches it.
What is a VBAC?
VBAC stands for vaginal birth after cesarean. It simply means giving birth vaginally after you’ve had a C-section (also called a cesarean) in a past pregnancy.
You may also hear the term TOLAC, which stands for trial of labor after cesarean. TOLAC is the attempt: going into labor with the plan of delivering vaginally. When a TOLAC ends in a vaginal birth, that’s a VBAC. If a C-section turns out to be needed during labor, that’s called a repeat cesarean.
The other option is an elective repeat C-section, a planned C-section scheduled ahead of time, usually around 39 weeks.
Am I a good candidate for a VBAC?
More women are candidates than you might think. According to Cleveland Clinic, 60% to 80% of women who try for a VBAC have one successfully. For women with one previous C-section, it’s up to 75%.
The most important question is what kind of cut was made on your uterus last time. This is the uterine incision, and it’s not always the same as the scar you can see on your skin.
- Low transverse incision (a side-to-side cut low on the uterus). This is by far the most common, and it carries the lowest risk. Most women with this type can try for a VBAC.
- Low vertical incision (an up-and-down cut low on the uterus). Risk is higher, but some women may still be candidates.
- High vertical or “classical” incision (an up-and-down cut on the upper uterus). This has the highest risk of the scar opening, so VBAC usually isn’t recommended.
That’s why one of the first things Dr. Kim will ask for is your operative report from your last C-section. It tells him exactly what type of incision you had. If you don’t have it, our team can help you request it from the hospital where you delivered.
What makes a VBAC more likely to succeed
- You’ve had a vaginal birth before, either before or after your C-section
- Your C-section was for a reason that may not happen again, like a breech baby or a problem with the baby’s heart rate
- Labor starts on its own
- You have no other surgery on the uterus, such as a fibroid removal (myomectomy) that went deep into the muscle
What can make it less likely
- Your last C-section was because labor didn’t progress
- Being over 35 (read Pregnancy After 35: What Actually Changes?)
- A larger baby, twins, or going past your due date
- Getting pregnant within 18 months of your last delivery
- Conditions like preeclampsia (high blood pressure in pregnancy)
None of these automatically rule you out. They’re factors Dr. Kim weighs with you, and the decision is made together.
Is a VBAC safe? The honest risks on both sides
There’s no risk-free option after a C-section. Both a VBAC and a repeat C-section have benefits and risks, and the right choice depends on you.
The main risk of a VBAC: uterine rupture
The biggest concern with a VBAC is uterine rupture, when the scar on the uterus from your previous C-section opens during labor. It’s rare, but serious for both mother and baby, and it requires an emergency C-section.
How rare? For women with a low transverse incision, Cleveland Clinic puts the risk at about 0.9%, or slightly less than 1 in 100. That’s exactly why where you deliver matters (more on that below).
Why many women choose a VBAC anyway
When a VBAC is successful, it avoids major abdominal surgery, which usually means:
- A faster recovery and a shorter hospital stay
- Lower risk of the complications of surgery, like heavy bleeding and infection
- An easier time caring for a newborn (and any older children at home) in the first weeks
- Lower risk in future pregnancies. Each additional C-section raises the chance of problems next time, including scar tissue, injury to the bladder or bowel, and placenta problems like placenta previa and placenta accreta (when the placenta grows too deeply into the uterine wall). This matters most if you’re hoping for more children.
The trade-off to understand
If a VBAC attempt ends in an unplanned C-section during labor, that surgery carries somewhat more risk than a C-section planned in advance. That’s why it’s so important to go in with realistic expectations, a doctor who knows your history, and a hospital that’s ready for anything.
Our stance at Yunella is simple. We understand why a vaginal birth matters to so many women, and we generally encourage it when it’s safe because it carries lower risk overall. But your safety and your baby’s always come first. If a C-section becomes the safer choice during labor, Dr. Kim will do one.
Can you have a VBAC after 2 C-sections?
Often, yes. This is one of the most common questions we hear, because many women have been told that two C-sections means “always a C-section.” That isn’t automatically true.
The guidelines from the American College of Obstetricians and Gynecologists (ACOG) allow women with two previous low transverse incisions to be considered for a trial of labor. Cleveland Clinic notes there’s no set limit on the number of C-sections, though the chance of success drops to about 50% with two or more previous C-sections, and the risk of uterine rupture is somewhat higher.
What matters most is the details of your history:
- What type of incisions you had
- Why each C-section was done
- Whether you’ve ever had a vaginal birth
- How long it’s been since your last delivery
- How this pregnancy is going
What about after 3 C-sections? It’s much less common, and most doctors won’t recommend a trial of labor after three or more. But every history is different, and it’s worth a conversation rather than an automatic no.
If you’ve had two C-sections and want to know your options, bring your operative reports to a consultation. Dr. Kim will go through them with you and give you an honest answer, whichever way it goes.
Why is it so hard to find a VBAC-friendly doctor?
If you’ve searched for a “VBAC-friendly OB near me” in Los Angeles, you’ve probably noticed it’s not easy. Many practices simply schedule a repeat C-section for anyone who’s had one before. There are a few reasons:
- A VBAC needs close attention during labor. Because uterine rupture is a medical emergency, the baby and the labor need to be watched carefully, and a team has to be ready to do a C-section quickly if needed.
- Not every hospital is set up for it. A VBAC should happen at a hospital that can handle an emergency delivery at any hour.
- It takes time and experience. A planned C-section fits neatly into a schedule. Supporting a VBAC means being available for an unpredictable labor and knowing when to keep going and when to stop.
Questions to ask any OB about VBAC
Whether you choose us or another practice, these questions will tell you a lot:
- Do you support VBAC, and how many have you done?
- Will you personally be at my delivery, or will it be whoever’s on call?
- Can I be induced if I don’t go into labor on my own? Some methods are safer than others after a C-section.
- Can I have an epidural? (In most cases, yes.)
- What happens if I go past my due date?
- When would you recommend switching to a C-section during labor?
- Which hospital do you deliver at, and is it equipped for emergency deliveries?
For more on choosing a doctor and hospital, read How to Choose an OB/GYN for Delivery at Cedars-Sinai.
How Dr. Kim approaches VBAC
Dr. Kim has delivered well over 7,000 babies and spent 15 years teaching OB/GYN residents at Cedars-Sinai. VBAC is one of his specialties, and he supports it whenever it’s safe for you and your baby. Here’s what that looks like.
Before labor: a plan built on your history
- A careful review of your past C-section(s). Dr. Kim goes through your operative reports and the reasons for each C-section, and gives you an honest picture of your chances.
- An ultrasound at every visit. Dr. Kim scans you himself at every prenatal visit, so he’s tracking your baby’s growth and position the whole way through. (Read How Many Ultrasounds Do You Get in Pregnancy?)
- A growth check around 35 to 36 weeks. Estimating your baby’s size helps plan the timing of delivery, because a larger baby can affect a VBAC.
- A real conversation about your preferences. If a vaginal birth matters to you, we want to know why, and we’ll build the plan around it.
If you need to be induced
Can you be induced for a VBAC? Yes, in many cases, though some methods are safer than others. Medicines that soften the cervix, called prostaglandins (such as misoprostol), are generally avoided after a C-section because they raise the risk of uterine rupture. A Foley balloon, a small balloon placed in the cervix to gently open it, works mechanically rather than with medication. Dr. Kim uses it routinely and places it right in our office. Read more in Does Being Induced Mean a C-Section? A Guide to Labor Induction at 39 Weeks.
During labor and delivery
- Delivery at Cedars-Sinai Medical Center, one of the largest labor and delivery hospitals in the country, with a Level IV NICU (the highest level of newborn intensive care) and teams ready for an emergency delivery at any hour. Our office isn’t inside the hospital, but Dr. Kim delivers there.
- Dr. Kim is there for your delivery in nearly every case. On the rare occasion he can’t be, a trusted physician he has already briefed on your history steps in. That matters with a VBAC, because the person making decisions in the room knows you.
- An epidural is available. Pain relief doesn’t rule out a VBAC.
- Safety comes first. If a C-section becomes the safer choice for you or your baby, Dr. Kim will do one, and he’ll explain why.
A direct line the whole way
With our Concierge Maternity Experience, you have a direct line to Dr. Kim from the day you enroll until six weeks after your baby is born. When you’re planning a VBAC, being able to reach the doctor who knows your history, especially in those final weeks, makes a real difference.
The bottom line
A previous C-section doesn’t automatically mean you need another one. Most women with one prior C-section, and many with two, can safely try for a vaginal birth. The key is a careful look at your history, honest information about the risks, a hospital ready for anything, and a doctor who supports you and will be there when it counts.
If you’re hoping for a VBAC in Los Angeles, the best time to start the conversation is early in your pregnancy, or even before you conceive with a preconception visit. We see each patient as part of a family, so partners and anyone you’d like to bring are always welcome.
We’re not all talk: watch Tessa’s story and read our patient reviews. Then book a consultation or call us at (424) 404-8832, and bring your past operative reports if you have them.
Medically reviewed by David Seil Kim, MD, PhD, MBA, FACOG · Last reviewed: October 22nd, 2026