VBAC Basics and How Pelvic Floor PT Helps You Prepare

A Guide to VBAC and Feeling Confident in Your Birth Plan

At Foundations Pelvic Health, our pelvic floor physical therapists help so many through pregnancy and help talk you through the ins and outs of labor and delivery. Our practice loves to support mamas-to-be throughout all the trimesters, and a one reason that patients seek us out is for support for a VBAC.

VBAC stands for ‘Vaginal Birth After Cesarean’. It refers to delivering a baby vaginally after having had a previous C-section. As of 2018, the VBAC rate was around 13%, and it has continued to rise in the years since. While not everyone may be an candidate for a VBAC, many people are!

Pelvic floor PT reviewing labor and delivery positions with pregnant woman.

One of our pelvic floor PTs reviewing different labor and delivery positions with a pregnant patient.

How to Know if a VBAC Is Right for You

Several factors help determine whether someone is a good candidate for a vaginal birth after a prior C-section. These include:

  • The reason for the previous cesarean

  • The type of incision (a horizontal low-transverse incision is typically preferred)

  • The number of prior C-sections

  • Overall health, mobility, and activity level

Understanding why the previous C-section occurred can offer insight into the likelihood of a successful VBAC—whether it was due to a lack of labor progression, fetal distress, or fetal positioning.

Why Consider a VBAC?

A successful VBAC comes with meaningful benefits. Compared to a repeat surgical birth, VBAC is associated with:

  • Less blood loss and lower infection rates

  • Shorter recovery time

  • Reduced risk of bowel or bladder injury

  • Lower chance of needing a hysterectomy or blood transfusion

  • Decreased risk of placenta previa and placenta accreta in future pregnancies

These benefits are largely due to avoiding major abdominal surgery, according to NIH data.

Preparing for a VBAC

If you're considering a VBAC, preparation can make a big difference in both confidence and comfort.

Find a supportive provider.
Choose an obstetrician or midwife who is genuinely comfortable supporting VBAC patients. Hospital policies can vary as well, so ask early about your delivery location.

Educate yourself.
Knowledge is empowering. Understanding the evidence, the risks, and the tools available helps you advocate for your preferences. Two great resources we frequently recommend include Evidence Based Birth and The VBAC Link.

Work with a doula.
A birth doula provides continuous support throughout pregnancy and labor. They offer hands-on comfort, help you navigate decisions in real time, and advocate for your birth goals. Check out some local birth doulas our pelvic floor PTs frequently with.

Address pelvic floor and muscular imbalances.
Preparing your body is just as important as preparing your mind. Pelvic health physical therapy can support your VBAC journey by focusing on:

  • Hip and spine mobility

  • C-section scar tissue mobility

  • Strength and stability

  • Diaphragmatic breathing

  • Pelvic floor coordination

  • Push preparation

  • Labor and delivery positioning

Understanding the Risks

The main risk associated with a VBAC is uterine rupture, which is a rare but serious complication involving a tear along the previous C-section scar. There is also a chance that labor may not progress as planned, resulting in a repeat C-section. Having open communication with your provider is key to understanding how these risks apply to you.

The Bottom Line

A VBAC is a safe and successful option for many people. Surround yourself with a supportive care team, prepare your body, educate yourself, and create space for honest conversations with your provider. Pelvic floor PT can play a pivotal role in increasing comfort, mobility, and confidence along the way.

At Foundations Pelvic Health, our team of perinatal pelvic floor specialists supports pregnant and postpartum patients every day. If you’re considering a vaginal birth after a previous C-section and want expert guidance on mobility, pelvic floor coordination, push prep, and overall labor confidence, we’re here to help.


Hi! We are Boston’s pelvic floor physical therapy experts specializing in all things bladder, bowel, sexual dysfunction & pregnancy and postpartum specialists.

If you’re struggling or have questions about preparing for labor and delivery, we’d love to help you at Foundations Pelvic Health - located in the South End of Boston, MA.

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