VBAC Induction

Last Updated: June 17, 2024
Liesel Teen, RN-BSN

By Liesel Teen

BSN, RN, Practicing Labor and Delivery Nurse

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Are you here to learn about VBAC induction? Before we get into it, I want to say this: VBAC inductions are a thing, and they can be successful! Let’s unpack this.

VBAC stands for vaginal birth after Cesarean. A VBAC occurs when a mama that has previously had a C-section has a successful vaginal birth with her next delivery. Not everyone is a candidate for a VBAC, but a large majority of previous C-section mamas are.

When it comes to VBACs and inductions, you will find there are some differing opinions. To learn more about VBACs, VBAC inductions, and tips for success – keep on reading, mama!

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What is a VBAC induction?

A VBAC induction is exactly what it sounds like – an induction of labor on someone that has previously had a C-section.

One of the keys to success in having a VBAC is finding a supportive provider. Unfortunately, a supportive provider is not always synonymous with pro-induction in the VBAC world. In other words, you can have a provider that is supportive of a VBAC, but not willing to induce you if you have previously had a C-section – have I thoroughly confused you

There are some thoughts that an induction can decrease the likelihood of having a successful VBAC, which is where the differing opinions piece comes in. We’ll touch on this more a little later.

Related Reading: Preparing for TOLAC and VBAC Birth: Facts, Risks, and Tips! (Explained by an L&D Nurse)

Why might I need to be induced?

There are plenty of reasons why your OB provider might recommend an induction of labor. A previous C-section alone is not typically a reason for induction, but if you find yourself with any of the following things going on, induction might be on the table.

  • Gestational hypertension
  • Preeclampsia
  • Fetal growth issues
  • Gestational diabetes
  • Overdue 
  • Cholestasis 
  • Too much or too little amniotic fluid

As I previously mentioned, there are lots of medical reasons why you might be induced; the above list just touches on some of the more common ones.

Are VBAC inductions common?

Common isn’t exactly the word I would use to describe VBAC inductions, but that’s not to say they don’t happen! You see, one of the best tips for having a successful VBAC is to go into labor spontaneously. 

Now I know what you are thinking, “Well yeah, it would be nice if I could just snap my fingers and go into labor!”…right? 

But sometimes, no matter what you do to try and naturally induce labor, your body just isn’t ready – and that’s okay! Successful VBACs with an induction are absolutely possible! As a labor and delivery nurse of almost a decade, I have seen it happen time and time again. 

And speaking of spontaneous labor, if you haven’t read my article on natural ways to induce labor, you’ve got to check it out!

Related Reading: Natural Ways to Induce Labor: I Have The Answers!

Does an induction make it harder to VBAC?

The short answer is yes, an induction can make it harder to VBAC. You see, going into labor spontaneously seems to be a helpful factor in a successful VBAC. Spontaneous labor indicates your body is ready and can help maximize your chance of success. 

Limiting the number of interventions needed is ideal for any labor, but especially for someone trying to VBAC. Inductions require the use of medication to get labor started – do you see where I’m going here?? 

But like I said above, I’ve cared for many successful VBAC induction mamas, so please don’t feel discouraged if you end up needing one – it is definitely not an impossible feat!

Do VBAC inductions put you at a higher risk for complications?

The biggest potential complication associated with a VBAC is a uterine rupture. I know, I know…those are two pretty scary words, but rest assured that the risk is quite low! According the the American Pregnancy Association, “if you had a previous Cesarean with a low transverse incision, the risk of uterine rupture in a vaginal delivery is .2-1.5%.”

What is a uterine rupture?

A uterine rupture is when a hole or tear forms in your uterus. It is most common in women that have previously had a C-section or any other kind of uterine surgery. And while it can happen to a woman that has not had a previous uterine surgery, it is extremely rare.

Aside from uterine rupture, other potential (and also rare) complications include infection, blood loss, and a hysterectomy.

C-section vs. VBAC

Keep in mind though, there are many potential complications associated with a C-section as well. I strongly encourage you to have an in depth conversation with your OB provider about which path is the best and safest for you. Just because you are a VBAC candidate does not mean you have to or even should have a VBAC. 

While the risk for potential complications might be less with a VBAC than a repeat C-section, neither are without risk. Each mama’s situation is unique and should be addressed on an individual basis. This is not a one size fits all scenario by any means. 

Now that we’ve covered potential complications associated with a VBAC, you should read my article below to learn more about potential risks associated with having a C-section.

Related Reading: C-Section vs. Natural Birth: Which is The Better Option?

4 Essential tips for a successful VBAC induction

The moment you’ve been waiting for! This section will focus on tips for a successful VBAC induction! I mentioned that going into labor spontaneously can increase your chances of success, but what if spontaneous labor just doesn’t happen?

Don’t worry, I’ve got you covered, mama! There are still things you can do to help increase your chances of having a successful VBAC even with an induction.

Let’s take a super fast look into the different methods of induction. The four main ways your labor might be induced include:

  1. Pitocin (most common) 
  2. Foley bulb or Cook catheter 
  3. Prostaglandins (Cervidil, misoprostol, laminaria) 
  4. Artificial rupture of membranes (AROM) 

Related Reading: An Overview of Induction Methods by an L&D Nurse

1. Be informed

Often the induction method of choice boils down to your provider’s preference. Doing your research ahead of time though can help you be more involved, allow you to be a better advocate, and might even increase your chance of success. 

The more informed you are about VBAC success, the more likely you are to succeed in your goal!

2. Supportive provider 

Equally as important as research and prep is making sure you have a supportive OB provider. If you are set on getting the vaginal delivery you’ve always dreamed of, I encourage you to find a provider who is not only supportive of VBAC, but who is also comfortable with a VBAC induction.

As I mentioned earlier, even with doing #allthethings to get spontaneous labor started, some babies have other plans and need just a little nudge. I would hate for you to get to your due date still hoping for a VBAC and be told by your provider that you’ll need another C-section because they aren’t comfortable with a VBAC induction.

Birth Plan

3. Hire a doula 

Another little gem to tuck in your back pocket when it comes to VBAC success is a doula! Doulas can be insanely helpful to all laboring mamas but especially VBAC-ing ones! 

The roles of a doula in the labor room are many, all of which are aimed at supporting you during labor and birth! It’s really a no-brainer how and why an additional support person and advocate in the labor room can increase your chances of VBAC success. 

In fact, research has proven that hiring a doula during your labor significantly reduces your likelihood of requiring a C-section!

To learn more about doulas and what they do be sure to give my podcast episode below a listen!

Related Listen: EP43: Doulas? What Do They Do? Oh, Also Liesel Had The Baby!

4. Delay or avoid getting an epidural

I delivered both of my boys without epidurals, so I get it – labor contractions (whether spontaneous or induced) are no joke! If your goal is to get an epidural then I strongly recommend trying to wait until you are in active labor (about 6 centimeters dilated) before doing so.

Have you ever heard of the cascade of interventions? It’s the idea that one intervention leads to another intervention which leads to another, and so on and so forth. 

For example, you get an epidural and…

…it causes your contractions to slow and space out…

…so you require more Pitocin to get them back in a good pattern…

…but baby doesn’t like the extra Pitocin…

…so your Pitocin is slowed down or stopped…

…then your contractions space back out…

…which causes your labor progression to stall…

…and your provider recommends a C-section.

Does this scenario happen all the time? Absolutely not. Have I seen this exact situation happen more than once? Yes. With that being said, I also see plenty of VBAC induced mamas get epidurals and go on to have successful vaginal births.

Labor can be strenuous, exhausting, and painful. How you choose to manage your pain during labor is personal and nobody’s business but your own. But, if you are wanting to make that goal of a VBAC a little more attainable, I would hold off on that epidural as long as possible, mama.

And if you are looking for some non-pharmaceutical labor pain coping techniques, look no further than my online birth class – Birth It Up: The Natural Series! In it you will learn TONS of different methods for coping with labor pain, as well as get access to an entire bonus lesson that takes a deep dive into VBACs.

There’s even a huge lesson on how to get your body to go into labor on its own. I want you to get the VBAC your heart desires, and some birth education will go a long way in making that dream a reality!

Things to keep in mind if I’m having a VBAC induction

So, what are the biggest takeaways if you plan on having a VBAC induction?

  • Find a supportive provider
  • Hire a doula
  • Delay getting an epidural
  • Knowledge is power
  • Find our your chance of success with this VBAC calculator 
  • Stay flexible and open to changes in your birth plan 

Where to learn more

Have I piqued your interest in not just VBACs but labor and birth in general? If so, be sure to look into all the labor and birth resources I have available on my site! 

And to help narrow your search, I’ve provided links to a few of my favorites below.

Birth Plan
Liesel Teen, RN-BSN

Liesel Teen

BSN, RN, Practicing Labor and Delivery Nurse

As a labor and delivery nurse, I’ve spent countless hours with women who felt anxious — even fearful — about giving birth. I want you to know it doesn’t have to be that way for you!

Are you ready to have an even better birth?

Everything in your hospital’s childbirth class – plus so. much. more. Get the knowledge and tools necessary for a positive birth experience – no matter how you deliver!

Natural Birth Class

Eliminate the what-ifs and feel strong and ready for your unmedicated birth.

Start here if birthing without an epidural is your goal!

Epidural Birth Class

Let go of fear and feel fully prepared for (and unafraid of!) your epidural birth.

Start here if you know you want that epidural – or you’re not sure what your birth goals are!

C-Section Birth Class

Release anxiety and gain a sense of control for your C-section birth.

Start here if you have a planned C-section on the horizon. You deserve birth education too!