I'd like to plan a VBAC. How can I increase my chances of having one?

If you have already had a vaginal birth (in addition to your C-section) and plan VBAC, you are more likely to give birth vaginally than a woman who has not had a vaginal birth. Your chance of having a vaginal birth also depends on choices you make during pregnancy and how you are cared for in labor. Here are some tips for ways to increase your chances:

• Choose a doctor or midwife who favors VBAC: Unfortunately, with changing cultural views of C-section and VBAC, it could be hard to find a provider who offers VBAC, especially in some community hospitals and rural areas. Discuss your goals and preferences with potential care providers and find out how they will work with you to meet your objectives. If their response does not satisfy you and you have other options, seek a better match.
• Hire a doula (trained labor support specialist): The continuous presence of a trained, experienced woman can help you deal with anxiety about VBAC. She will know ways to help you relax, ease pain and promote progress. Read more here.
• Stay in touch with a nurse or care provider by phone to help you delay hospital admission until you are in "active" labor (you are having regular, strong contractions and your cervix is open about 6 centimeters - out of about 10 total): Women who are admitted to the hospital before their uterine contractions are well-established are less likely to have VBAC.
• Avoid labor induction when possible: The risk for C-section increases when providers use drugs or other techniques to start labor.
• Commit yourself to vaginal birth: If you ask for a C-section in a weak moment, your request is likely to be granted.
• If a C-section is proposed and you're not in an emergency situation: Ask why it's being recommended; the benefits and risks of surgery; other possible solutions to the problem, including just waiting longer; and the benefits and risks of those options. If you aren't in labor at the time the issue arises, you should have time to do your own research and talk things over with your partner and care providers before making a decision.
• If your baby is in a buttocks- or feet-first position (breech): Very few care providers will agree to vaginal birth with a breech baby. Ask your doctor if he or she can turn the baby to a head-first position with hands-to-belly movements (external version). This may be an option if your baby is breech and you have reached "term" (about the 37th week of pregnancy). You may need to search to find a provider who has skills and experience with this technique. There is not much research on external version in women with prior C-sections, but existing research does not indicate extra problems.