VBAC at Home - What You Need to Know
/Before the month ends, we want to give a shoutout to April as Cesarean Awareness Month, a time to advocate for informed birth choices and celebrate the many paths to a safe and empowered birth experience. For many parents who have had a prior cesarean, vaginal birth after cesarean (VBAC) is a viable option—and it is one that you can absolutely pursue at home with the support of a skilled midwife.
Can You Have a VBAC at Home?
Yes, for many women, a home VBAC is a safe and viable option. The key is careful risk assessment, choosing an experienced midwife, and ensuring you meet the criteria for a safe out-of-hospital birth. While hospital-based VBACs are more common, many women prefer birthing at home to avoid unnecessary interventions, labor in a familiar environment, and have a more autonomous birth experience.
Key Factors for Home VBAC Eligibility
A midwife will assess your health history, prior birth experiences, and overall pregnancy to determine if you're a good candidate. Some factors that support a safe home VBAC include:
A low-transverse uterine incision (the most common type, which has the lowest risk of rupture).
A healthy pregnancy with no major complications (e.g., preeclampsia, placenta previa).
An adequate interpregnancy interval, ideally 18-24 months between deliveries.
A previous vaginal birth, which increases VBAC success rates.
A supportive birth team, including an experienced midwife with hospital transfer protocols in place.
If you have any concerns at all, talk with your midwife! She will be happy to cover all your options and go over the best plan for your specific situation.
Benefits of a Home VBAC
Choosing a home VBAC can offer several benefits, including:
Avoiding unnecessary interventions that might increase the risk of repeat cesarean.
A more comfortable labor environment, where you can move freely and follow your body's instincts.
Personalized, continuous support from a midwife who trusts your body’s ability to birth.
Lower risk of infections associated with hospital settings.
A peaceful postpartum transition, with immediate bonding and uninterrupted skin-to-skin contact.
Understanding the Risks
While VBAC is a safe option for the vast majority of women, it does come with risks that need to be acknowledged:
Uterine rupture (an extremely rare but serious complication, occurring in about 0.5-1% of VBACs). Talk with your midwife if you have concerns in this area.
Potential transfer to a hospital if complications arise.
Limited access to emergency interventions at home.
A qualified midwife will continuously monitor for warning signs and have a transfer plan in place to ensure you receive emergency care BEFORE complications arise.
Keep in mind, having a VBAC does not make you a high-risk client, which means you are usually eligible for midwife care and a home birth.
Preparing for a Home VBAC
If you're planning a VBAC at home, consider these steps to increase your chances of success:
Choose an Experienced Midwife
Find a midwife with VBAC experience and a strong emergency protocol.
Discuss their transfer plan and relationship with nearby hospitals.
Educate Yourself
Read VBAC success stories to build confidence.
Learn about the physiological process of labor and how it differs after a cesarean.
Take a childbirth class focused on VBAC and home birth.
Prioritize Optimal Fetal Positioning
Practice spinning babies exercises to encourage a good fetal position.
Stay active and use positions that support optimal engagement in the pelvis.
Ensure a Supportive Birth Team
Have a doula or support person trained in VBAC births.
Prepare family and friends for your birth choices and tune out any negative responses.
Have a Backup Plan
Know the nearest hospital and their VBAC policies.
Pack a transfer bag just in case.
A home VBAC is a deeply empowering and transformative experience for many mothers. If you’re considering a home VBAC, take the time to educate yourself, consult with experienced midwives, and trust in your ability to birth on your own terms.
