VBAC at Home: Is It Safe and Is It Right for You?

Birthstone Midwifery

VBAC · Home Birth

VBAC at Home: Is It Safe
and Is It Right for You?

By Tayna Chessman, LM, CPM  ·  Temecula, Riverside County

If you have had a previous cesarean and are pregnant again, you may have been told that a VBAC — vaginal birth after cesarean — is too risky, that you must have a repeat cesarean, or that home birth is simply not an option for you. I want to offer you something different: honest, evidence-based information so you can make a truly informed decision.

What Is a VBAC?

VBAC stands for vaginal birth after cesarean. It refers to giving birth vaginally in a subsequent pregnancy after having had at least one prior cesarean delivery. VBAC is not a new or experimental concept — it has been studied extensively and is supported as a safe and appropriate option for carefully selected candidates by major medical organizations including ACOG (American College of Obstetricians and Gynecologists).

What Does the Research Say About VBAC Safety?

For appropriate candidates, the VBAC success rate is approximately 60–80%. The primary risk associated with VBAC is uterine rupture at the site of the prior cesarean scar — which occurs in approximately 0.5–0.9% of VBAC labors for low-transverse incisions. This risk must be weighed against the real risks of repeat cesarean surgery, including surgical complications, longer recovery, and increased risk in future pregnancies.

"The question is never whether VBAC carries any risk — everything in birth carries risk. The question is which risks are acceptable for your specific situation, your specific history, and your specific goals."

Who Is a Good Candidate for VBAC at Home?

✓ Favorable Factors

• Prior low-transverse uterine incision
• Known reason for prior cesarean that is not recurring
• One prior cesarean (lower risk than two or more)
• No uterine rupture in prior pregnancy
• Currently low-risk pregnancy
• Strong desire for vaginal birth
• Within reasonable distance of a hospital

✗ Factors Requiring More Discussion

• Unknown uterine incision type
• Two or more prior cesareans
• Prior uterine rupture
• Classical or T-shaped uterine incision
• Current high-risk factors in this pregnancy
• Very short interpregnancy interval

What VBAC at Home With Birthstone Midwifery Looks Like

VBAC at home requires more thorough risk screening, more detailed informed consent conversations, and a midwife who is experienced, honest, and equipped. Here is what I bring to every VBAC birth:

• A thorough review of your operative report from your prior cesarean to confirm incision type
• Detailed informed consent conversations about VBAC risks, benefits, and your specific factors
• More frequent fetal monitoring during labor to watch for any signs of uterine distress
• Full emergency equipment including IV access, oxygen, and hemorrhage medications
• Clear and practiced transfer protocols with no hesitation if transfer is indicated
• Complete transparency at every step — if something does not feel right, we talk about it immediately

Frequently Asked Questions About VBAC

Is VBAC legal at home in California?

Yes. VBAC at home attended by a California Licensed Midwife is legal in California. The decision to pursue VBAC at home is made between you and your midwife based on your individual risk factors and informed consent.

What is the risk of uterine rupture during VBAC?

For a low-transverse uterine incision — the most common type of cesarean incision — the risk of uterine rupture during VBAC labor is approximately 0.5–0.9%. This risk increases with certain factors and decreases with others. Your specific history matters enormously.

How do I get my operative report from my prior cesarean?

Contact the medical records department of the hospital where your cesarean was performed and request your operative report. This document confirms your incision type and is essential for VBAC candidacy assessment.

Can I have a VBAC if I have had two cesareans?

Two prior cesareans increases the complexity of VBAC candidacy. It does not automatically disqualify you, but it requires a much more thorough conversation and risk assessment. Contact me to discuss your specific history.

Considering VBAC in Temecula or Murrieta?

You deserve honest, individualized information — not a blanket policy. Schedule a free consultation and let's talk through your history, your options, and whether VBAC at home is right for you.

Schedule Your Free Consultation →

Tayna Chessman, LM, CPM (#784) is a California Licensed Midwife and the founder of Birthstone Midwifery,
serving families in Temecula, Murrieta, Winchester, Menifee, Lake Elsinore, and throughout Riverside County, California.