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VBAC in Amsterdam: How to Inform Yourself and Choose the Right Support

If you’ve had a previous cesarean and want to explore a VBAC (Vaginal Birth After Cesarean) for your next baby, you’re not alone — and you deserve clear, evidence-based information to make empowered decisions. This topic has been on my mind lately, and I felt called in sharing more to make sure women understand their VBAC options, preparing body and mind, and navigating conversations with care providers.


What Is VBAC (Vaginal Birth After Cesarean)?

VBAC refers to a vaginal birth after having had a previous cesarean. It’s also clinically discussed as a trial of labour after cesarean (TOLAC). Generally, VBAC is considered safe for many women when care is individualized and evidence-based, with 60–80% of VBAC attempts resulting in successful vaginal births


In the Netherlands, vaginal birth after a previous cesarean has traditionally been an accepted option within maternity care, though intended VBAC rates have changed over time. A 20-year nationwide study found that the proportion of women intending a VBAC decreased from around 77% in 2000 to about 56% by 2019. While the CS rate in our country is has been historically low compared to other countries, we have seen a rise from 5% in 1980 to a 16.6% in 2020. Contributing factors seem to be an increased incidence in metabolic disorders, increase maternal age (mothers over 40 (41.8%) and the so called defensive medicine approach. In 2010 the Netherlands introduced systematic, mandatory perinatal audits to review perinatal deaths and improve care. Post-2009 legal actions often stem from these audits, focusing on identifying substandard care factors, particularly in cases of late preterm mortality. Key legal challenges involve professional liability for midwives and doctors concerning fetal monitoring, with audits classifying deaths to determine potential negligence. The impact of the audits seems to reflect in the numbers as it leaves more women having a belly birth and considering their best options for a subsequent pregnancy.


This article is for you, hoping it can support you in making informed choices and have better discussions with your health care provider.


Finding Reliable Information: Evidence-Based Resources

The Evidence-Based Birth website offers comprehensive articles on labour and pain management, including epidural options, induction, and VBAC topics — helping you weigh what research shows about benefits and risks before making choices about your birth. It’s excellent for parents who want facts supported by scientific evidence and clear explanations of research conclusions.

While online communities sometimes debate the term “evidence-based,” the site’s use of scientific references and clear summaries makes it a solid resource for educating yourself. 

Another helpful tool is the VBAC Project, which was created to help families understand:

  • Benefits and risks of planning a VBAC vs a repeat cesarean

  • How to improve your chances of a successful VBAC

  • Questions to ask your care provider

  • Strategies for a safe and empowering experience

     

Amsterdam Context: VBAC in the Dutch System

In the Netherlands, the maternity system supports a variety of birth settings — from home births with midwives to hospital births in second-line care. Dutch guidelines often recommend that VBAC planning — especially after a previous cesarean — is done in a hospital setting with continuous monitoring using cardiotocography (CTG) because of the scar on the uterus and the small risk of uterine rupture. 


Even so, your location matters: Amsterdam offers excellent midwifery and obstetric care, and midwives here are experienced in supporting evidence-based discussions about VBAC.

As a Birth Doula in Amsterdam, together with many others, I help you work with your care team — whether it’s a hospital, birth centre, or combined approach — so that your preferences, evidence, and safety are all part of the conversation.


Preparing Your Body & Mind: Courses and Approaches

One well-known prenatal resource is Spinning Babies, a program that focuses on birth biomechanics — how baby’s position and maternal pelvis alignment can affect labour progress. Techniques and gentle movements can help optimise fetal positioning and make labour more efficient, which some women find useful as they prepare for VBAC. 

Many parents also use Spinning Babies routines, stretching and pelvic balancing to support baby’s engagement and comfort in late pregnancy — sometimes alongside other practices like birth yoga, bodywork, or gentle chiropractic approaches to help with positioning and movement.

Created with the intent to support informed choices and spread education for parents and doulas supporting parents' choices on the matter


How a Doula Can Support Your VBAC Journey

A doula — especially one experienced with VBAC — can be a game-changer throughout your planning and birth experience, providing:

Information & Education

  • Helping you understand VBAC research and what it means for your body

  • Sharing reliable resources like Evidence-Based Birth and Spinning Babies

  • Supporting you to create a birth plan that aligns with your goals

Provider Conversations

  • Assisting you in preparing questions to ask your midwife or obstetrician

  • Supporting informed consent discussions

  • Helping you advocate for your preferences when discussing VBAC vs repeat cesarean

Emotional & Physical Support

  • Offering continuous support during labour and birth

  • Using comfort measures rooted in physiology

  • Supporting your partner so they feel confident and included


Women often tell me that having a doula made their VBAC experience calmer, more empowered, and more connected.


Steps to Inform Yourself About VBAC

Here’s a practical roadmap for pregnant women considering VBAC in Amsterdam:

1. Get Clear on Terminology

Understand what VBAC and TOLAC mean, and the difference between planning a VBAC and planning a repeat cesarean.

2. Read Evidence-Based Sources

Use structured resources:

  • VBAC Education Project for decision tools 

  • Evidence-Based Birth for scientific context

3. Evaluate Your Individual Situation

Factors like previous vaginal births, reason for your first cesarean, and current pregnancy health all influence VBAC success. Discuss these with your provider.

4. Take a Birth Education Course

Consider courses covering:

  • Birth physiology

  • Spinning Babies or similar body-balance techniques

  • Preparation for labour support and comfort

5. Meet Potential Providers

Talk with midwives and obstetricians in Amsterdam about their experience supporting VBAC and how they monitor the process.

6. Consider Doula Support

A VBAC-knowledgeable doula helps you integrate evidence, personal preferences, and emotional support throughout the journey.


Final Thoughts: Your Birth, Your Choice

Choosing whether to pursue a VBAC is deeply personal, and the best decision is one made with clear information, support, and confidence. In Amsterdam, you have access to excellent care, evidence-based resources, and supportive practices that honour both your body and your choices.

If you’re curious about how birth doulas — support through VBAC preparation and birth — can help you, I’d love to walk with you through that conversation and help you feel informed, empowered, and ready for your next birth.


By Ayu — Birth Doula Amsterdam 

 
 
 

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