Exploring VBAC: Your Journey to Empowerment
- Ayu Doula Ombretta
- Feb 7
- 4 min read
Updated: Aug 17
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. Studies show that 60–80% of VBAC attempts result in successful vaginal births. You can find more detailed information here.
In the Netherlands, vaginal birth after a previous cesarean has traditionally been an accepted option within maternity care. However, 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 cesarean section (CS) rate in our country has historically been low compared to other countries, we have seen a rise from 5% in 1980 to 16.6% in 2020.
Several factors contribute to this trend, including an increased incidence of metabolic disorders and the rise in maternal age, particularly among mothers over 40 (41.8%). Additionally, the so-called defensive medicine approach has gained traction. 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. Audits classify deaths to determine potential negligence. The impact of these audits seems to reflect in the numbers, as more women are having cesarean births and considering their best options for subsequent pregnancies.
This article aims to support you in making informed choices and having better discussions with your healthcare 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. It helps 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). This is due to 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, 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. This involves understanding how your baby’s position and your pelvic alignment can affect labour progress. Techniques and gentle movements can help optimise fetal positioning and make labour more efficient. Many women find these practices useful as they prepare for VBAC.
Parents often use Spinning Babies routines, stretching, and pelvic balancing to support their baby’s engagement and comfort in late pregnancy. These techniques can be complemented by other practices like birth yoga, bodywork, or gentle chiropractic approaches to help with positioning and movement.
This resource was created to support informed choices and spread education for parents and doulas. It’s an excellent tool for those seeking to understand VBAC better.
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. Here’s how:
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 in creating 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, the 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. 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 can support you through VBAC preparation and birth, I’d love to walk with you through that conversation. Together, we can help you feel informed, empowered, and ready for your next birth.
By Ayu — Birth Doula Amsterdam
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