How You Can Have a Low Intervention VBAC in the Hospital

Is a low intervention VBAC in the hospital even possible?

If you’ve ever asked yourself that question, I promise you’re not alone. So many women planning a vaginal birth after cesarean (VBAC) feel like they are stuck between two extremes. Either go all in on a medicalized birth where every move is monitored or leave the hospital entirely to avoid unnecessary interventions.

But if you’re somewhere in between I want you to know that you can have a low intervention VBAC in the hospital. And not only is it possible, but with the right preparation and support, it’s more likely than you think.

I want to walk you through some of the biggest myths around VBAC and interventions in the hospital so you can stop second-guessing yourself and start planning the birth you desire.

Myth 1: VBACs are high-risk and always need more interventions

This one comes up a lot and I get why this is a belief. When a hospital sees the word VBAC on your chart, there is often a different level of attention. But that does not automatically mean you need ALL the interventions.

Here is what you need to know:

• VBAC is a safe and good option for about 80-90% of women who have had a c-section.

• The risks of VBAC, like uterine rupture, are low and doesn’t mean your birth should be micromanaged.

• Many interventions are offered as protocol, not as evidence-based necessity.

You can absolutely have intermittent or wireless monitoring, move around during labor, and labor without pain medication. It comes down to knowing your rights, having the right provider, and creating a plan that supports physiological birth.

Myth Two: You have to be induced if you do not go into labor by your due date

One of the most common reasons VBAC plans may turn into repeat c-sections is pressure to induce. Many providers are uncomfortable letting VBAC patients go past 40 or 41 weeks.

But there is a lot of nuance here.

• Induction does slightly increase the risk of uterine rupture but ACOG supports induction of labor for TOLAC/VBAC utilizing low and slow Pitocin.

• Going into labor spontaneously after 40 weeks is not “dangerous” just because you had a previous cesarean.

• You can advocate for non-invasive methods of induction or ask for more time if you and baby are healthy and stable.

Ask your provider what their policy is about going past your due date early on. And be sure to ask open-ended questions that give you a clear explanation rather than a yes or no answer.

Myth Three: Continuous monitoring and IVs are non-negotiable

You do not have to be tied to a machine the entire time you are in labor. Continuous monitoring is often hospital policy but that does not mean it is always necessary or evidence-based for a VBAC.

You can ask for:

• Intermittent monitoring with a handheld Doppler OR wireless monitoring if you would like to have continuous monitoring with freedom to move.

• Saline lock instead of a continuous running IV

• Freedom to move, labor in different positions, and use the shower or tub if available

Yes, hospitals often have policies and a routine. But your birth is not a routine. You are allowed to ask for alternatives that support mobility, autonomy, and comfort.

Myth Four: If you VBAC in the hospital you must have an epidural

Let me be clear. Just because you are giving birth in a hospital does not mean you have to accept interventions you do not want. You are more than able to decline an epidural or other pain medications for your VBAC. But you do need to prepare to birth unmedicated if that’s what you want.

This is where your preparation really matters:

• Take a class or read books on unmedicated birth specifically.

• Hire a doula who knows how to help you prepare and cope through unmedicated birth.

• Practice and prepare EARLY and consistently through pregnancy.

• Use an epidural or other pain medications as a tool when it is truly needed.

Myth Five: Your provider and hospital are the only factors that matter

Yes, they matter a lot but so do YOU.

So, even if you are unable to find a supportive hospital or provider, you still have options and choices to make.

Your mindset, your knowledge, your preparation, your voice. They are the foundation. You are not just going with the flow. You are in control.

Here’s how you can prepare if your provider is unsupportive and you can’t switch:

• Take a VBAC-specific childbirth class that supports low intervention birth.

• Hire a doula who knows how to support VBAC clients and navigate hospital environments.

• Build a supportive team and prepare your partner to advocate with you.

• Write a birth plan and review it out loud with your provider so there are no surprises.

You can have the birth you want.

It is okay to feel nervous. It is okay to have questions.

I want you to hear this loud and clear:

You can have a low intervention VBAC in the hospital. You don’t need permission. You need preparation.

You deserve a provider who supports your vision. You deserve a team that respects your choices. And you deserve to walk into that hospital with confidence, not fear.

Want to learn more about how I support VBAC preparation and advocacy? Come hang out with me on Instagram @thehannahgill or visit my website thehannahgill.com to learn more about my free and paid VBAC resources.

Keep flowing, 

Hannah Gill