Women having their second birth vaginally whose first birth was by caesarean section

Caesarean section in a first pregnancy makes a second birth by caesarean section more likely. Repeat caesarean section and vaginal birth for women with a previous history of caesarean section each have associated risks and benefits. For more information, see Clinical commentary.

This indicator examines women having their second birth vaginally whose first birth was by caesarean section (VBAC).

Key findings

In 2022, around 1 in 8 women (12%) had their second birth vaginally after having their first birth by caesarean section.

The proportion of women having their second birth vaginally after having their first birth by caesarean section:

  • has decreased slightly from 13% in 2007 to 12% in 2022
  • was around 3 times as high in public hospitals compared with private hospitals (15% and 5.3% respectively in 2022)
  • generally decreased with age, with the rate in women aged 20–24 (18%) around three and a half times as high as in women aged 40 and over (4.9%).

The interactive data visualisation (Figure 12) presents data for women who had a second birth vaginally whose first birth was by caesarean section by selected characteristics. Select from the drop down menu to view data by selected characteristics and select the current data button to explore data for 2022.

Figure 12: Women having their second birth vaginally whose first birth was by caesarean section

This data visualisation presents data on women having their second birth vaginally whose first birth was by caesarean section. Interactive charts show proportions for the latest year of data and over time, for selected demographic and birth characteristics. Data can be explored for each characteristic. Data are presented through to 2022.

Clinical commentary

For women who have had a previous caesarean section, the choice for method of birth in their next pregnancy is either a trial of VBAC or a repeat caesarean section (RCS).

Caesarean section in a first pregnancy makes a subsequent caesarean section more likely, with 87% of women with a history of one or more previous caesarean section births, having a subsequent caesarean section (AIHW 2023). However, many women who choose to give birth vaginally after having had a previous caesarean section are successful (RANZCOG 2019).

Both RCS and VBAC are associated with benefits and risks. A successful VBAC can include a higher likelihood of an uncomplicated normal birth in future pregnancies, a shorter recovery and hospital stay, reduced abdominal pain after birth and lower risk of respiratory problems for the baby. Additional risks for the mother and baby when attempting a VBAC can include a chance of an emergency caesarean during labour, uterine scar rupture (5 to 7 out of 1000 attempts) which can result in serious problems for both the baby and mother and a low risk (2 in 1000 women) of the baby dying or having brain damage. The risks associated with an RCS includes those associated with any major surgery and the increased likelihood that all future births will be by caesarean section (RANZCOG 2016).

An individual woman’s preferences and risk profile will vary. Choice of birth option is best informed by discussion with maternity care clinicians with consideration of medical history, previous pregnancies, and availability of suitably qualified and trained staff and an appropriately equipped maternity unit (RANZCOG 2016).

Indicator specifications and data

Excel source data tables are available from Data.

For more information, refer to Data specifications and Methods.

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