Can I Have a VBAC If... I Go Overdue?

It’s one of the most common questions I hear: "Can I still have a VBAC if I go overdue?"

The short answer? Yes, you can-but like many things in maternity care, it's nuanced.

What Do the Guidelines Say?

NICE (the National Institute for Health and Care Excellence) recommends that all pregnancies are offered induction of labour from 41+0 weeks. This is based on a small increase in risks that may come with continuing pregnancy beyond this point, including:

• Increased likelihood of caesarean birth

• Higher chance of baby needing admission to neonatal care

• Slightly increased risk of stillbirth or neonatal death

  
  

According to NICE, induction from 41+0 weeks may help reduce these risks.

But... Induction for Post-Dates Is a Contentious Topic

It’s important to understand that induction for going “overdue” is not a settled science. While it is commonly recommended, especially after 41 weeks, there is still debate in the birth world- among professionals, researchers, and birthing women- about how beneficial and necessary it really is.

Some experts argue that the current evidence doesn’t support routine induction for everyone at 41 weeks, especially if both mother and baby are otherwise well. Others see it as a useful tool to prevent rare but serious outcomes. The jury is still out, and depending on who you speak to, you may hear very different interpretations of the same data.

If you're keen to explore this more deeply, “In Your Own Time” by Dr Sara Wickham is a fantastic resource. Her work explores the topic of induction with nuance, providing a broader view beyond clinical checklists. You can also access free resources on her blog

What About VBAC and Going Overdue?

The RCOG Green-Top Guidelines acknowledge a lack of solid data around how best to manage post-dates pregnancies in women who’ve had a previous caesarean. They’re clear that this area is uncertain, and that a cautious approach is recommended.

Here’s what we do know:

• The risk of stillbirth after 39 weeks is higher in women who have had a caesarean compared to those who haven’t:

  • Around 11 per 10,000 (0.11%) vs 5 per 10,000 (0.05%)

• This means that the potential benefit of offering delivery from 41 weeks may be greater in this group

• But at the same time, induction of labour in women planning a VBAC carries its own risks, including:

  • Increased likelihood of emergency caesarean (by around 1.5x)

  • Increased risk of uterine rupture (by 2–3x compared to spontaneous labour)

    
    

It’s a tricky balance and one that deserves personalised care- not a blanket policy.

What Does RCOG Recommend?

For women planning a VBAC who go past their due date, RCOG suggests a review with a senior obstetrician at 41+0 weeks. This review should consider:

• The likelihood of a successful VBAC

• Your understanding of the risks and benefits of different options (induction, spontaneous labour, repeat caesarean)

• Your preferences- including whether to have membrane sweeps, continue waiting for labour to start on its own, opting for a scheduled repeat caesarean, or considering induction if things progress favourably by 40+10 weeks

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So, What Are My Options?

If you go over your due date, your pregnancy should be managed similarly to anyone else who is post dates. There’s currently no official recommendation to intervene earlier just because you’ve had a caesarean.

You can choose to:

• Wait for spontaneous labour

• Accept an offer of induction at or after 41 weeks

• Opt for an elective repeat caesarean

  
  

It’s important to know: you don’t have to accept every offer. Care is always an offer- not a requirement. You can say yes, no, or "not right now."

A Note on Planning Ahead

If planning a VBAC is important to you, it’s worth thinking about your preferences for going past your due date earlier in pregnancy. Consider:

• How much do you want a spontaneous labour?

• How do you feel about induction?

• Would you be open to a repeat caesarean if things don’t unfold as hoped?

  
  

There’s no single right answer here- only the right answer for you.

Final Thoughts

Yes, you can have a VBAC if you go overdue. But your journey will involve some decision points that may feel weighty. Take your time. Ask questions. Reflect on your values and goals. Remember: this is your body, your baby, your birth.