Where can I have a VBAC in Perth?

Vaginal birth after caesarean (VBAC) can be a safe and satisfying birth option for many women who have had a previous caesarean, yet the rates of VBAC remain low. Finding the right care provider can helps your chances of a successful VBAC – and it doesn’t have to be obstetrician-led care in a hospital. You do have options when it comes to preparing for a VBAC – let’s explore some of these options, the differences in models of care and the VBAC birth options in Perth.


A recent study out of Europe looked at the impact of maternity culture and VBACs. It found that clinicians in the countries with high rates VBAC there  was a positive and pro-VBAC attitude. In comparison, the low-VBAC rate countries had both pro and anti-VBAC clinicians and this adversely impacted women seeking a VBAC.

In other words – your care giver matters!

Model of care options for a VBAC

The model of care simply refers to the type of care you receive – for example continuity of care or fragmented care, obstetric-led care or midwifery-led care.

Midwifery-led continuity of care for VBAC

Midwifery-led continuity of care means having a known midwife through your pregnancy, labour, birth and into the postpartum period.

There are many known benefits to having continuity of care including increased chances of spontaneous vaginal births, fewer instrumental deliveries and episiotomies, no increase in the risk of caesarean and less chance of having an epidural.¹.

A recent study (from Sydney) explored the differences in women’s experiences between continuity of care (CoC) with a doctor, standard maternity care (fragmented care) and CoC with a midwife. It found that;

Women found VBAC less traumatic than their previous caesarean and those who had CoC (continuity of care) with a midwife were more likely to feel in control of the decision-making, feel that their midwife was confident in their ability to have a VBAC and to receive positive support. Women who had CoC with a midwife were also more likely to have been active in labour, experience water immersion and have an upright birthing position.

Specifically, the results showed that women who had CoC with a midwife were;

  • More likely to have a birth plan (82% compared with 74% with standard maternity care and 66% for CoC with a doctor)
  • Less likely to use pain relief (35% of women reported no pain relief compared with 19% under standard maternity care and 13% for CoC with a doctor)
  • More likely to have a water birth (21% compared with 5% with standard maternity care, 3% for CoC with a doctor)
  • More likely to use active/upright birthing positions (45% compared with 34% with standard maternity care and 18% with CoC with a doctor)
  • More likely to feel their care provider was confident in their ability to have a VBAC (89%, compared with 54% standard maternity care, 71% for CoC with a doctor)

Community Midwifery Program

The Community Midwifery Program (CMP) provides Medicare-funded continuity of care midwifery care to women with certain known risk factors (including previous caesareans). Unlike the ‘low-risk’ CMP model, there is no catchment area for a VBAC. 

Under this model, you have care by a known midwife and must birth in King Edward Memorial Hospital (KEMH). The CMP does not support Home birth after caesarean (HBAC). 

This is a popular option for many VBAC mothers – if you are considering the CMP for your VBAC, it’s worth enquiring early!


Private Practising Midwives

A private practising midwife is one who is not linked with the CMP or the Midwifery Group Practice (MGP). 

Private practising (or independant) midwives largely support homebirths and it is worth having a discussion when talking to your potential midwife whether they feel comfortable supporting HBACs. 

Some independant midwives also have admitting rights to some of the hospitals which means that if a transfer to hospital was necessary, or you chose to birth in a hospital instead of at home, you could have a known midwife providing your care. If your midwife doesn’t have admitting rights, and a transfer to hospital is needed, your midwife will then continue on with you as a support person with your care being provided by the hospital midwives.

Private Obstetricians for a VBAC

If you choose a private model of care, you will be able to choose your own obstetrician. If you have the appropriate cover, your private health insurance will cover a portion of their fees.

If you are choosing your own obstetrician it is important to have conversations, before hiring them, around their philosophy on VBACs to help you determine whether they would be supportive of you having a VBAC. There are a number of obstetricians in Perth who are very supportive of VBACs, others who are tolerant of VBACs (at best!). It is worth asking lots of questions, talking to other women who have had VBACs about their experiences or joining VBAC support groups to get some opinions from those in similar situations to yourself.


Public Hospitals

Most public maternity hospitals throughout Perth are able to support a VBAC. Under the public model you may either have shared care with your GP, or antenatal care provided by the hospital obstetricians and midwives, with your care on the day of your birth being provided by the staff on duty.

Next birth after caesarean (NBAC) Clinic

The NBAC clinics offers midwifery-led antenatal clinic for those who have had previously had a caesarean birth. These clinics are available at King Edward’s Memorial Hospital (KEMH), Armadale Hospital and Fiona Stanley.

The NBAC clinic is available to all women whose local maternity hospital does not provide a NBAC option which means you don’t have to be in the catchment to access it.

The NBAC clinic offers antenatal education and support.


VBAC after two caesareans


KEMH and Fiona Stanley are the only public hospitals that routinely accept VBAC after two caesareans. Some private hospitals *may* accept VBA2C however it very much depends on your care provider whether they will support you and whether the hospital they work with will ‘allow’ it.

Doula Support for a VBAC

While doulas are not able to provide any medical care, it is worth considering having a doula when preparing for a VBAC. A doula is a non-medical birth support person who provides you and your birth partner with physical and emotional support during your pregnancy, labour and birth. A doula’s essential role is providing continuous labour support and doing so regardless of the choices you make during your birth.

What are the benefits of having a doula?

According to this Cochrane Review² the benefits of having a doula include;

  • 39% decrease in the risk of having a caesarean
  • 15% increase in the likelihood of spontaneous vaginal birth
  • 10% decrease in the use of medications for pain relief
  • 41 minute shorter labours
  • 31% decrease in the risk of being dissatisfied with your birth experience

To find out more about my birth doula services, click here

Finding the right care provider for your VBAC can help you feel more calm, confident and in control during your birth – take your time, do your research and find the right model of care for you!

Want to know more about how you can best prepare for your VBAC? My VBAC with Confidence course gives you everything you need to approach your birth feeling confident and empowered to give birth on your own terms. 

Questions for your VBAC care provider.

As you can see, there are a number of options available when choosing your model of care and your care provider when preparing for your VBAC. How do you know you’ve found a VBAC supportive care provider? By asking questions!

Download your free guide ‘5 questions you need to ask to find out if you have a VBAC supportive care provider’

Questions for your VBAC care provider

Kate Vivian is a self-professed pregnancy and birth geek who is finally learning to embrace the chaos of having 3 kids. It was the birth and ‘bringing baby home’ experience of her first baby, and the overwhelming guilt that went with it, that led her to start Bright Mums – and create a world where Mums matter.

 A Certified Hypnobirthing Australia Practitioner, childbirth educator and postpartum doula, Kate works with Mums-to-be not only supporting them through pregnancy, and birth but also teaching them to honour themselves at a time when the world is telling them their baby is the most important thing.

With almost 2 decades in adult education, Kate has the ability to create a safe space, a non-judgey space. A place where Mums can relax and feel supported regardless of what their journey looks like. 

A keen traveller in a former (pre-kids) life, Kate dreams of the day her kids are big enough to take skiing and they can completely show her up while she is busy falling down mountains.

You can find out more about Kate and her VBAC with Confidence course here.