VBAC and TOLAC: Making Sense of Obstetric Choices

Creating a birth plan can be a nerve-wracking process, especially if you’ve already had a cesarean section. You can rely on your Ob/Gyn to offer reliable guidance and answer your questions. You might be surprised to hear that most moms can indeed have a safe vaginal birth after a cesarean (VBAC). However, since every woman’s health situation is a little different, it’s best to consult an obstetric specialist about this possibility.

Understanding VBAC and TOLAC

When a woman chooses to try for a VBAC, it simply means that she’s previously had a cesarean, but would like to give birth vaginally this time. It’s recommended that a woman with a high-risk pregnancy plan a hospital birth, rather than home birth. Know that, while most women can successfully give birth vaginally, there is always the possibility that a C-section will be needed. This is why some doctors use the acronym, “TOLAC.” It refers to a trial of labor after cesarean. In other words, TOLAC means that you’re planning a VBAC, but acknowledge that you might still have to have a C-section if complications arise during labor.

Assessing the Likelihood of Success

It isn’t possible to definitively say whether any given woman can have a successful VBAC or not, but your obstetrician can give you a general idea. According to the American Pregnancy Association, 90% of women who have had a C-section are candidates for a VBAC. An assessment of compiled studies suggests that between 60% and 80% of women do have a successful VBAC. It’s thought that women who have previously given birth vaginally, as well as via C-section, have the highest statistical likelihood of success.

Understanding the Potential Risks

Before you make a decision to plan a TOLAC or not, talk to your obstetrician about the potential risks involved. The most significant risk associated with VBAC is a uterine rupture, especially among women whose C-section involved a low transverse incision (the most common incision for C-sections). It’s thought that avoiding labor induction and augmentation may help manage this risk.

At Women’s Healthcare Associates, we pride ourselves on delivering the exceptional medical services women need, and the compassionate, supportive care they deserve. Our obstetric specialists in Houston often work with women who are considering a VBAC. We welcome inquiries from new and current patients at 713-654-8128.