What is the Difference Between TOLAC and VBAC?
Trial of Labor After Cesarean, or TOLAC, refers to the attempt to have a vaginal birth after a prior cesarean delivery. If that trial leads to a vaginal birth, it’s known as a VBAC.
These terms get mixed up often, and for good reason since they’re closely related. TOLAC is the process of trying for a vaginal birth, while VBAC is the successful result of that effort. One is a plan, and the other is an outcome.
Either way, this path is about giving your body another chance to deliver vaginally—with the right safety measures in place and support that meets your needs.
What TOLAC Really Means
A Trial of Labor After Cesarean is just that: an attempt to have a vaginal birth after having had a prior cesarean section. It’s not guaranteed, but it is safe and achievable for many patients. If successful, it avoids another surgery and allows for a more natural recovery.
Planning for TOLAC starts with a conversation. Your provider will look at several factors, including:
- Type of Uterine Incision
- Number of Previous Cesareans
- Reason for Previous Cesarean
- Overall Health and Pregnancy Progress
These conversations are honest, clear, and always grounded in what’s safest for both you and your baby. If you and your provider agree that trying for a vaginal delivery makes sense, we’ll help you move forward with a plan. Your provider may also talk to you about the type of hospital where you’ll deliver, since not all are equipped to support TOLAC.
Please note that some hospitals may require patients pursuing TOLAC to sign a specific consent form due to the higher-risk nature of the delivery.
Understanding VBAC
VBAC is how we describe a vaginal delivery that follows a previous cesarean, and it brings some of the following benefits:
- Shorter Recovery Time: Compared to cesarean recovery, VBAC often allows for quicker return to daily activities.
- Lower Risk of Surgical Complications: Avoiding another surgery reduces risks associated with multiple cesarean deliveries.
- Future Pregnancy Considerations: VBAC can decrease the likelihood of complications in subsequent pregnancies.
VBAC also gives some patients a chance to experience labor and birth in a different way. That matters to many who want a different experience this time around.
What Labor Looks Like with a TOLAC Plan
Once labor begins, your care team will keep a close eye on how things are progressing. It is recommended that patients have IV access and continuous monitoring during labor to track your baby’s heart rate and contractions. If things go smoothly, you may go on to have a vaginal delivery.
While many individuals successfully achieve a VBAC, it’s essential to be aware of potential risks, like uterine rupture. This is a rare but serious complication where the cesarean scar on the uterus may open during labor.
If anything changes along the way, your provider will explain next steps and adjust your plan if needed. This may include transitioning to a cesarean. What matters is having the right people by your side to guide you through those decisions.
Let’s Talk About Your Options
At UWH of The Carolinas, we want you to feel empowered by your birth plan. If you’re considering TOLAC or just want to learn more about VBAC, we’re here to talk through your questions and explore the possibilities together.
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