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Vaginal Birth Post Cesarean

What is a vaginal birth after cesarean delivery (VBAC)?
What is a trial of labor after cesarean delivery (TOLAC)?
What are the some of the benefits of a TOLAC?
What are the risks of a TOLAC?
Why is the type of uterine incision used in my previous…
What other factors should be considered when deciding…
Whatever I decide, are there things that can happen…

What is a vaginal birth after a cesarean delivery (VBAC)?

If you previously had a cesarean delivery (C-section) you can choose to have either a scheduled cesarean delivery or a vaginal birth.

What is a trial of labor after cesarean delivery (TOLAC)?

When you attempt to have a vaginal birth after a previous cesarean delivery, it is called a trial of labor after cesarean delivery (TOLAC).

What are some of the benefits of a TOLAC?

The following benefits are associated with a successful TOLAC:

  • No abdominal surgery
  • Lower risk of infection
  • Shorter recovery period
  • Less blood loss.

If you are planning to have additional children in the future, VBAC helps to avoid problems linked to having multiple cesarean deliveries such as:

  • Increased probability of hysterectomy
  • Placenta problems
  • Injury to bowel or bladder.

What are the risks of a TOLAC?

There is a possibility of a rupture of the cesarean scar on the uterus.

Ruptures are rare, but it is very serious if it does occur. Do not use TOLAC if you are at risk of a rupture.

Why is the type of uterine incision used in my previous cesarean delivery a factor when deciding on TOLAC?

Some types of incisions used are more likely to cause a rupture.

  • Low transverse (side-to-side) incisions have the least chance of rupturing. Women who have had one or two cesarean deliveries with this type of incision may try TOLAC.
  • High vertical (up and down) incisions have the highest chance of rupturing. Women who have had this type of incisions should not try TOLAC.

What other factors should be considered when deciding to try TOLAC?

In addition to the type of incision used, other factors to consider are:

  • Planning to have more children in the future
  • The hospital you will be using and whether they can deal with any emergencies that might arise
  • Having any medical complications that might make vaginal delivery risky
  • Having had a previous uterine rupture.

Whatever I decide, are there things that can happen that changes my plans?

Always be prepared for any changes to your delivery plan. If you choose TOLAC, things can happen during pregnancy and labor which may result in your labor may needing to be induced. However, this may reduce the chances of a successful vaginal delivery and increase the chances of complications during labor. If your circumstances change, you may have to reconsider your decision.

Sometimes, if you have chosen a scheduled cesarean delivery, TOLAC may be advised. If you planned a cesarean delivery but go into labor before your scheduled surgery and your baby is healthy, it may be best to consider TOLAC.