What is TOLAC? The Difference Between TOLAC & VBAC

One of the reasons that inspired us to create The VBAC Link was that it can be challenging to make sense of the medical terms and definitions for someone not in the medical field. Two of the most common acronyms used in the pregnancy and birth world are VBAC and TOLAC.

Doctors often use TOLAC seemingly in place of the term VBAC, but what do these terms mean exactly, and more importantly, how do they impact your birth plan?

Originally published August 22, 2018, this article was updated and republished on January 11, 2021.

What is TOLAC?

The TOLAC medical abbreviation stands for Trial Of Labor After Cesarean. If a pregnant woman has only had vaginal birth before, or is pregnant with their first child, it is simply referred to as Trial of Labor (TOL).

All it means is that a woman will attempt to have a vaginal birth after a cesarean (VBAC). So, the act of trying and working towards VBAC is called TOLAC.

The “successful” TOLAC birth is a VBAC. The “unsuccessful” TOLAC simply means a Cesarean became necessary at some point during labor. Make sense? I hate referring to labor as success or failure but, for lack of a better word and differentiation, I think it is appropriate in this case.

Is a TOLAC right for my birth?

According to the APA, 90% of parents with a previous Cesarean are great candidates for a TOLAC. However, choosing TOLAC for your pregnancy and birth is a personal decision. 

Finding an OBGYN or Midwife you trust to support you during your TOLAC pregnancy is important. Your decision should be made based on conversations with your provider and what you feel is the best route for your family. 

Here are some reasons why parents choose to have a TOLAC:

• Family size and future pregnancies: If you plan to have more than two children, vaginal births decrease the risks that come with multiple Cesareans like placenta Accreta, dense adhesions, postpartum hemorrhage, and the need for blood transfusion.
• Lower risks of medical complications: Vaginal birth has a lower risk for excessive bleeding, infection, injury to abdominal organs, and other complications that come with major surgery. 
• Recovery time: VBACs have shorter hospital stays, and you can usually return to normal activity sooner than with a surgical birth. 
• Individualized care: Choosing a vaginal birth allows more freedom of birth choices, locations, and providers. Having customized care is essential to a lot of parents. 

Is VBAC safe?

VBAC is a safe option for most parents. It is generally associated with fewer complications, quicker recovery, and better birth outcomes. VBAC is a reasonable option for parents who have low-risk pregnancies and have a supportive VBAC provider to assist them. 

Not only is VBAC safe, but the average success rate for VBAC is up to 80%.

However, some medical conditions make scheduling an elective C-section the best choice.

The main risk with VBAC is uterine rupture, which will happen in roughly 1 TOLAC in every 200. While uterine rupture sounds scary, most of the time, it is a small tear in the uterus and is resolved by performing an urgent repeat Cesarean. 

Knowing the risks of VBAC and repeat Cesarean will help you make an informed decision about TOLAC during your pregnancy.

Benefits of VBAC

The benefits of VBAC are similar to the benefits of vaginal birth in general. They include avoiding major surgery, quicker recovery, and reducing the risk of excessive blood loss. Some other significant benefits include being able to hold your baby right away and not feeling drowsy or drugged up by anesthesia. Babies born vaginally are also more likely to have longer breastfeeding relationships. 

Some parents appreciate feeling the sensations of childbirth and desire that experience. Others don’t mind having a Cesarean birth. Besides the medical benefits, deciding what type of birth preferences you have for your delivery is a personal decision and should be considered in the context of your unique pregnancy needs.

Make It Work For You

Knowing that TOLAC simply means you are “trying for a VBAC” makes it easy to turn it into a positive in your mind.

Mentally preparing for those conversations with a provider or nurse who only refers to you as a TOLAC rather than a VBAC makes it easier to understand. It would be a great idea to beef up that definition a little and make TOLAC mean “on my way to a VBAC” for you!

Mental preparation accounts for so much, especially when preparing for a journey such as this.

Easy, right?

Are you getting ready for a VBAC? Register today for our Ultimate VBAC Prep Course for Parents, and feel confident and prepared as you enter into your birth journey.