VBAC

A VBAC, or vaginal birth after cesarean section, occurs when a patient has a vaginal delivery after having had a C-section in a previous pregnancy. Before this is completed, the attempt for the vaginal delivery is called a TOLAC, or trial of labor after cesarean section. There are both risks and benefits to a TOLAC and VBAC, and some patients are safer candidates than others. The most serious risk of TOLAC and VBAC is uterine rupture, which can occur because the scar tissue from the previous C-section is weaker than the uterine muscle. This is a rare complication, but can have serious implications for you and your baby. Patients with the highest risk of uterine rupture are not candidates for TOLAC, and include patients with a certain type of uterine incision in their previous C-sections (classical or T), those with prior uterine rupture, and those with a history of uterine surgery (such as an extensive fibroid removal). For those who are good candidates for TOLAC, benefits include no abdominal surgery, shorter recovery period, lower risk of infection and less blood loss. In terms of future pregnancies, a vaginal delivery results in a reduction in the risks of placenta accreta.