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If you’ve had a C-section before and are now thinking about your birth options, you’ve probably come across the term VBAC (Vaginal Birth After Cesarean). It’s often talked about as an alternative to a repeat C-section, and for many moms, it’s an option worth considering.
But what about TOLAC (Trial of Labor After Cesarean)? This term doesn’t get as much attention, yet it plays a huge role in the process of attempting a VBAC. Understanding the difference between the two can help you feel more confident and informed as you weigh your options for your next delivery.
What is a TOLAC?
A TOLAC (Trial of Labor After Cesarean) is just what it sounds like — it’s when you decide to go into labor and try for a vaginal birth after a previous C-section. If that labor leads to a successful vaginal birth, it becomes a VBAC (Vaginal Birth After Cesarean). So, every VBAC starts as a TOLAC, but not every TOLAC turns into a VBAC.
Knowing the difference is important because choosing a TOLAC means being open to either outcome — a successful vaginal birth or another C-section if things don’t go as planned. No matter what happens, the goal is always a safe and healthy delivery for both you and your baby.
How often does TOLAC lead to VBAC?
Research shows that 60-80% of women who attempt a TOLAC go on to have a successful VBAC. That means the majority of women who try for a vaginal birth after a C-section are able to have one.
The chances of success are even higher for women who have had a vaginal birth before, go into labor on their own, or have a low transverse incision from their previous C-section. On the other hand, about 20-40% of TOLACs result in another C-section, often due to labor not progressing as expected or medical concerns that make a surgical birth the safer option.
The American College of Obstetricians and Gynecologists (ACOG) supports VBAC as a safe and reasonable option for most women with a prior C-section, as long as they don’t have specific risk factors that make a repeat C-section the better choice.
Why would someone want a VBAC?
There are a lot of reasons why moms think about trying for a VBAC instead of scheduling another C-section. For many, it’s about easier recovery — less time in the hospital, less postpartum pain, and being able to get back to normal life (and, let’s be honest, chasing older kids around) sooner.
For those planning to have more children, VBAC can also lower the risks that come with multiple C-sections, like placenta issues that can make future pregnancies more complicated.
Then, there’s the emotional side. Some moms want to experience labor and birth in a different way than they did before. If a previous C-section was unplanned or felt disappointing, a VBAC can be a way to reclaim that birth experience. Others are totally fine scheduling another C-section because that feels like the best choice for them.
No one approach is better than the other — it’s all about what makes sense for you.
Who can try for a VBAC?
Not everyone who’s had a C-section is a good candidate for VBAC, but many are. Several factors make it more likely that a TOLAC will result in a successful vaginal birth.
The type of incision from your previous C-section is a big one. If you had a low transverse incision (the typical horizontal one across the lower uterus), your chances of a safe VBAC are much higher. If your C-section scar is vertical or high on the uterus, the risk of complications goes up, and a repeat C-section may be the safer option.
Other things that improve VBAC success rates? Having had a vaginal birth before, going into labor naturally, and being in overall good health. On the flip side, if you’ve had multiple C-sections, a history of uterine rupture, or certain pregnancy complications, your provider may recommend another C-section instead.
This is why open, honest conversations with your provider about your medical history are so important.
What about the risks?
The biggest concern when attempting a VBAC is uterine rupture — which sounds terrifying but is actually quite rare. It happens when the scar from a previous C-section tears open during labor, which can be dangerous for both mom and baby. Fortunately, the risk is very low for most women (around 0.3–1%), especially if they have the right type of incision and no other risk factors.
There’s also the chance that labor won’t go as planned, leading to an unplanned C-section. While that can be frustrating, it’s worth remembering that the goal is always a healthy mom and baby, no matter how you end up delivering.
Busting some VBAC myths
There’s a lot of outdated (and honestly, just plain wrong) information floating around about VBAC.
One of the biggest myths? "Once a C-section, always a C-section." Nope. While that used to be the standard advice, research has proven that many women can safely have a vaginal birth after a C-section.
Another misconception is that VBAC is super risky. Yes, there are risks, but for many women, the risks of multiple repeat C-sections (like increased scar tissue and placenta complications) are actually higher than the risks of a VBAC. It’s all about weighing the risks for your specific situation.
And then there’s the idea that hospitals won’t “allow” VBAC. While not every hospital offers it, plenty do. If VBAC is important to you, it’s worth finding a provider who truly supports it — not just one who says they’re “open to it” but makes it sound scary at every appointment.
The mental and emotional side of VBAC
Birth isn’t just a medical event — it’s an emotional experience, too. For some moms, the idea of a VBAC feels empowering, like they’re taking back control of their birth story. For others, the uncertainty of labor makes a planned C-section feel like the less stressful choice. Both are totally valid feelings.
It’s also okay to change your mind. Maybe you were set on a VBAC but started feeling uneasy about it as your due date got closer. Or maybe you planned for another C-section but suddenly felt really drawn to trying labor. Your comfort and confidence matter.
Choosing between a TOLAC and a repeat C-section isn’t about proving anything — it’s about what’s best for you, your baby, and your situation. Understanding your options, working with a trusted provider, and listening to your instincts can help you make the right choice. No matter how your baby arrives, what matters most is that you feel supported, respected, and ready for the beautiful journey ahead.
Kristyn Hodgdon is the Co-Founder and Chief Creative Officer at Rescripted.
