TOLAC Explained: Understanding Your Options After a Cesarean
What Does TOLAC Mean?
TOLAC stands for Trial of Labor After Cesarean. It’s the medical term for attempting to labor and give birth vaginally after having a previous cesarean. When this process leads to a vaginal birth, it’s called a VBAC (Vaginal Birth After Cesarean).
You can think of TOLAC as the journey — and VBAC as the destination.
What ACOG Says About TOLAC Safety
According to the American College of Obstetricians and Gynecologists (ACOG), most people with one prior low-transverse cesarean incision are good candidates for TOLAC. Research shows VBAC success rates range from 60–80%for those who attempt it.
In other words, for many families, TOLAC is both possible and safe. The key is choosing supportive providers and birthing environments that understand VBAC care.
“Women with one previous low-transverse cesarean delivery are candidates for and should be counseled about VBAC.” — ACOG Practice Bulletin No. 205
Why Families Choose TOLAC
The decision to attempt a VBAC isn’t just medical — it’s personal, emotional, and often healing.
Here are some reasons families choose to try a TOLAC:
Desire for a gentler recovery and shorter postpartum healing
Wanting to experience vaginal birth
Hoping to avoid surgical complications or scarring
Planning more children and wishing to reduce risks associated with multiple cesareans
Wanting a more physiological birth experience in alignment with body and faith
Your reasons matter. You don’t have to justify them — they are part of your story.
What Makes a Good Candidate for TOLAC
You may be a good candidate for TOLAC if:
You’ve had one previous low-transverse cesarean incision (the most common type)
There are no additional uterine scars or ruptures
You’re carrying a single baby in a head-down position
Your pregnancy has no major complications (like placenta previa)
Even if you don’t meet all of these, it doesn’t automatically mean VBAC is off the table. It simply means your provider should discuss the specific risks and benefits for you.
The Role of Your Birth Team
Choosing a provider who truly supports VBAC — not just tolerates it — can make all the difference.
Here’s what supportive care often looks like:
Explaining benefits, risks, and alternatives in plain language
Allowing labor to progress without unnecessary deadlines
Offering induction methods proven safe for VBAC (like Foley bulb or low-dose Pitocin)
Avoiding the use of Cytotec (Misoprostol), which increases uterine rupture risk in prior cesarean births
Partnering with doulas who understand VBAC-specific positioning and emotional support
A supportive birth team helps you stay centered in your choices while maintaining safety and communication.
TOLAC vs Repeat Cesarean: Weighing the Choice
Some families feel strongly drawn to VBAC, while others prefer the predictability of a planned cesarean. Both choices can be valid and empowering when they are yours.
TOLAC is about autonomy — being part of every decision, from induction options to pain management and postpartum recovery.
How to Prepare for a Confident TOLAC
Learn about the process and your options early in pregnancy
Ask questions about your provider’s VBAC protocols
Practice fetal positioning techniques (like those from Spinning Babies®)
Build your nervous system resilience with rest, breathwork, and emotional grounding
Create a postpartum plan that includes rest and support — not just baby care
Preparation isn’t about control. It’s about clarity and calm.
You’re Not Alone
If you’re planning a TOLAC or just beginning to explore your options, know that you’re not walking this path alone.
At Eden & Embrace, I provide emotionally safe, evidence-based support through pregnancy, birth, and postpartum — including those preparing for VBAC and home birth after cesarean.
→ Explore VBAC Support Here
→ Read More on VBAC in The Village Voice
Final Thoughts
TOLAC is more than a medical label — it’s an opportunity to experience birth differently. Whether your story leads to VBAC or another cesarean, your decision deserves respect, patience, and evidence-based care.