Background
Cesarean delivery can be life-saving when medically necessary, but it also carries short- and long-term risks. For people who have had a prior cesarean birth, one important option is trial of labor after cesarean, often called TOLAC. When TOLAC is successful, the result is vaginal birth after cesarean, or VBAC.
VBAC can help reduce the chance of complications associated with repeat cesarean delivery, including surgical injury, infection, hemorrhage, placenta accreta spectrum in future pregnancies, and longer recovery. However, access to TOLAC and VBAC is not equal across all hospitals or patient groups. Prior research has shown that hospital characteristics, staffing patterns, local practice culture, and racial segregation in obstetric care can all influence whether people are offered labor after cesarean.
