If your previous birth ended in an unplanned surgical delivery, you may carry feelings of disappointment or wonder if your body will ever be given the chance to labor naturally. Perhaps you were told during your last pregnancy that "once a cesarean, always a cesarean."
At MomDoc, we believe in honoring your birth choices while upholding the highest clinical standards of safety. Modern obstetrics recognizes that for the vast majority of women with a history of a single low-transverse C-section, attempting a vaginal birth after cesarean (VBAC) is a safe, appropriate, and deeply empowering option [1]. Our team of OB/GYN physicians and Certified Nurse-Midwives is dedicated to evaluating your candidacy, answering your questions honestly, and walking beside you every step of your labor journey.
Understanding TOLAC vs. VBAC
When discussing vaginal delivery after a prior C-section, you will hear two clinical acronyms used by your care team:
- TOLAC (Trial of Labor After Cesarean): The clinical journey of laboring with the intention of giving birth vaginally after a prior C-section.
- VBAC (Vaginal Birth After Cesarean): The successful completion of a vaginal delivery following a TOLAC.
Nationwide, clinical studies show that 60 to 80 percent of women who choose a trial of labor achieve a successful vaginal birth [1]. Choosing TOLAC allows you to avoid major abdominal surgery, experience a faster postpartum recovery, lower infection risks, and establish immediate skin-to-skin bonding with your newborn.
Am I a Candidate for a VBAC?
Evaluating your candidacy for a trial of labor begins early in your prenatal care. During your consultation, your MomDoc provider will review your previous operative reports, surgical history, and overall health.
Key Factors Supporting TOLAC Candidacy
- One Previous Low-Transverse Uterine Incision: The standard horizontal incision across the lower, thin segment of the uterus carries a very low risk of rupture during labor (less than 1 percent) [1].
- Two Previous Low-Transverse Incisions: ACOG guidelines support offering TOLAC to select candidates with two prior low-transverse cesareans [1].
- Prior Vaginal Delivery: Having given birth vaginally at least once (either before or after your previous C-section) significantly increases your likelihood of a successful VBAC [2].
- Non-Recurrent Reason for Prior C-Section: If your first C-section was performed for a non-repeating reason (such as breech presentation, fetal distress, or umbilical cord prolapse), your chances of a successful vaginal birth are exceptionally high.
- Spontaneous Labor Onset: Going into labor naturally without medical induction is associated with the highest rates of VBAC success.
Contraindications (When a Repeat C-Section Is Safer)
To ensure your safety and the safety of your baby, a trial of labor is not recommended if you have:
- A prior high-vertical (classical) or "T-shaped" uterine scar
- A history of prior uterine rupture
- Prior extensive transfundal uterine surgery (such as deep fibroid removal)
- Medical or obstetric complications that require a planned cesarean delivery
Safety Standards During Your Hospital Labor
Safety is the absolute cornerstone of every trial of labor at MomDoc. We support your desire for a low-intervention, natural birth environment while ensuring immediate medical safeguards are seamlessly in place.
1. In-Hospital Delivery Environment
TOLAC is conducted exclusively in premier partner hospitals (including Mercy Gilbert Medical Center, Chandler Regional Medical Center, and Banner Health facilities) equipped with 24/7 in-house obstetricians, anesthesiologists, and surgical teams [1].
2. Continuous Fetal & Uterine Monitoring
During labor, continuous electronic monitoring allows your team to track your baby’s heart rate patterns and monitor uterine contractions closely. Subtle changes in heart rate patterns are the most reliable early indicator of uterine scar stability.
3. Collaborative Physician & Midwife Support
Whether you choose a MomDoc OB/GYN physician or a Certified Nurse-Midwife as your primary birth attendant, our collaborative model ensures a physician is immediately accessible on labor and delivery if medical intervention becomes necessary.
Debunking VBAC Myths
"Once you have a C-section, all future babies must be delivered by C-section."
Fact: This outdated rule from the 1970s was disproven decades ago. ACOG guidelines explicitly state that most women with one prior low-transverse C-section are candidates for TOLAC and should be counseled on VBAC options [1].
"Uterine rupture happens all the time during a VBAC."
Fact: For women with a single low-transverse scar, the risk of uterine rupture during labor is extremely low, occurring in less than 1 out of 100 trials of labor (approx. 0.5 to 0.9 percent) [1]. Continuous hospital monitoring ensures immediate emergency care if needed.
"If I choose TOLAC, I cannot have an epidural."
Fact: An epidural does not mask the signs of uterine rupture and is completely safe during a trial of labor. You have full freedom to choose pain management that fits your birth preferences.
The MomDoc Approach to VBAC Support
At MomDoc, we view birth as a partnership. We honor your personal birth plan while maintaining clinical vigilance.
- Early Records Review: We request and analyze your previous surgical records during your first trimester to give you clear, transparent guidance.
- Collaborative Midwifery Care: Work with our Certified Nurse-Midwives for hands-on, continuous labor support, hydrotherapy, and position changes.
- Doula Integration: We welcome doulas as vital members of your birth support team in all our partner hospital labor suites.
- Bilingual Prenatal Visits: Complete VBAC birth planning and clinical consultations available in Spanish across Phoenix, Mesa, Tolleson, and Glendale.
Available Appointment Types
- Pre-Conception / First Trimester VBAC Consultation: Operative report review, candidacy evaluation, and joint birth planning.
- Prenatal TOLAC Care Visit: Ongoing physical monitoring, birth plan refinement, and labor preparation.
- Midwifery Birth Consultation: Planning low-intervention labor support with our Certified Nurse-Midwifery team.
Take the Next Step Toward Your Birth Goals
If you are pregnant or planning a pregnancy after a previous C-section, let us help you explore your options with safety and confidence.
Call us directly at 480-821-3601 or send a quick text to 480-821-3601 to schedule your VBAC consultation today.