OBSTETRIC TECHNOLOGY
Trial of Labor After Cesarean ( TOLAC )
Most C-sections today are made using a horizontal incision on the uterus . With this type of uterine scar , the risk of uterine rupture during labor with the next baby is less than 1 %. Because of this fact , an attempted trial of labor and vaginal delivery with subsequent pregnancies is acceptable . Depending on the indications for the initial C-section , a vaginal delivery rate of 60-80 % can be predicted . Of course , we cannot guarantee that you will not require a repeat C-section for one of the above listed indications . It is considered safe to do a trial of labor in a location such as the UAB Women and Infants Center , where emergency obstetric and anesthesia care is immediately available . Surgical risks are greater during a C-section delivery for a patient who has failed a trial of labor than for a patient who has a planned , elective , repeat C-section .
If you do not wish to have a TOLAC , a repeat C-section will be scheduled at the beginning of your 39th week of pregnancy . Delaying delivery until the 39th week is done to ensure that the baby is mature and ready for birth . Of course , if you go into labor before this time , we will proceed with your C-section . If you have a classic C-section , which requires a vertical incision on the uterus , a C-section must be performed with each subsequent pregnancy . The risk of uterine rupture with this type of incision is 6-10 %. We will discuss this early in prenatal care and schedule a repeat C-Section at 37 weeks . uabmedicine . org 37