VBAC & TOLAC, Same or Different?

Posted on: April 23, 2018 | Doula, Labor & Birth

Ahh… The ever confusing acronyms associated with birth… VBAC and TOLAC, they’re sisters but not twins. 

There are a lot of letters flying around pregnancy and birth but when it comes to the desire to have a vaginal birth after having had a previous cesarean section, there are two commonly used acronyms. However, there seems to be quite a divide surrounding the understanding and use of them.

The first one we will discuss is VBAC.

This acronym stands for Vaginal Birth After Cesarean. This is the acronym that is used to acknowledge that a vaginal birth has physically occurred after having had a previous cesarean birth. This term means that it has happened unless the words, “hoping to” proceed it.

Next, is a TOLAC.

This acronym stands for a Trial Of Labor After Cesarean and is used to express that someone is intending or attempting to have a vaginal birth after having had a previous cesarean birth. It has not occurred, yet.

Pretty similar, right?


They are different. Very different. To individuals with a deep desire to have the VBAC experience, the term, TOLAC makes it sound like a wish; a hope, a desire… anything but a reality.

In order for this person to bring this vaginal birth to fruition, they must believe with every fiber of their being, that they are capable of it. TOLAC steals a bit of that belief and the message that comes with it can be hurtful; even infuriating.

The point is, language matters. And the person using the language matters even more.

Doulas, I’m talking to you!

When speaking with a client who intends to have a vaginal birth after having had a previous cesarean:

We say, VBAC.

We say, you are a VBAC.

We say, when you VBAC.

We say, after your VBAC.

We speak it to our client and we speak it out into the universe. It tells our client that we believe in their ability and anticipate it happening.

A quick google search for the keywords, “the power of positive language” is all it will take for you to understand the benefit of using these words. Language creates positive thoughts surrounding an experience or challenge.

On the other side of that coin, we are professionals who work closely with medical providers. The language they use until the birth actually happens is, TOLAC. They are caring for their patient who wants a trial of labor after a cesarean in hopes of a vaginal delivery. Once the baby is born vaginally, their patient had a successful VBAC.

To medical providers, this isn’t negative, it’s just reality.

As doulas, we instill strength and we reduce fear. As professionals, we recognize the need for this shift in language and we are happy to speak support to our clients in the language they find comforting and affirming.

We also recognize that the medical professionals we work with, use language that defines their work and we respect that.

It is best for us to choose the terms we use, based on who we are speaking.

It’s pretty simple, if they say “TOLAC”, you say “TOLAC.” If they say “VBAC”, you say “VBAC.”

Knowing the difference is very important, but knowing when to use them to best support your clients and communicate with other professionals is what matters most. As doulas, flexibility is our strong suit!

Jessica Anne Dill
Owner, ​Doulas of Greater Lafayette