On the acronym TOLAC (trial of labor after cesarean)…. Some studies break out statistics in four ways.
1. ERCS/D (elective repeat cesarean section/ delivery)
2. VBAC (vaginal birth after cesarean)
3. CBAC (cesarean birth after cesarean aka cesarean after planned VBAC)
4. TOLAC
TOLAC often includes VBAC and CBAC stats because as a post-cesarean mom, no one can predict if you will have a VBAC or a CBAC.
The TOLAC stat enables us to compare those risks against ERCS and then VBAC to ERCS and CBAC to ERCS so we can understand our options from various angles.
Some women find the TOLAC acronym offensive, because it implies “trying,” so practitioners sensitive to this may way to use the phrase “planning a VBAC.” Understanding that TOLAC isn’t a dig at moms, but just a straightforward, objective term that care providers use, can (hopefully) take the sting out of the word.
You use the language that works for you! Just remember that TOLAC is really more of a clinical term. Moms don’t typically say, “I’m so excited for my TOLAC!”
Two points for the person who knows how this picture is relevant…
I have no problem with TOLAC as a retrospective term. I do not like it when used by CPs in talking to VBAC mothers. That language (trying) is not generally used in primip births, and shouldn’t be used in VBACs either.
I know that it’s a technical term, and (like Kimberly) I don’t have a problem with it used in retrospect. However, I feel that a supportive care provider will talk about a woman’s future VBAC, rather than emphasizing that he will let her “try.”
Maggie,
Yes, when care providers say “you can try for a VBAC,” that really rubs me the wrong way. To me, that smells a bit of unsupportive lingo.
Jen
Hahahaha! If only we really had ‘TOLAC Troopers’ – I bet the VBAC success rates would be higher if we rocked up to hospital with one of them for birth support.
Ding, ding, ding, ding, ding!
Glad to see there is a fellow birthy person who loves the SciFi!
When I was trying to find a pic for this post, that was one of the first things that came up and I just cracked up!
Warmly,
Jen
Absolutely!!! I first heard the term TOLAC when I was being triaged for the birth of my second child. It felt so condescending. In the same sentence I was told that the doctor had done her calculations and that I had a 53.7% chance of a successful VBAC. Luckily I shrugged it off and didn’t listen to her and chose to focus on my plan and with the help of a wonderful doula, nurse and husband delivered my second baby vaginally. What an empowering and awesome VBAC I had!
Do I find it offensive? No. Does it bother me? Yes. I am not asking your permission if I want to have my next baby vaginally, I am telling you what I am doing. I heard that phrase bantered about while in the hospital recovering from my first birth which was a c-section. I had two providers while getting my prenatal care, and after my c-section the first one to visit told me that I could have a TOLAC. After I looked up the term I was a bit miffed. I was not asking her permission, I was telling her that is what I wanted. When I saw my second provider for my post-partum, he delivered me, he said he saw no reason why I had had the c-section other than length and so was highly optimistic. He said he preferred I try a home birth and he would be there for me if I had to transfer!! Two very different reactions from doctors. One made me feel upset and one was encouraging. Guess which doc I will see when it comes time for #2!
Megan,
I hope care providers read these responses so they can see the great difference a small change of language can make.
Warmly,
Jen