ObGyn Professor Co-Author of New SOGC TOLAC Guideline

Originally published by the Society of Obstetricians and Gynaecologists of Canada:

An updated Society of Obstetricians and Gynaecologists of Canada (SOGC) clinical practise guideline recommends that trial of labour after Caesarean (TOLAC) be offered to all eligible pregnant women with a history of previous Caesarean delivery.

Each year in Canada, over 30,000 pregnant women who have had a previous Caesarean section (CS) must decide between TOLAC and elective repeat Caesarean section (ERCS). The guideline states that TOLAC should be offered to women for whom labour and vaginal birth are a possibility, to those with a previous vaginal birth, and/or to those in spontaneous labour. Women are good candidates for planned TOLAC when the balance of risks and chances of vaginal birth after caesarean (VBAC) have been discussed appropriately and are acceptable to both themselves and their care provider.

“As with any kind of birth, there are risks associated with TOLAC and repeat CS. Overall, the risks are quite low for both birth options. However, these risks change depending on the pregnancy and other obstetrical factors that we cannot control. Vaginal birth after Caesarean does not mean vaginal birth at all cost,” says Dr. Jessica Dy, ObGyn and one of the authors of the guideline. “What’s most important is that women and their health care providers look at the pros and cons of both TOLAC and ERCS together to determine the best plan of care for the best possible outcome throughout the course of the pregnancy and labour.”

The guideline reviews the available evidence surrounding TOLAC and ERCS and provides an overview of options for delivery and the associated risks for mothers and babies. It can be accessed in the July 2019 issue of the Journal of Obstetrics and Gynaecology Canada.

Professor with UofT ObGyn Dr. Jon Barrett is a co-author of this new clinical practise guideline.

Read the new Trial of Labour After Caesarean guideline here.

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