Let’s start with the biggest question: what does VBAC mean? VBAC is an acronym for the term “vaginal birth after cesarean.” Clinically, if I see the word VBAC on a chart or hear a mama use it in her story, it means that she has had a cesarean birth with one child, and has then had a vaginal birth with an additional child after that cesarean birth. 

What is a TOLAC?

Another important acronym for you to understand in this conversation is TOLAC. This stands for “trial of labor after cesarean.” Clinically, a TOLAC is the word that is used to describe someone who is actually in labor, “attempting” a VBAC. When the baby is born vaginally, that TOLAC then becomes a VBAC. The words may get used interchangeably, but technically, they do describe different things. I’ve also known some mamas who do not like the term TOLAC and the idea that their body is on “trial” for anything - which I definitely understand! I’d change that vocabulary too, if I could. Ultimately, I just want you to know that both of these terms exist so that they’re familiar to you if they come up. 

Additional VBAC Vocabulary

There’s a little bit more vocabulary surrounding VBAC that I think you need to be aware of. I’m just going to march through this list for you. 

First, I want you to hear the term uterine dehiscence. A uterine dehiscence occurs when the prior cesarean scar layers start to thin, but they have not actually separated or ruptured. Sometimes, when dehiscence has occurred you may also see something called a “uterine window.” This is when there is such significant thinning of the uterine wall that you may actually be able to see the fetus through the tissues. Dehiscence is usually not something that is known until a cesarean surgery is done and the provider sees it when they open the abdomen.

I want you to know what the term is for 2 reasons:

1) you may hear it used and I don’t want it to sound unfamiliar

2) a lot of research about VBAC and uterine rupture lumps dehiscence and rupture together. They technically are not the same thing, as a dehiscence has not progressed to a rupture. 

The American College of Obstetricians and Gynecologists, also called ACOG, notes this crossover of terms in their VBAC Practice Bulletin as well, when they state: “It should be noted that the terms “uterine rupture” and “uterine dehiscence” are not consistently distinguished from each other in the literature and often are used interchangeably. Furthermore, the reported incidence of uterine rupture varies in part because some studies have grouped true, catastrophic uterine rupture together with asymptomatic scar dehiscence.” Basically, literature often uses the terms in the same way, and one of the reasons uterine rupture rates may vary a little bit is because uterine rupture and uterine dehiscence are all classified as the outcome uterine rupture in research.

Alright, lets move into some important acronyms: 

• Elective repeat cesarean: Also called an ERCS, this is someone who chooses to have a repeat cesarean birth instead of planning a VBAC. This means there is not a TOLAC attempt.
• Sometimes, there is a number attached to the VBAC acronym. This number relates how many prior cesarean births mama has had. 
  • Technically, VBA1C is a vaginal birth after 1 cesarean birth (usually this is just called VBAC)
  • VBA2C or VBA3C are vaginal births are 2 or 3 cesareans, respectively
• HBAC is a homebirth after cesarean 
• CBAC refers to cesarean birth after cesarean. This is the term used to describe one who was planning and desiring a VBAC birth and instead had a repeat cesarean birth. This term was actually created by the International Cesarean Awareness Network, also called, ICAN, as an alternative to the (in my opinion, bad) terminology that indicates TOLAC or VBAC “failure” if vaginal birth does not occur. No matter what happens, you have not failed. Bodies and births aren’t failures - ever. When discussing cesarean birth during a VBAC process, I’ll use the term CBAC as well.