Algorithm for choosing the subsequent route of birth after a previous cesarean birth

TOLAC: trial of labor after cesarean birth; VBAC: vaginal birth after cesarean birth; PRCD: planned repeat cesarean birth.

* The decision for a TOLAC or PRCD is made by the patient in collaboration with their provider. This decision should be based upon the best available evidence and involves a combination of factors, including:

• Availability of TOLAC at the planned birth setting
• Probability of successful VBAC
• Significance and estimated frequency of complications with TOLAC and PRCD, including individual patient factors that affect the risks and benefits for each birth route
• Personal values, preferences, past birthing experiences, and future pregnancy plans

Refer to UpToDate content on choosing the route of birth after a cesarean birth for detailed information.