Volume 55, Number 4, December 2012James R. Scott, MD, Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, Utah Cesarean delivery rates have increased dramatically during the past decade, and rates of trial of labor after cesarean (TOLAC) and vaginal birth after cesarean (VBAC) have decreased. The National Institutes of Health held a Consensus Conference in 2010 to examine the safety and outcome of TOLAC and VBAC and factors associated with decreasing rates. They encouraged organizations to facilitate access to TOLAC. However, a number of practical issues involved warrant careful evaluation and require solutions in order for physicians to be able to offer VBAC to their patients. The purpose of this symposium is to review contemporary evidence on VBAC risks versus benefits that will allow physicians to decide on the role of VBAC in their individual practices and to outline measures to safely manage a trial of labor after cesarean.