Risk of Fetal Death Comparing TOLAC to ERCS
Studies of fetal mortality (deaths in utero at 20 weeks of gestation or greater) suggest a higher death rate in TOLAC at 50 to 130 per 100,000 compared to ERCS at 0 to 40 per 100,000. ERCS may have contributed to the reduction of stillbirths that occur in the late third trimester and the decline in perinatal mortality observed over the last two decades because ERCS is rarely performed after 40 weeks whereas women who undergo TOLAC may have longer gestations.

Studies of perinatal mortality (death between 20 weeks of gestation and 28 days of life) show that the perinatal mortality rate is increased for TOLAC (130 per 100,000) compared to ERCS at 50 per 100,000. Although this difference is statistically significant, the magnitude of the difference between the two groups is small and comparable to the perinatal mortality rate observed among laboring nulliparous women.

The neonatal mortality rate (death in the first 28 days of life) is 110 per 100,000 for TOLAC compared to 50 per 100,000 for ERCS.

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