An innovation platform sponsored by the Novo Nordisk Foundation
TOLAC App – Hvidovre Hospital


The TOLAC App aims to provide clinicians with data-driven insights that help qualify the advice given to expectant parents at important stages of pregnancy to reduce risks and complications that might cause severe injuries during labour and delivery. 

More specifically, the app aims to help obstetricians, midwives and expectant mothers make informed decisions regarding the safest mode of delivery after a prior caesarean section.

The Inspiration Behind the Innovation

Every day, clinicians must weigh complicated combinations of risks, benefits and possible scenarios in order to predict and advise women on their probability of achieving a successful trial of labour after caesarean (TOLAC) for subsequent pregnancies.

60% of Danish women who deliver by caesarean attempt TOLAC for later pregnancies – and 71% of these women have a successful vaginal delivery.

While vaginal births are associated with lower complication rates and shorter recovery times vs. caesarean sections, TOLAC comes with a risk of severe complications, such as emergency cesarean or even uterine rupture, which can result in fetal death. The resulting emergency caesareans are associated with a higher risk of negative outcomes, including excessive bleeding and infections. With such high stakes, it's imperative that clinicians have as many tools as possible to help them confidently assess each woman's characteristics and risk profile to provide the best advice possible.

The Innovation

For the past 50 years, the Danish healthcare system has collected detailed information on all deliveries. The TOLAC App uses data-driven software to mine these extensive datasets and create personalised risk profiles for women in specific clinical situations to better predict the probability of a successful vaginal birth after a prior caesarean delivery.

The TOLAC App provides individualised risk assessments for women who have previously undergone caesarean sections. It aims to reduce complications and unnecessary operations while assisting clinicians in advising women on the right interventions at the right times during labour and delivery – empowering them to make the best decisions for themselves and their babies.

The Team

Lone Krebs: MD, Professor, DMSc; Hvidovre Hospital, Department of Obstetrics and Gynecology

Ida Näslund Thagaard: MD, PhD; Rigshospitalet, Department of Obstetrics and Gynecology