There are some health factors that can influence your decision to plan a VBAC and whether it is a viable option for you. These can include:
The type of scar and previous uterine surgery.
Previous uterine surgery.
The reason why the previous Caesarean was done and the subsequent pregnancy.
The type of scar from a previous Caesarean. The type of scar present on your uterus is an important factor when considering a VBAC. There are 3 types of incisions that may have been used for your previous Caesarean birth. These are a:
Low transverse incision (Lower segment Caesarean section or LSCS)
A previous 'Classical Caesarean'
Low vertical incision
Low transverse incision (Lower segment Caesarean section or LSCS). This is the most likely scar, being the method of choice for the last 20 years. Extensive research supports the fact that women with a lower segment transverse (or horizontal incision) are at lowest risk of the scar splitting or opening, in a subsequent pregnancy and labour (when compared to an incision in the upper segment).
The lower segment of the uterus, is less muscular, has less blood supply, and is less involved in uterine contractions with future labours, therefore decreasing the chances of the previous suture line separating (about 0.3% to 0.7%).
Image 9-02shows where the incision would have been made in the lower segment of the uterus.
A previous 'Classical Caesarean'. This type of Caesarean is only performed occasionally. The incision in the uterus is made vertically, up the middle of the uterus (instead of horizontally down low in the uterus).
A classical Caesarean may be performed if: