A vertical (classical) uterine incision changes everything
It rules out labor in every future pregnancy.
Most cesareans use a side-to-side cut low on the uterus, which heals into a relatively strong scar. Sometimes, because of prematurity, an unusual position, fibroids or an emergency, the surgeon has to cut up and down on the upper uterus. This is a classical incision.
A classical scar carries a much higher risk of rupture, and rupture can occur before labor even starts. Women with a classical incision are advised against a trial of labor and are usually delivered by scheduled cesarean before term.
Get your operative reportYou cannot tell what was done to your uterus by looking at your skin scar. A low horizontal skin cut can sit above a vertical uterine cut. Ask for the operative report in writing and keep a copy.
Where this comes from:
287. American College of Obstetricians and Gynecologists. Vaginal birth after cesarean delivery. ACOG Practice Bulletin No. 205. Obstet Gynecol. 2019;133(2):e110-e127.
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