Bicornuate uterus and natural birth

A bicornuate uterus has two upper cavities, giving it a heart-like shape. The available space can influence how the baby lies as labour approaches. A head-down position may support a planned vaginal birth, while a breech or sideways position can make caesarean birth the safer option. The uterine shape alone does not decide the mode of birth.

Your maternity team also considers the placenta, the baby's growth, signs of early labour, previous uterine surgery and your obstetric history. Imaging before or between pregnancies can clarify the anatomy; pelvic MRI may sometimes be used when more detail is needed.

Attend scheduled antenatal visits so the team can follow growth, cervical changes when relevant and fetal position. Near delivery, ask where you should give birth, what monitoring may be recommended in labour and what findings would prompt a change from vaginal birth to caesarean birth. Bring previous scan reports if your diagnosis was made elsewhere.

A flexible plan is useful because fetal position can change. Discuss pain relief, induction and caesarean birth in advance so you understand the available choices without having to make every decision during labour.

Seek urgent maternity assessment for vaginal bleeding, leaking fluid, regular painful contractions before your expected labour window, severe or persistent abdominal pain, fainting, fever, or a clear reduction in your baby's usual movements. During labour, follow the hospital's instructions about when to attend, especially if the baby is not head-down.

Ask which side of the uterus contains the pregnancy, whether the baby is head-down, whether the placenta or cervix changes the plan, and which circumstances would lead the team to recommend caesarean birth. Also ask whether delivery should take place in a unit with immediate obstetric and newborn support.