VBAC after two caesareans: understanding your options

The word caesarean describes the delivery, but the uterine incision is especially relevant to future labour. Ask the maternity team to review both surgical reports. They will consider the incision pattern, previous healing problems, the reasons for the operations, any other uterine procedure and whether a vaginal birth has occurred before.

The current placenta, baby's position, estimated size and your health also shape the recommendation. If VBAC is considered, labour should be managed in a unit able to monitor you and the baby and perform urgent surgery when needed.

Raise the topic at an antenatal appointment rather than waiting for labour. Gather operation notes and ask how your team would handle spontaneous labour, induction, pain relief and a change to caesarean birth. Clarify who to call, where to arrive and which records should travel with you.

A plan can be revisited as the pregnancy develops. Understanding both routes may help you prepare emotionally and practically for an unexpected change during labour.

Contact your maternity service promptly for bleeding, fluid leakage, contractions, reduced fetal movement or new severe pain. Emergency symptoms include heavy bleeding, fainting, marked weakness or persistent abdominal pain. During labour, report pain that does not ease between contractions or any sudden deterioration.

What do my two operative reports show? Is my scar pattern compatible with planned labour? How would you respond if labour starts before the planned date? What would make you recommend repeat Caesarean Section, and how will my baby's wellbeing be monitored?