Type of incision

During a Caesarean birth, your health care provider creates two incisions. One is in your abdomen, and one is in your uterus. The incision in your abdomen goes through skin, fat and muscles. From this opening, your surgeon makes the incision in your uterus. The incision in your uterus is different from the incision in your abdomen. You can't tell what kind of uterine incision you've had just by looking at your belly. Instead, to find out which type you had, check with your health care provider or look at your medical records.

The three types of uterine incisions are as follows:

• A low transverse incision is the most common type. It's made horizontally across the lower portion of the uterus. It usually bleeds less than an incision made higher on the uterus. It also tends to form a stronger scar and presents less danger of rupture during subsequent labors — between a 0.2 percent and 1.5 percent chance. If you have had one or even two of these incisions, you may be a candidate for VBAC.

• A low vertical incision is made low on the uterus, where the uterine wall is thinner. It may be used to deliver a baby in an awkward position or when the doctor thinks that the incision may need to be extended. A low vertical incision presents a slightly higher risk of uterine rupture — 1 percent to 7 percent. But if you've had this type of incision, you may still be a candidate for VBAC.

• A classical incision, also called a high vertical incision, is made higher up on the uterus, on the rounded portion. This type of incision was once used for all Caesarean births but is now rare. Because a classical incision is associated with the highest risk of bleeding and of subsequent rupture of the uterus — 4 percent to 9 percent — it's used only in emergency situations. VBAC is not recommended for women who have had a classical uterine incision.

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