Cesarean sections are performed differently today from when your mother had her babies. The surgery requires two incisions, one through the mother’s skin and the other in the mother’s uterus. When your mom had her cesareans, her uterine incision was probably vertical, or classical. Today, cesareans are performed with horizontal uterine and skin incisions. A horizontal uterine incision is called low transverse. As several studies confirmed in the early 1990s, this type of incision makes it safe to attempt a vaginal birth after cesarean (VBAC) with a second pregnancy. More recent studies have found a small risk—1 chance in 200 to 400—of the uterus’s tearing during VBAC with a horizontal incision. (The risk is much greater after multiple cesareans.) Because of these latter findings, the trend toward repeat cesarean sections has increased in recent years. Yet many women still choose VBAC, and 70 percent of those who do elect this type of delivery succeed in delivering vaginally.
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