What factors are considered to assess the safety of a vaginal birth after cesarean (VBAC)?

The safety of a vaginal birth after cesarean (VBAC) is primarily assessed by considering the previous cesarean deliveries a woman has had and the type of uterine incision that was made during those procedures.

When evaluating the risks associated with VBAC, it is crucial to know the type of uterine incision used in the prior cesarean. A low-transverse incision is the most favorable when considering a VBAC, as it has a lower risk of uterine rupture compared to a vertical incision or a classic incision. Therefore, the history of cesareans provides vital information about the likelihood of a successful trial of labor and the potential risks to both the mother and the baby.

Other relevant aspects, such as obstetric history including past complications, and personal preferences might play a role in the decision-making process, but they do not directly assess the safety of the procedure in the same way that the previous cesarean history and the type of incision do. Similarly, maternal age and weight, and factors like family medical history and socioeconomic status may influence overall health or healthcare access but are not the primary determinants of VBAC safety.