Which scar type is considered safer for VBAC eligibility?

• A. Classical uterine incision
• B. Vertical midline scar
• C. Low-transverse cesarean scar
• D. Posterior scar

Answer: (C)

Focusing on how the uterine scar behaves during labor helps determine VBAC eligibility. A low-transverse cesarean scar, placed horizontally in the lower uterine segment, carries the lowest risk of rupture during contractions. This scar type tends to heal in a way that allows the uterus to stretch more safely in labor, supporting a higher likelihood of a successful vaginal birth after cesarean when medical monitoring and appropriate criteria are in place.

In contrast, a classical or vertical incision penetrates the upper part of the uterus and is associated with a significantly higher risk of uterine rupture during labor, making VBAC less safe and typically not recommended unless under very careful supervision. A posterior scar isn’t a defined, consistently safer option for VBAC and doesn’t offer the same well-established risk profile as the low-transverse scar. That’s why the low-transverse cesarean scar is the safest and most commonly chosen for VBAC eligibility.