What Happens to the C-Section Scar During a VBAC

If you’re considering a vaginal birth after cesarean (VBAC), it’s natural to wonder what happens to your previous C-section scar. Having a general understanding of how your scars behave during labour, the risks they pose, and how to care for yourself helps you make important decisions calmly and confidently.

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Conceiving again after a cesarean can feel both exciting and a little frightening. You may be ready for a vaginal delivery this time, but one question might keep you tense about what will happen to your old C-section scar during labour.
Even if your body is strong and capable of healing, the scar from your earlier surgery does play a role in how your next birth unfolds. Let’s understand this together, exploring what actually happens below the surface, the signs to look for, and how you can stay safe.

What Exactly Is a C-Section Scar Made Of?

When you had your cesarean, doctors made an incision through your lower abdomen and uterus to deliver your baby. Once healed, this cut forms a scar made of fibrous tissue. This tissue is strong but not identical to your original uterine muscle; it’s slightly less flexible.

Most modern C-sections use a low transverse incision, which heals better and carries a much lower risk of complications in future pregnancies than older, vertical incisions.

Does the Scar Stretch During a VBAC?

Yes, during a natural birth, your uterus naturally expands and contracts to help your baby move down the vaginal canal. This means your abdominal area also stretches along with the rest of your uterus.

Generally, the scar stretches safely because it has healed well over the months or years since your last surgery. Your body’s natural healing process recovers the tissue enough to handle labour.

What Are the Chances of the Scar Tearing or Opening?

Medically, it is called uterine rupture, and it sounds frightening than it generally is, but the best part is, it is rare.

For individuals with a low transverse scar, studies indicate that the risk of rupture is approximately 0.5% to 1%, meaning it occurs in 1 out of 200 to 300 VBAC attempts.

Your doctor will go through your medical history and recovery before opting for VBAC. Factors that may slightly increase risk include:
  • A short gap between pregnancies (less than 1.5years)
  • Having more than one previous surgical delivery
  • Labour is being induced with strong medications
  • If the incision didn’t heal properly

What Signs Show the Scar Might Be Under Stress?

Your body gives certain signs for attention even when you can’t feel the scar directly. During labour, you and your nursing team should watch for:
  • Sudden sharp abdominal pain between contractions
  • Pain that doesn’t fade even when contractions stop
  • Abnormal fetal heart rate
  • Vaginal bleeding or tenderness near the scar
If they occur, your doctor will act immediately. Most hospitals are well-prepared for such cases and can perform an emergency surgery if needed.

Can You See or Feel Any Changes in the Scar During Pregnancy?

As the skin and tissues beneath the belly are stretching again, it’s common for your surgery scar to feel tight or itchy as your uterus enlarges, which can cause a bit of discomfort.

You may also notice your scar becoming lighter, darker, or slightly raised; that’s common and not a sign of risk. However, if you experience painful pulling, redness, swelling, or discharge, consult your doctor to rule out an infection or abnormal healing.

How Do Doctors Check if Your Scar Is Ready for VBAC?

Before recommending VBAC, your doctor will review your previous surgery report to check the type of incision you had. They may also suggest an ultrasound in late pregnancy to determine the condition of your surgical scar.

A thick and healed scar generally means a lower risk of opening. Some hospitals also have continuous fetal monitoring during VBAC labour to see any early signs of rupture.

Emotional and Mental Aspects of a VBAC

Apart from the physical side, VBAC can be emotionally encouraging. Many describe it as empowering, finally getting to experience a vaginal delivery after a C-section.

It’s okay to feel anxious and worried about your scar or possible risks. Talking openly with your partner, loved ones, and nursing team can help you stay calm and composed.

Remember, whether it’s vaginal delivery or C-section, what matters most is a safe and healthy delivery for you and your baby.

When Should You Call Your Doctor?

Consult a doctor if you experience:
  • Sharp, consistent pain near your incision scar
  • Bleeding or fluid leakage from the scar area
  • Fever or any signs of an infection
  • Severe contractions not easing between waves

What To Do Next: Your VBAC Readiness Checklist

  • Ask your doctor to look into your previous C-section details
  • Check the type of incision used
  • Maintain a healthy lifestyle
  • Discuss managing pain options for VBAC labour
  • See if your hospital can perform an emergency surgery if needed
  • Stay emotionally strong, talk to your partner and loved ones
During a VBAC, your scar stretches with your body as you go through labour. In most cases, it stays strong and doesn’t cause trouble, but there’s a small risk of complications. Good medical care, preparation, and awareness can make your VBAC experience safe and positive.

The most important key is to trust your body; it’s already proven its strength once. With guidance and calm confidence, you can have a healthy birth and an easy recovery.

Whether you’re pregnant, a new mom, or navigating postpartum, you don’t have to do it alone. Join our support group to connect, share, and support one another.

FAQs on What Happens to the C-Section Scar During a VBAC

  1. Does incision scar pain occur during a VBAC?
    You may feel mild pulling or soreness as your uterus contracts, but constant or severe pain isn’t normal. Always inform your doctor if the pain feels unusual or persistent.
  2. Can a thin scar allow a safe VBAC?
    Yes, it can, but it depends on how your scar has recovered. If your doctor says it is too thin on ultrasound, they might recommend a repeat C-section for safe delivery.
  3. After how much time should I plan a VBAC after my first C-section?
    It’s best to wait at least 1.5 to 2 years before trying to conceive again, providing enough time to heal the scar completely, lessening the risk.
Disclaimer: Approved by: Dr. Sushma K - Consultant Obstetrician & Gynecologist at Apollo Hospitals Sheshadripuram