Uterine Rupture – Symptoms and Signs of A Rupture

Uterine Rupture - Symptoms and Signs of A Rupture

Uterine Rupture

In countries such as Australia, the UK and the US, around 1 in 3 women have their baby via c-section. This means a significant amount of women are going into their next labour with a uterine scar. Uterine rupture is the main risk which concerns women who are planning a VBAC, and the main reason their care providers place limitations around the way and length of time they can labour (called a ‘trial of labour’).

It can be challenging to sift through the available information to find the facts about uterine rupture and how it might impact your labour and birth.

What Is a Uterine Rupture?

A uterine rupture occurs when the scar opens completely along its length and through all three layers of the uterus. The amniotic sac surrounding the baby ruptures and the baby or placenta can be pushed through the rupture and into the abdominal cavity.

When a scar ruptures through all of the uterine layers, it is referred to as a complete or catastrophic rupture. It’s a rare complication, but does have the potential to be very serious for both mother and baby. It requires a c-section immediately.

When a scar only stretches or partially opens, this is referred to as a ‘window’ or a uterine dehiscence. The existing scar tissue stretches, and the underlying two layers may separate, but the outer layer of the uterus (perimetrium) remains intact.

This can also be called a silent or incomplete rupture, which is misleading, as the scar has not opened completely, but only thinned or partially separated. Scar dehiscence is a common event, and rarely has any risks for mother or baby.

Signs Of Uterine Rupture

A uterine scar rupture cannot be predicted before it happens, only diagnosed as it actually occurs. There are studies that suggest measuring the thickness of the scar by ultrasound, or following closely the pattern of contractions in labour may indicate if a rupture is likely to occur. But there is not enough information available to indicate if these methods are accurate enough to be widely adopted.

Uterine rupture usually has the following signs:

  • Excessive vaginal bleeding
  • Sharp pain between contractions and/or sharp pain at scar site
  • Contractions that slow down or become less intense
  • Unusual abdominal pain or tenderness
  • Baby’s head moving back up not down the birth canal
  • Baby’s head is bulging under the pubic bone, indicating the head is outside the uterus
  • The uterus loses muscle tone (uterine atony)
  • Rapid heart rate and abnormally low blood pressure in the mother
  • Baby’s heart tones are abnormal, variable or slow.

What Are The Risk Factors For Uterine Rupture?

There is no way to predict which women are more likely to experience uterine scar rupture during a VBAC.

However, studies have shown the risks are reduced if:

  • Labour begins on its own (no induction of labour) and continues without augmentation. There is an increased risk of uterine rupture and c-section in induced and augmented labours compared with spontaneous labours
  • Your due date is at least 18 months after your previous c-section
  • Previous c-section incision was low-transverse (horizontal incision made in the lower part of the uterus).
  • A previous successful VBAC
  • Previous c-section was performed for reasons other than obstructed labour (such as placenta previa or breech presentation) and is unlikely to be repeated.
  • You have only one previous c-section
  • Your doctor used a double layer suture rather than a single layer to close the incision for your previous surgery.

Many studies report that women who’ve had one previous c-section and have a low-transverse scar, the risk of uterine rupture is less than 1%.

What Are The Complications Of Uterine Scar Rupture?

Uterine rupture is rarely life-threatening for the birthing woman, although there are risks associated with c-section surgery.

Rarely, mothers will require blood transfusions or even a hysterectomy if the blood loss is excessive, or the tear cannot be repaired.

While a uterine scar rupture during VBAC labour is rare, the consequences for the baby are serious. The immediate medical response is an emergency c-section.

If there is a lapse of time in diagnosing and responding to a uterine rupture, there is a greater risk of the baby/or placenta being pushed through the uterine wall and into the mother’s abdominal cavity. This increases the chances of the mother haemorrhaging, and the baby is more likely to be deprived of oxygen, causing brain damage and death.

The loss of the baby occurs in less than 6% of all uterine ruptures. As uterine scar rupture is itself a rare event, occurring in less than 1% of VBAC labours, the overall risk of losing a baby due to uterine rupture is extremely low. You are more likely to experience a cord prolapse or placental abruption during a VBAC labour than uterine rupture. Babies are more at risk of dying from those rare complications than of uterine scar rupture.

What Puts Me At High Risk of Scar Rupture?

There are rare situations when your risk of scar rupture is greater if you attempt labour after a c-section. These risk factors are believed to affect about 10 out of every 100 women:

  • The previous c-section was a classic or T-shaped incision. Classic incisions are vertical cuts made in the upper part of the uterus. T-shaped (or inverted T) are incisions that involve a vertical and horizontal cut. The risk of rupture for these scars has been reported to be between 4% and 9%.
  • Previous uterine surgery for reproductive or gynaecologic problems
  • Ultrasound during late pregnancy may detect the scar area has thinned to less than 2.5 millimetres
  • During a previous labour a uterine scar has ruptured.

It important that women planning a VBAC have access to evidence based information and the support of their care provider in order to make the best decision for their personal circumstances. Most women have a good chance of success for a VBAC and should choose care providers who are trained and experienced in attending VBAC births in order to maximise their chances of a successful birth outcome.

You need the BellyBelly Birth & Early Parenting Immersion!
MAXIMISE your chances of getting the birth you want… MINIMISE your chances of a disappointing or traumatic birth experience. Feel MORE CONFIDENT heading into birth… GUARANTEED.
  • 156


Sam McCulloch enjoyed talking so much about birth she decided to become a birth educator and doula, supporting parents in making informed choices about their birth experience. In her spare time she writes novels. She is mother to three beautiful little humans.


  1. Hi my name is Tina an i had a uterus rupture like 5 years ago, since then i’ve been having abdominal pain, lower left back pain, bloating and pain during sexual intercourse..what’s wrong with me

    1. You could have adhesions (can happen after any surgery) or endometriosis, or something else. You’d need to find a good gynaecologist to do a proper investigation, likely via laparoscopy.

  2. I delivered in Dec w/ baby # 7 my 6th pregnancy. I’ve had two vaginal births & 4 cesareans. I am pregnant w/ baby #8 four months after giving birth. I’m scared…what could or may happen?

  3. Hi , I had a uterine rupture at 25 weeks of pregnancy two yes ago , and I lost my baby girl as she was premature a . I only want to know should I get pregnant again or not ?? Waiting for ur reply

    1. I can say that I’ve been in the same boat. I had an uterine rupture at 31 weeks in 2013. Since then I got pregnant roughly 1 1/2yrs ago and successfully had a pregnancy I had to deliver slightly earlier than I would have liked at 34 -35 weeks but my son is now 3 and I am pregnant again about 4 months along. A pregnancy can be done you just have to take precautions and take it as easy as possible. Just make sure you have a thick skin as a lot of doctors and midwives will try to bash you about your choice. But with proper and diligent prenatal care it can be done. Good luck and know you are not alone.

  4. Hi,my name is Nancy.l had a classic CS 18 years ago and delivered a healthy baby.l have then had successful 3 VBACs and another CS afterwards.am expecting a 6th baby now.Is it advisable to try a VBAC.

  5. I have that same concern I had a c-section in 1994 a low insicion and I’ve had 4 vaginal births and I had a miscarriage at 5weeks in 2015 and I’m know 32 weeks pregnant now the obgyn Dr I was seeing just told me that with the policy of the hospital he can’t deliver my baby girl vaginaly so he said if I wish to go natural he refers me to a great Dr that will do vaginal but I don’t know wat to do I don’t want c-section but I don’t want my uterus to rupture I had a very bad experience with the epidural can I plz get some feed back has anyone else been thru it

    1. Hi. My name is April. I had a complete uterine rupture during an attempted VBAC with baby #4. I was rushed to OR across the hall Literally minutes away from catastrophic consequences. Scariest moments of my life. I do have autoimmune diseases and was severely preeclamptic with all of my pregnancies. I came to the site hoping to find someone who had also been through it. I have so much pain when I have my period. And I never had bad periods before. Also a lot of pain at my incision site internally. I’m pretty sure that’s adhesions, as I was cut from hip bone to hip bone. I don’t mean to scare anyone, but make sure you listen to your body and be vocal about how you are feeling. I had 3 epidurals that did not touch my labor pain, (my 2nd baby, I delivered with zero meds and left hospital 12hrs later) my Dr wanted to wait another 2 hrs before he did anything. Mind you, I labored for over 24 hours, preeclamptic, and progress was going backwards. The resident on call took charge and rushed us to me to OR. Later when I cried thanking her, I skied how she knew it was serious and she stated she had lost a mom and baby the year before. My little 4# 4oz baby boy is now 3 and a half and doing fantastically!

  6. i hv deliverd my 3 rd baby 10 months ago n via c section im again five month pregnnt ….im afraid of thmg uterine rupture ……how can i make my self safe from these risk

  7. Hi, I had my first pregnancy in 2010 and at about 27 weeks I felt this painful pain and i was rushed to hospital when i get there my doctor was on holiday and i waited for another doctor who was on standby. When he arrived he checked me and told my mum that the baby heartbeat is not working, he induce for three days and induction failed and was taken to theater. After was told that i had ruptured uterus but after one year of healing i can still have chance to fall pregnant again infect i can have as many children as i wish. Hmmm, in 2011 i tried but my baby past away again due to rupturing of uterus, then in 2013 i tried again and i was put to bed rest for two months at 24 weeks of pregnancy and believe me when i said uterus ruptured again and my baby was weighing 1.25kg alive and she stayed in ICU for seven days and in bottle for 3 weeks. in 2015 i fell pregnant again i miscarriage the baby at 3 months, in 2016 i tried again, behold at 16 weeks i felt this sharp pain and i was rushed to hospital and doctor said am lying am just overreacting. it took them hours to realize that am actually in pain and bleeding heavily internally. I was rushed to theater as weak as i was and i lost another baby due to complete uterus rupturing. They said no more babies for me. and worse part is am married women and my husband want kids but i can not give him.

    Now am feeling same pains again for two weeks now but am not pregnant am really felling sic. Please help me.

    1. I just had my second baby -no more kids for me either… Too much for my body and it is disappointing but better than dying.

      If Your husband really wants more kids despite your life being in danger he is a total donkeys ass and believe me I would know cause I have a donkeys ass too.

      If you ever want or need to talk email me

  8. I had a c section 2016 October 27th my doctor told me it was ok to try for a VBAC this route as long as I went to a bigger facility the only reason I was rushed into c section was cuz baby was Sunnyside up and refused to come out after pushing for 4 hours and I was induced. She said as long as I my self go into labor on my own I should be finr. I’m pregnant again I’m currently 24 weeks my due date is August 7th 2018. Id the likely hood of this happening to me not so much or could I be a 1% chance?

  9. i had 1 vaginal birth and 4 c-sections but the 5th baby didnt survive… the cord had been tied in a knot and he had passed from that and a few days later my uterus has ruptured but they are saying if i have another baby im high risk either baby or i could die or both of us.. doctor said that i would be hospitalized and would have to deliver early… can someone who has experienced this or have any info help me.. i was really happy about having a 5th baby and do want to try again just not right now cause i am trying to heal from losing my son.. i just want to be reassured that i could try and have another baby instead of being told i shouldnt have another baby…

  10. I have had 5 c sections and I am preg 14 weeks now. My youngest son is 2.5. I have been spotting brown and small clots. No pain at all. This has been happening for 3 days. I go to the doctor Friday for a cerclage. I’m still too early to feel the baby move. But can this be from my c section scar ( they used the exact same place every time) would I definitely have pain? What else could this be?

    1. Do get checked what’s happening with u. Mind this that for every c section, the Dr uses the same scar as on ur skin but another one on ur uterus, so after 5 c sections u have 5 scars on ur uterus. U r very brave mashallah for attempting a sixth cesarean, good luck for u and good wishes but strictly stay in touch with a very good dr and stop for more babies dear for future, u have had enough. U may adopt more babies and breastfeed them if u like a bigger family but stop thinking about delivering ur own babies

Leave a Reply

Please note: in order to prevent spam and inappropriate language, all comments are moderated before they appear. We appreciate your patience awaiting approval. BellyBelly receives many comments every day, and we are unable to approve them all as soon as they are posted.

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.

loaded font roboto