Considering Labor After Cesarean in a Woman with Class 3 Obesity.

Because of the high cesarean rate in the United States, perinatal care providers are increasingly called upon to counsel women considering labor after cesarean. This counseling can be more complicated for women with class 3 obesity, defined as a body mass index at or exceeding 40. Although labor after cesarean may be less likely to result in successful vaginal birth after cesarean (VBAC) for this population, the risks of repeat cesarean are also higher for these women. This case report describes the benefits and risks of labor after cesarean, the chance of successful VBAC, and clinical recommendations to aid women in achieving VBAC when class 3 obesity is present.