What is the primary risk associated with a vertical cesarean incision?

A vertical cesarean incision presents a primary risk of a higher chance of uterine rupture in future pregnancies. This type of incision extends vertically through the uterine muscle, affecting a larger area of the uterine wall than a horizontal incision. In subsequent pregnancies, this can lead to an increased risk of the uterus rupturing during labor due to the stress placed on the healed incision site. This risk is especially relevant if the woman attempts to labor after having had a vertical incision, as the integrity of the incision must be considered.

While longer recovery periods, increased pain during labor, and risk of infection are factors related to surgeries in general, they do not specifically increase the risk for future pregnancies as critically as the risk of uterine rupture. Thus, the potential for serious complications linked to the integrity of the uterine wall makes the vertical incision particularly concerning in this regard.