It is possible to have a cesarean delivery for the first child and to have a normal delivery for the second child, but vaginal trial of labor with a uterine scar does not apply to all women who have a cesarean delivery. There is still a risk of uterine rupture in vaginal trial of labor with scarred uterus, and the chance of occurrence is about 1%, which means that out of 100 women who go for trial of labor, about 1% of them may have uterine rupture, and it is quite dangerous if uterine rupture occurs. If the first pregnancy is delivered by cesarean section and the second pregnancy is delivered by vaginal trial of labor, the doctor should make a comprehensive assessment of the woman and understand the reasons for the first cesarean section. 1. If the reasons for the first cesarean section still exist in this pregnancy, such as pelvic stenosis, cephalopelvic disproportion, or fetal malposition, it is still necessary to choose cesarean section again. 2. The doctor should understand the surgical method of the first cesarean section, whether to choose a lower transverse uterine incision or a uterine rupture. The doctor should know whether the first cesarean section is a transverse incision of the lower uterus or a longitudinal incision of the body of the uterus. If a longitudinal cesarean section is performed for the first time, there is a higher chance of uterine rupture in this trial of labor, which is not suitable for vaginal trial of labor. 3. Before this trial of labor, the healing of the upper uterine incision should be evaluated by ultrasound, if it is a class III scar, it is not suitable for vaginal trial of labor; if it is a class II scar, there is also a certain risk of uterine rupture. 4. For example, a large fetus or malposition is not suitable for vaginal delivery. It is also important that the woman herself is willing to have a vaginal trial of labor. If the doctor’s comprehensive assessment shows that the woman is eligible for a vaginal trial of labor with a scarred uterus, it is recommended that she go to a tertiary hospital with emergency care and labor analgesia for a trial of labor to ensure the safety of mother and baby.