Evidence-based guidelines regarding vaginal birth after cesarean from 3 countries (United States, Canada, and United Kingdom) were reviewed. The similarities in the 3 national guidelines (trial of labor after 1 previous cesarean, informed consent, delivery facility and available resources, epidural analgesia, continuous fetal monitoring, and induction and augmentation of labor) are understandable. Differences in recommendations (uterine rupture risk, success rate, intrauterine pressure catheter, and mechanical cervical ripening) are not explained. The likelihood of recommendations being categorized as level A differed: United States, 27% (3/11); Canada, 32% (6/19); and United Kingdom, 0% (0/17). Only 6 publications were cited by all 3 guidelines.