I went for my 5 week check up today. Mom is here to help me while David is gone for a training this week, so I left Seth at home. The nurses all took turns cuddling the baby, so I could talk to the doc unhindered.
I asked him how often he sees a thin uterus like mine on a repeat c-section. He said that he sees it in less than 5% of his repeats, so it wouldn't have been easy to predict that I would be one of those. He also said that a thin area in the uterus doesn't happen because of the way they sewed me up the first time. It's just a product of how your particular uterus heals up. He said that he's had a woman with a thin spot have a couple of c-sections after that with no trouble, but she won't be having any VBACs. The spot is too fragile.
A week after I had the baby, I was at a toddler birthday party, and I started talking to a friend of mine who used to be a labor and delivery nurse at a local hospital. She told me that if I'd decided to have a VBAC, she would've given me some advice based on what she'd seen in the hospital. What she'd seen hadn't been pretty.
She told me about a woman who'd had a c-section for her first delivery who came into the hospital after laboring at home for awhile with her second child. My friend started getting her settled in, and she pulled out the monitor to check the baby's heartbeat. Tragically, she couldn't find one. The woman's uterus had ruptured during labor at home, and she hadn't known it. Because her uterus ruptured, the baby died. There was nothing anyone could do, and there was no warning.
So this leads me to something important I've learned from this experience...
If you've had a c-section, you need to be very, very careful if you want to have a VBAC later on. If you want to have a VBAC, you MUST go straight to the hospital once you start having contractions. You cannot wait for them to get strong because strong contractions can rupture your uterus. Once you are at the hospital, the baby can be monitored, and if things start going south, they can do an emergency c-section to get the baby out immediately if your uterus starts to rupture.
After my experience, and after what I've heard from medical professionals, I really feel that un-monitored VBAC laboring is dangerous and irresponsible. You are putting yourself and your baby at risk. Please don't. The most important thing is that your baby arrives safely, no matter how it gets here...
7 comments:
Hope last night went well with out David. I prayed and am praying now...wish I could help you! Love you!
Thanks for these posts you've done on VBACs. Very helpful.
The information you have posted in this post along about VBAC is very inaccurate. The risk of uterine rupture for VBAC is less than 1%.
Going to a hospital when labor starts with VBAC can in turn cause a failed VBAC because of all the hospital interventions also.
I labored for 26 hours with my VBAC and had no issues.
I have had 3 home VBAC's all 3 of my babies were fine they came in their own good time my longest home labor was 33 hours my shortest was 4 ish hours I had a c section with my 2nd child because I was INDUCED with PITOCINE it caused hyper stimulation of my uterus and a placental abruption my son was born LIMP and GRAY My son has Eye damage and autism I wish I had known the dangers of induction before I agreed to it I wish I had been informed but I was not and my son is paying the price .... Let your baby come to you the way god designed ... dont let a doctor medal in your birth ....
I stand by my original statements. I am aware that ruptures happen in less than 1% of VBACs, but that number is still too high if its your child that would have lived if you had been monitored. A failed VBAC is a small price to pay for monitoring that could save a life.
Hi Ellen,
I realize you feel strongly about this, and I do respect your feelings. Being told you have a very thin uterus that might have ruptured and hearing those horror stories can be quite scary!
Since it appears you recently gave birth and were subjected to all this fear-mongering, I would first like to say congratulations on the recent birth and would also like to gently ask you to please refrain from passing judgments on women who choose to birth differently than you chose to. It is not selfish to stay home for a VBAC; research bears out that midwives who attend one woman without distraction of multiple patients have a better chance of catching a potential problem (including rupture) before an electronic monitor, as used in a hospital. And women who choose this method, choose it because they believe it to be best for their baby, not for some hippie birth experience, I can assure you.
I know the hospital folk like to say how many failed homebirths they've seen, but in my research on birth I've heard more horror stories of hospitals that missed things than I have of homebirth horrors (anecdotal, granted).
Moreover, while you state that the less than 1% chance of rupture is too high to risk (which I think should be the decision made by each mother, not a decision made by one person that everyone is required to abide by), please bear in mind that amniocentesis has a 1%risk of miscarriage, twice the risk of rupture in a VBAC, and doctors routinely recommend the procedure. Moreover, almost every other emergency (cord prolapse, placental abruption, etc.) have a higher rate of occurrence than rupture in a VBAC patient, yet homebirth for low risk patients has been shown to be at least as safe as hospital birth for low risk patients and their babies.
Even more disturbing, there seems to be a growing trend toward ruptures in unscarred uteri, due to "pit to distress" (giving pitocin until the baby goes into distress necessitating a c/sec) commands given by doctors in hospitals.
While I feel your fear of VBAC, and your relief that you had a repeat c/sec, I honor your experience and these feelings. But please understand that this is based on your personal experience, not evidence based research, and may not be consistent with someone else's experience. While your decision was right for you, it will not necessarily be right for every mother and every baby.
Every mother should be able to make her own decisions after being presented the risks and benefits of all modes of delivery...and in many cases, the risks to the baby and mother resulting from c/sec are glossed over or outright denied. C/sec has risks as does VBAC, hospital labor has risks as does home labor.
Birth is never w/o risk, you just trade one set of risks for another. And, once cut, even if you schedule a repeat c/sec, there is still a 0.2% chance of rupture (as opposed to 0.5% for VBAC with no chemcial augmentation). So one could potentially say that the 0.2% chance of rupture is too high, and a c/sec should necessitate mandatory tying of one's tubes. This is why I hesitate to mandate policy based on someone's assessment of too risky; to me it has to be the mother, who arguably has the greatest interest in the baby's health and is the only person (aside from the father) that will have to live with the results of her decision, good or bad, for the rest of her life.
Congratulations again, enjoy the early days wtih baby.
I have friends who choose homebirth, and I have noticed that they have a different frame of reference and way of making decisions than many who choose hospital births. It seems that they consider hospitals to be more treacherous than giving birth at home, and some of us who give birth at hospitals find this pretty hard to understand. So we're not going to agree about a lot of things, this just being one.
I don't want it to be assumed that I'm a victim of "fear mongering." As I've mentioned before, the doctor who did my c-section is a huge proponent of VBAC. The medical establishment is not pushing some sort of agenda on me.
Honestly, I hesitated from writing this post because I feared I would draw the ire of the home birth advocates. Looks like I did! =) But I decided that sharing this, and possibly saving a life or causing someone to have a much less scary birth experience, was more important than that.
I'm not saying don't try for a VBAC. I'm simply saying that if you want one, monitoring is a small thing that you can do it make it much, much safer, and you should do that.
Those who have another viewpoint have already probably written far more extensively on their blogs about their view than I have about mine. So you can go to their blogs to read all about it! =) Comments are now closed.
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