Help me get my VBA3C please !!

[rurumummy]

Hi all,

Well i went to my first antenatal appointment at Bankstown Hospital and i was pleasantly suprised i must say.

Firstly they actually accepted me which that on its own it fantastic for me because with last bub i got transfered to RPA because Caterbury hospital said i was high risk due to my type 2 diabetes.

Secondly the midwife was very freindly and informed me that They had a very high VBAC
success rate!.

BUT... she said that they are happy to do a vba1c and vba2c you need to kinda push it,but she told me i have a real battle on my hands if im gonna convince any DR their to let me have a VBA3C.

So i told her i will arm myself with as much info as i can and hopefully i will get the support of the Ob

What im asking for is if anyone can help me with any articles,studies etc.. that show the safety of VBA3C and any additional info you think might help me convince the docters to give it a go.

I have about 4wks till my next antenatal visit and when i see the dr for the first time im hoping to show them that im confidant because im the type that tends to break under pressure .

Thanks in advance : )

[Traveller]

This is a fairly recent one from the uk, in the British Journal of Obstetricians and Gynacologists

Vaginal birth after caesarean for women with three or more prior caesareans: assessing safety and success

Authors
AG Cahill, M Tuuli, AO Odibo, DM Stamilio, GA Macones

Please cite this paper as: Cahill A, Tuuli M, Odibo A, Stamilio D, Macones G. Vaginal birth after caesarean for women with three or more prior caesareans: assessing safety and success. BJOG 2010;117:422–427.

Objective  To estimate the rate of success and risk of maternal morbidities in women with three or more prior caesareans who attempt vaginal birth after caesarean (VBAC).

Design  Retrospective cohort design.

Setting  Multicentre, from 1996 to 2000, including 17 tertiary and community delivery centres in north‐eastern USA.

Population  A total of 25 005 women who had had at least one prior caesarean delivery.

Methods  Women who attempted VBAC with three or more prior caesareans were compared with those who attempted after one and two prior caesareans. Univariable and stratified analyses were used to select factors for multivariable analyses for maternal morbidity. Maternal characteristics were compared using a Student’s t test, Mann–Whitney U test, chi‐square test or Fisher’s exact test, as appropriate.

Main outcome measures  The primary outcome was composite maternal morbidity, defined as at least one of the following: uterine rupture, bladder or bowel injury, or uterine artery laceration. Secondary outcomes were VBAC success, blood transfusion and fever.

Results  Of 25 005 women, 860 had three or more prior caesarean deliveries: 89 attempted VBAC and 771 elected for repeat caesarean. Of the 89 who attempted VBAC, there were no cases of composite maternal morbidity. They were also as likely to have a successful VBAC as women with one prior caesarean (79.8% versus 75.5%, adjusted OR 1.4, 95% CI 0.81–2.41, P = 0.22).

Conclusion  Women with three or more prior caesareans who attempt VBAC have similar rates of success and risk for maternal morbidity as those with one prior caesarean, and as those delivered by elective repeat caesarean.

[BellyBelly]

There are heaps of studies and info posted in here on birth after multiple c/s... and the fact that the more c/s you have, the riskier the surgery - that should be a big one. The risk factors jump heaps with each c/s.

[rurumummy]

Thanks for that article Traveller,

I know my main point to try and convince them is to proof to them that vba3c is just as safe as vba1c.Im doing my own research as well but please if anyone has any other info,articles,tips or anything that can help i would be really gratefull.

[Arimeh]

The risk of rupture increases slightly with each VBAC you have - so for a VBAC its about 0.7% chance of rupture, 0.9% in a VBA2C. So even if its 1%, its still not a very big risk, and unlike people who "scaremonger" with their "statistics" even if it DOES rupture, it doesn't automatically mean instant death for the mother and child. Things like intermittent monitoring, no epidural etc - are all things that can help you be aware of whether your body is rupturing or not.

Good luck - I have faith in you that you can do it!

[rurumummy]

Arimeh's Eden thank you very much for your kind words,To be honest with you that is the first time i get such supportive words said to me in regards to my births.So i really appreciate it : )

[Arimeh]

Not a problem. Join up with the VBAC chatter thread - they are great girls in there, and very supportive.

[1MOREPLZ]

i am in intense research mode so i can get my VBA3C next year
I have to get preggers first but i am madly getting DH printing stuff off for me at work and i am keeping it all in a folder

[rurumummy]

Hi katones,

Unfortunalty after speaking to the docters at my hospital they will not let me try for a vba3c,so basically my only chance is if i homebirth which i cant afford to do.So i guess i need to come to terms with having another c/section,but i think im ok with that...i think..im still trying to accept it i guess

[1MOREPLZ]

hun my hospital says no aswell...but hey they can't make you have a cesarean......i will stay at home as long as i can when in labour along with my doula & hopefully midwife and go to hospital when ready and refuse when they mention cesarean..... i am not going to go down without a fight....

[Arimeh]

Its a shame when care providers don't "Care" enough about what YOU want to do with YOUR body - that they have the final say.

Is there any other hospital you can try to find in your area that will take you?