Uterine rupture during VBAC?

[Indadhanu]

Just talked to my mum (bit of history, mum has had 4 children - VB at 40w in '86, VB at 36w in '88, C/S at 33w in '94, VBAC at 42w in '01) who was talking about her VBAC.

She said when she was pushing my little bro out she starting getting a uterine rupture. She got her VBAC (and a 4th degree tear in the process because she pushed when they said "wait, we have to do a c/s"...) but ended up needing surgery for a rupture.

The dr told her this was common...?

Is it common?

I mean, there was almost 8 years between c/s and VBAC...? Do you think the suturing used was weaker than what they use now?

My bro was 10lb something (2 ... or something like that, 10 something...), do you think that owuld have anything to do with it? Her biggest (I was born 40w, and was 8lb5ish I think, and my bro and sis were both small premmies).

She never really looked into WHY, since she had her tubes tied (4 was enough for her lol), so she was no help when I asked but... WHY?!?!?! LOL!

And... do you think somethinhg like that is genetic? Since stretchmarks are genetic, so the ability for skin to stretch is genentic... so it is possible right?

[Ozziehoffy]

Leash, from everything I've seen it's not common. I had Joshua as c/s in '93 and Oskar was born 2 years ago VBAC...so it was almost 14 years between them. There are others on here who can certainly give you more info on the whys, hows etc...but I don't think it's genetic. I know it's something which plays on the mind of a person thinking about VBAC's...played on mine too hun.

[~Kim~]

Well I had one a fortnight ago. The doctor who did my csec wanted my DH to take photos because it is quite rare in his own words. None of the midwives had ever seen one.
My last csec was 3 years ago so you think it would have had time to heal....

[Indadhanu]

Another question, do you think this would be important for whoever my next careprovider (m/w or Ob) is to know? Or would it hinder a VBAC?

[boobaloo]

leash, i don't really think you'd need to tell your next ob/gyn thate history, but i spose it can't hurt. i just don't really imagine that that would be genetic... but i'm no expert. on another note though, does that mean that you and shel have decided that you're going to be the booby mumma again?

[Pandora]

I think the risk is about 1 in 1000?
im not sure about whether the number of kids youve had, or family history come in to play at all though

[Arimeh]

Leash - I know my OB (who is like a god to me!) said that scars heal after 3 months.

That's it. They don't get stronger, they don't get weaker - they do all their healing they are going to do within the first three months of recovery.

So if you are going to rupture - it doesn't matter how long between sections. Its all a game of chance ya know? I think its like a lottery - you never know if you are going to until you try it.

Everyone is a perfect candidate for a VBAC (unless they have had a classical incision) so I reckon its worth givin it a go if you truly want to.

Ruptures do happen - thats why there are statistics for them - but it doesn't necessarily mean that because your mum had one that you would. You are not your mother - you are YOU. Nobody's body works the same, no matter how close they are genetically.

Well, this is all my take on it anyway.

[Nai]

The rate is about 1 in 200 - I had one 3 weeks ago and I also had 3 years between pregnancies. My ob said the hospital did about 600 vbac per year and had 3-4 ruptures a year.

[Tobily]

C/S at 33w in '94, VBAC at 42w in '01

Two things here that I wanted to ask you Leasha -

The c/s at 33w was in 1994 - so 15 years ago. Just wondering what kind of incision was done (bikini or classical)? Also whether a double layer suture was used to close the wound. The answers to both of those questions would impact on her risk of a rupture with the next baby.

The other question was in relation to the next bub who was born at 42 weeks - was your mum induced at that point, and if so, how?

Again, that would also have a bearing on her risk of rupture.

As far as telling future careproviders about it - I wouldn't see that it would be relevant or likely to increase your own risk.

In women who have had a bikini incision, double layer sutures with their previous caesar, and who labour spontaneously the risk of rupture is low - and interestingly is the same as for a first time mother induced with a syntocinon drip. What's infuriating is that women are induced with synto all the time and rupture is never even mentioned to them as a risk - yet VBAC'ing women whose risk is the same have the bejeesus frightened out of them from day one.

Access to vbac is under a climate of fear at the moment and the onus is truly on mum to get herself informed. Don't rely on what anyone tells you (including us here! ) Source your own information and make up your own mind.

ETA also wanted to say with regard to the size of the baby - we're are in a climate at the moment where big babies are feared even in normal low risk pregnancies. So they are feared even more in a vbac. There doesn't appear to be any good evidence for this. I know several women who have vbac'd larger babies with no problems, one recently had a home vbac with a babe who was a bit over 11lbs. 5 hour labour and no problems at all She had no idea the baby was the size it was, those awesome scans we place so much faith in had estimated the baby at 8.5lbs. So everyone was pleasantly surprised

[~clover~]

I agree that there are so many things that come into play & you & your mum are very different, so are the way things are done now.
I do hope that when you guys do decide to try again that you can have the birth you want. Weather it be VBAC or c/s