Considering c-section - what's the likely impact on baby?

[IwishIknew]

First off, I don't want to scare you, but I wish I had know more information before deciding on a VBAC myself.

I had one c-section for failure to progress and was not told I had an inverted-T incision.

I decided to go for a VBAC with my 2nd child and due to some concerns about my daughter's heart rate and size, I was given a cervical ripening drug to help induce labor one day before my EDD.

After three hours in light labor (only got to 3cm), my uterus ruptured and I lost my daughter. They were able to save my uterus, but it required 2 hours of surgery and 9 layers of stitches due to the prior inverted T incision.

I was told the risk of rupturing during a VBAC with an inverted T-incision is similar to that of a classical incision or around 10%-15%. Any induction ups the risk to up to 30%. They told me if they knew about the inverted T, they would have never let me attempt a VBAC. I am a member of a support group for women that experienced uterine ruptures. Several had children that survived the rupture without any problems, several have children with mild to profound long-term health problems due to the rupture and the majority lost their babies.

I just passed my daughter's one year birth/death day and there is not a day that goes by that I wish I had known about the inverted T incision. Of course I am biased and will tell you the risk of any labor is not worth potentially losing your baby or your own life. I only came across your posting because I still scour the Internet trying to find answers, to which there are few. Uterine rupture is rare enough that statistics don't really help- especially if you have any other issues like a different type of incision or breech presentation, etc. The rupture can happen very quickly, and the baby must be taken out in less that 10 minutes, which is unlikely if you rupture at home. I only posted my story here because I wish I had known about my incision and heard a similar story about a year ago.

[Traveller]

IwishIknew, what a heartbreaking story and I am so sorry for your loss. How wonderful that you are strong enough to use your own experiences to support other women who have lost a child through uterine rupture.

I am surprised that you were induced for your VBAC though as I thought that this was generally advised against regardless of the type of incision. Do you know is this practice common in Australia?

[jessicaanne010]

Grr, I responded to this yesterday but my post disappeared. :-(

According to the Landon Study (2006?) the risk of rupture after a Classical, Inverted T or J incision is only 1.9%. I had a VBAC after an Inverted T and I know a few other women who did too. Our stories are here: Pregnancy and Birth

Please at least consider waiting until you go into labor to have a c-section there are so many benefits for your baby.

IwishIknew - My deepest sympathies to you. I am so sorry that you lost your daughter. I hate to bring this up, but was the cervical ripening drug Cytotec? That drug is known to cause uterine ruptures, there is a warning from the manufacturer NOT to use it for a woman during labor.

In the case of uterine rupture, catastrophic ruptures like yours are rare, 1 in 2000 I think. Even if you are IN a hospital it is truly rare to actually get into a surgical room in under 30 minutes. I'm sorry, I cannot imagine how painful this is for you, but your information is not accurate.

Any of you that had an Inverted T incision are welcome to join my Yahoo Group - Life_After_InvT. We are a relatively small group, but we are there are supportive.

[girlonamission]

I am surprised that you were induced for your VBAC though as I thought that this was generally advised against regardless of the type of incision. Do you know is this practice common in Australia?

I find this surprising too, I know when my waters broke at 35.5 weeks with DS2 but no labour/contractions followed, I was taken in for a repeat C-section. There wasn't even any consideration made for inducing.

However having said that, I do know of a friend who found herself in a very similar situation (a different hospital though) and the doctors were talking about inducing her when her waters broke but labour didn't start (she was hoping to attempt a VBAC) but from her own research she refused to be induced based on the risks she felt would be involved.

RoyaUK, I'd like to look into a VBA2C if we have a 3rd child so I'll be watching this thread closeley

I'm so sorry for the loss of your precious daughter IwishIknew

[IwishIknew]

Thanks for your thoughts. Losing my daughter was the hardest things I've ever gone through and I hope no one else has to live with the guilt of a decision they made (VBAC) causing the death of their baby. Despite what I've been through, I am still supportive of VBACs IF you have the whole story about prior c-sections AND you do not have any added risk factors. Yes, what I went through is a rare, but the new members that come to my support group are evidence that it happens too often (which is at all). Most of the newest members were not induced, just VBACs and they didn't have any known risk factors beyond a prior C-section.

No, the drug wasn't cytotec...I'd have to look up the name, but when I looked in the past, it was a different type of drug. And yes, my doctor went against VBAC protocols when inducing me. I didn't know about the problems with induction and I trusted she was making the right, medically sound decision. I think she believed the riping agent wouldn't work and I'd end up with a c-section anyways, but she wanted to give me a 'chance' at VBAC because of my preference.

Honestly, I do not believe in statistics anymore. I quoted the statistics my doctors and a specialist gave me at the time. Whether the chance is 1.9 out of 100 or 10 out of 100, I would tell someone to listen to their heart rather than the numbers. I wanted the 'natural' experience so much for me and my baby girl that I went against my gut feeling that I should go with a repeat C. Ultimately, we all have to live with the decisions we make. I just wanted to present a 'real life' example in case it could help someone.