Death twice as likely by caesarean

[MantaRay]

Isn't the risk of uterine rupture with VBAC still very low? I thought it wasn't much higher than other vaginal delivery in most cases.

[BellyBelly]

When my clients have been pushing for a long time and close to a 'cut-off' I get them in a supported squat position. My last client was fully dilated for an hour or two then given an hour to push, they were getting out the lithotomy poles when I suggested the squat and baby's head was on view right away. This happens often and usually a change of position to better facilitate pushing works well. Flat on your back/reclining is harder for you to use your stomach muscles and is more painful, and more likely to tear. So many are having epidurals that standing is even not possible for a big percent that make it to 10cms.

Rupture is a risk with an induction, caesarean or VBAC. The risk of rupture is 0.7% and that includes everyone, not just VBAC women. Consider that if you have an amnio you have about that or more risk of miscarriage, but its seen as far more acceptable and recommended by the medical profession. Yet VBAC is far less supported even though its very healthy. I've supported some awesome VBACs, not only did the mums get their VBACs but drug free too. Amazing things happen when you believe, get great support and put your heart and soul into it. Not to mention a VBAC supportive carer/place of birth.

[maz]

ON a completely different token here girls

I love the fact that this is one discussion that is very personal to some yet it is being spoken about in here tackfully and respectfully manner to each other

I will keep my opinions out of this but thank you for being so open and sharing your thoughts on the matter.

[BellyBelly]

After one c/s it's 0.7% and after 2 c/s or more it increases by a measly 0.2% to 0.9%. Your scar is strong and heals well, you dont hear about people having open heart surgery and their heart popping open again after being stitched up! So why is a uterus any different?

[Beach Mama]

Been following with interest and I agree with Maz! Kelly is there any research about rupture and births close together?? Mine will be 16 months apart so although it hasn't deterred my determination for a vbac I just wonder if the risk is higher when they are so close together? Also isn't the risk of u/rupture the same percentage as the risk for cord prolapse in any vaginal birth?

ETA- Also, what are the signs that a rupture has occured? Would you know while in pain of labour that there was something else wrong????

[BellyBelly]

You could never compare it to cord prolapse because you could have a midwife or Ob rupture the membranes on a high baby and get a prolapse which was completely unavoidable in the first place. I think Obs like the scar to be healed for 12 months but prefer 24 but I am not sure with the scientific answer sorry.

A good Ob would recommend you not have an epidural if you have a VBAC as you will be quicker to spot a rupture in the RARE event it will happen. An epi will cover the pain. But my teacher who has been doing support for almost 30 years has only seen one rupture ever and they actually were able to repair it and she saved her uterus. Thats one birth in 30 years of practice. Also you have to remember that rupture rates are increased by inductions, so they wont induce you, or if they do they are VERY silly. And I mean pharmaceutical inductions. You can still rupture with no prior c/s but if you are induced - so why aren't people afraid of inductions? You can even lose your uterus from haemorrage. It DOES happen. But people are more comfortable being induced than a VBAC. Don't get it.

Maz - natural childbirth rarely does go wrong - its a process as natural as digestion. Sometimes we get digestive disorders but heck the world has a functioning digestive system that serves us well! But vaginal birth can go wrong where inductions have been involved, forceps etc. Natural (i.e. vaginal + NO drugs or pharmaceuticals) is the way of minimal complications. Its just a fact that there are more complications with surgical birth and again, its not something we should hide from the public - they would be outraged if no-one said anything. For some women it's needed and in those cases then the benefits definitely outweigh the risks.

It's just a sad fact that many women are having unneccesarians and the wool is being pulled over their eyes. Its all in the care of the woman and how she is treated - and what support is available to her. As someone said to me today after asking what I do, 'I had continuity of care from my ob! I was induced twice at 9 days past my due date so my Ob just did a ceaser, so I already had continuity of care.' Of course we can all guess what happened with the second birth.

I'm glad she's happy with that though, I wouldn't be. We take too much as gospel.

[BellyBelly]

Speaking of digestion, here's a great article

Birth as a Bowel Movement

ps. it's okay, throw tomatoes, I can take it! I have seen enough behind the scenes of birth to know that some things happen far more than once

[maz]

I have had 4 c/s - 2 emergancy c/s and 2 planned. with my 2nd pg I wanted a VBAC but as I went into early labour (it was stopped) at 34 weeks - I had to have a planned c/s due to my scar being torn internally from contractions. I had a nice black bruise across my scar for well over a year due to this.
I get really peaved at this mummies who are to posh to push as it gives us mummies who really cant do the ah la natural birth (and we really want to) and have to have a c/s a bad rep.

YEs, its great to know the facts but I get so sick and tired of hearing all the negetives about a c/s and statistics along with it. We dont hear the bad things about natural child birth.

I think people need to tread carefully on this subject as yes, It is very hurtfull to continually hear that c/s's are terrible and without realising it, people can often make us feel like second class citizens

Apologise to anyone I may peeve off about my post - and for not keeping my mouth in my draw PMSL

[*Belle*]

Is it the risk of uterine rupture still low if you have more than 1 c-section? or have VBAC close together to the last c-section? What happens if you do rupture the uterus? do you have to have a hysterectomy?

ETA - BB what you wrote is very interesting thanks for that info. Its amazing that amnio is more accepted than VBAC thats horrible.