Vaginal birth after surgery?

Hey all,

I have a big phobia of having a c-section and I'm trying to come to terms with that is what might happen due to a few factors, but mainly due to surgery I had between my last pregnancy and this one.

I need to hear from other women that have possibly been in the same situation of having babies after a few uterine/ovarian surgeries.

A bit of history - I had a lapraoscopy when I was 15, due to PCOS and had ovarian drilling.

Later in life, I had two vaginal births and was able to have them pretty closely to what I wanted, drug free active births, gravity assisted, etc. First was 8 hours (induced due to PE) and 2nd was 10 hours (requiring membrane rupture 7 hours in). I had to have a D&C few weeks after each birth because bits of the placenta broke off causing uterine infections both times. I am convinced this was because of the rushed 3rd stage.

Since DD was born, I developed endometriosis that grew through my reproductive organs, as well as on bits on my bowel, uretha area. I only found this out when a large endometrioma I didn't know I had ruptured and caused perionitis. They weren't sure what they would find when they opened me up, but found this endometriosis everywhere. I had laser removal of it, done privately by a gynae and it seemed to get rid of it all.

A year later, I had symptoms of another rupture. I was rushed to emergency in a public hospital and they for some reason which I will never understand, did a laparotomy (open stomach surgery) instead of a lap. I don't know what they found, it was very painful and I couldn't stop scratching or throwing up, I was allergic to the painkillers and therefore could have none, I had to leave two days later to be with my kids and had a mental breakdown 2 weeks after the event, later developing post traumatic stress disorder due to the surgery and an abusive marriage which I decided to leave during this time. I now live in another state and still dont' know what happened, or why they did open surgery.

This was two and a half years ago. They didn't sew it up well, the scar was about 25cm and it looks kind of botched now, hurts often. The hospital is well known to stuff things up and have dodgy surgeons.

Have had a scan or two since which showed fibroids. I also developed severe PCOS last year which made my AF stop altogether for months. Basically, it's a miracle I conceived again with my scarred body and endo and PCOS.

So now I'm starting to wonder, if this is going to affect my chances of having my natural birth? I have read stories about people not being able to dilate due to scarring, people not being allowed to have vag births because of open surgery (I have no idea in the world if they cut into my uterus or not).

Because of the open surgery gone wrong, I have a major fear of having a c-section. I have gone to great lengths to avoid any medical input at all into this pregnancy, but I was informed when I went to my first AN appoinment at 24 weeks that because of my PE history, retained products and kidney & liver problems during pregnancy that I can no longer be in midwife care and that I cant' give birth in the birth centre most likely.

I am scared, really scared. I know c-sections these days aren't a big deal, but I woke up from my open surgery with no drugs being pumped in - I felt like I had been gutted. I can handle a lot of pain, I'm an endo & migraine suffere and I had drug free posterior births, but that pain when I woke up from the open surgery changed something in me, it broke me and was a major cause of the breakdown. I am scared of that happening again. I can't have morphine and other major painkillers except pethadine, but they don't like giving peth these days in public hospitals. I can't have any antinausea medication as I'm allergic to it. Surgery and me just don't go together.

I'm sorry this is so long!

I'd love to hear from anyone that has any experience or knows a bit about having a vaginal birth after major abdo surgery.

Tara I'm sorry I don't know much, I hope someone can help though. Its really hard without those medical records. Maybe your hospital now would be able to gain access and let you know? If you fill in a request form, you may not have to get any more involved with acquiring the information. I can totally understand your fears, you have had such an intense time.

I had a vaginal birth after caesarean in November. I found hypnobirthing very helpful in relaxing through labour. I did have a bit of pethadine earlier in labour and that was all. Even when they were stitching me up because I can't have the gas as I react to it.

Do you have a midwife or doula? I think laying this information down to her would help sort out some answers for you. Birth support will become invaluable to you no matter how you deliver. If you don't have a doula or midwife assigned to you, consider it.

Hey Christy,

Thankyou for the reply :hug:

I don't have a midwife or doula assigned to me, because when I went to my first AN appointment through the midwifes at the hospital (they have a birth centre that I wanted to use run by a GPM), they said because of my history, I have to see the hospital OB for all AN appointments now. So I don't even get to see midwives at all according to them. My next visit is in about 2 weeks where I have to see the OB, and I am very scared as there were all these natural childbirth plans I had and wanted to go over them with a midwife in the birth centre, but because of my history it is unlikely that i can even go into the birth centre. I will have to go to the hospital delivery suite which I have been to once for a PROM scare and they are like set up to be medical intervention rooms, not suitable for my natural active labour that i wanted.

I am going to try and face it and see if I can get them to order my prior medical records from another state which I suppose they will do anyway. I can't explain it, but I get very scared of this and do things like cancel my appointments rather than have to face/talk about, or find out more of what happened in that surgery, I'm scared to know. I will have to try and find out how to go about that, as I realize it's necessary now. I was just hoping they wouldn't need to know and they would let me have my vaginal birth, I'm regretting ever talking about my pg history now because so much has been taken out of my hands, and if I hadn't told them about PE, etc I still would be just seeing midwives and going to the birth centre. I havne't even told them about the prior surgeries yet. I realize that is a totally selfish horrible thing to think as it's about my baby's health.

Thankyou Christie..it's reassuring that you and so many others on here have pulled off a VBAC and a c-section is very similiar surgery to laprotomy, so they must allow it.

Tara, a laparotomy is not like a c/section. They both give you an abdominal scar, but the c/sec is uterine surgery. What they are worried about with a VBAC is uterine rupture, related to the uterine scar. they are not worried about the scar on your tummy. I think you are going to have to get your records and take them in.
I think you are talking about the JHH. I don't know what to say to reassure you, but I wish I could. I was a high risk patient there too. You will see an OB but the midwives will still do your basic AN care. The doctors don't want to spend time measuring your tummy! Don't regret telling the truth about your history. It's always the best thing. HUGS.

Thanks Castle...I think the did open up my uterus when they did the surgery as it was looking for things in there and on my ovaries and I had a lot of vaginal bleeding afterward that went on for weeks. I guess I won't know until I get the records.

Yes, I am talking about the JHH for birthing this time around and I am put down as high risk. Thanks for sharing your experience with high risk patient there, I feel better knowing I'll see the midwives for the basic things still :) I didn't know that at all, so it's good that I still can discuss birthing with them and hopefully some of my concerns about avoiding medical intervention.

The other hospital was in QLD, I just want to clarify that the bad surgery wasn't at the JHH.

Thanks again Castle, I feel a little better knowing that.

I'd like to a little a quote that is worth reading, if I may...

Quote... just think for a minute. If you were in a terrible car accident and had to have a piece of metal removed from your leg (sorry for the visual there, ugh) .... say they had to cut in to get it.Then they stitch you all back up. What do you expect the scar to do? Do you expect it to fall open when you start to walk? No? Well, okay maybe normal walking is okay, but what about running? Maybe running will cause it to fall open. No? Alright maybe not normal running, but I bet a marathon would cause enough pressure to just rip it open, right?

Hmmmm ... wait a second, maybe not. Perhaps if they hooked the repaired leg up to a machine that mimicked running, it could cause problems ... esp a machine that pulled the muscle further than normal use would, that didn't do it "naturally" (kind of like pitocin!). But for regular use, we expect ourselves to stay shut. We expect wounds to have healed. We expect normal function to be obtainable for straightforward injuries.

If we get a cut or have stitches anywhere else on our bodies, we expect it to stay shut. If we looked at the doctor and said, "I don't think this is going to stay shut", they would be highly offended because we were doubting their skill as a surgeon AND we would be turning our noses up at our body's ability to heal and reams of scientific evidence that it does.

But then when we have a c-section, we look at that and think, OH NO this thing isn't going to hold!!! Do you think the surgeon stitched you up? Do you think s/he is a skilled surgeon? If your old surgeon questions the integrity of your healing, then he or she is expressing a complete lack of confidence in his/her work. Point that out. They need to think about this. If your new OB or midwife is questioning the integrity of your womb, then they need to be confronted about doubting the surgical skill of your previous surgeon. If they doubt his or her skill that seriously, perhaps they need to express their concern to the medical board.

Anytime someone is stitched back together the ultimate goal is to prepare the organ or muscle or whatever to perform its normal function. I have had 2 c-sections. One was with my first and one was with my fifth. The rest have been hbacs. All my births up through the second c-section were to fairly tiny babies, weighing between 6.5 and 8 pounds. My sixth ... the fresh vbac who was testing out the surgeon's skill ... was 11 pounds 4 ounces. I had some nifty pushing contractions. And I can compliment my surgeon for a job well done because her work held up under Normal Use. Giving birth is Normal Use,
yes even when giving birth to an 11 pounder. It is exactly what the uterus was created to do. If we expect that a straightforward incision and stitching should restore other muscles to regular use, then why do we doubt the womb?... End Qoute.

Think about this... the human body, if allowed, can and will do what we think to be extraordinary normally. The above story basically led me to have the perfect vbac in intended on having and I delivered a 10lb 4oz baby with no tears, no cuts, only 2 slight grazes internally that were left to heal on their own. Less than 24 hrs after my perfect vbac I was allowed home. The above story was enough positive motivation to remain focused on my goal even during the heights of labour.

Good luck to anyone contemplating a vbac and keep positive. And do the research, gain the knowledge you need to get you through this stage. If you choose not to know then you're allowing yourself to be put at unnecessary risk and intervention. Remember despite the medical operations of the past, this is still your body, your mind, your birth so you have every right to take control and make it the best birth you can. You need to gather together other people who will be strong and supportive of every step you take on this journey to help you remain optimistic and positive. Let your birthing goddess shine through and show you the way, the right way for you and only you.

Gosh...You poor thing..What an ordeal! I certainly hope you find the answers and support that you need. Good luck hun.

Just wanted to add about the JHH...have you visited the birth centre and Delivery Suite yet? Don't worry about the birth centre being a lovely natural birthing environment and Delivery Suite being high-tech. In fact, what surprised me about the JHH was that although there is a physical difference between the two, it's not enormous.
My first 2 babies were not born there. At the birth centre where I had the 2nd one, the room looked like a cosy hotel room (with a tile floor!). There was a lovely Q-size bed, a quilt, equipment was put away in a dresser and in a wardrobe, the bathroom (bath and toilet) was completely separate.
The JHH birth centre is not like that. There is a large bed and a large bath in each BC room, but it is NOT homelike, definitely still in a hospital. The bath is out in the open, not away in the ensuite. On the other hand, I was surprised that the delivery suite rooms there, were LESS high-tech in appearance than I expected. You don't feel like you're in an operating theatre. The rooms are big. One does have a bath--Room11--you can request this room when you go into labour & if it's free you can have it.
You can bring to the birth of your baby, the mindset of the birth centre, no matter which type of room you're in!
I should add that the birth centre does have a different team of midwives. That is probably the biggest difference between the BC and DSuite. And I don't want you to think the BC rooms are horrible--they aren't--an effort has been made to have them comfortable and attractive, and it IS a more relaxed environment than Delivery Suite. But Delivery Suite isn't horrible either and you haven't failed by giving birth there. In any case, if the birth centre is full on the day, you'll go into Delivery Suite anyway! That's what happened to me ;) .

Wow Caro, you've had a lot done, you poor thing :( Thanks for sharing that and it's great to see you went onto have a vag birth. Did any of your surgeries go into you uterus? Was the adhesion removal successful? That's a worry I have is that I have adhesions in my uterus and around my cervix, I'm hoping it doesn't hinder dilation.

Castle - I desperately wanted to give birth in the birth centre. I was at one delivery room suite for a PROM scare, and it seemed so small! No room for walking around to get through birth, no bars, no big balls or beanbags, etc, which is a big reason that I'm very put off about giving birth there. I haven't gone to the birth centre, but I've heard it's set up way better for a natural active birth.

I'll keep Room 11 in mind...thankyou very much for that. I really appreciate your positive views on it, it's really helping me to feel better about if I actually have to go to the hospital delivery suite. I just need loads of room, my big gym ball to sit under the shower on and I was looking forward to see if a bath helps the pain, especially if I have another posterior labour.

I'm slowly starting to accept some things, that even if for whatever reason I need a c-section that it will be different, not like the botched surgery I had done. I realize I've got to stop putting walls up when it comes to possible intervention. I even plan to keep my 28 week appointment, that is my goal, even though it's in the hospital, I know I'll do it.

Thanks so much again Castle, it really helps hearing from someone that has given birth there. I really appreciate your positive thoughts :hug:

Is your 28 week appt on a Wednesday? Ask to see Dr Bisits if you can. He is director of obstetrics and very pro VBAC. If he can't see you, ask the midwife about which consultant you could see...I am guessing Dr Brown or Dr Somerset. I've had the best luck with appointments first or last thing in the morning.

The rooms in Delivery Suite are different sizes. I've been in several. You are right, some are fairly small. The BC rooms are not huge, though. Do look at Room 11. When you do your tour, ask to see it if it's not in use.

3 of my 4 babies loved being posterior. It's something about my pelvis. I highly recommend Optimal Foetal Positioning, or the newer book by the same author which is geared towards mothers, Sit Up and Take Notice! If you follow the suggestions, you can minimize the chance of another posterior labour. Now is not too early to work on positioning. Give it a go! And I'd love to hear how your appointment goes.

Hey Tara,
Thinking of you.
I think the room that you are talking about is the little assessment room, tucked into one of the quadrants corners? It is really tiny but generally not used for births.
I echo all that Castle has said. See Andrew, he will listen to your fears and what's more he will advocate choice.