SIL told she CAN'T birth bub naturally!

Ok, SIL was due on the weekend and her Ob has booked her in for a c-section on Friday.

With bub #1 routine ultrasounds revealed a cyst on an ovary that increased in size over the duration of the pregnancy that would require surgery. Ob was wary of her labouring and erupting the cyst. She had a c-section earlier than planned as fluid levels dropped, and her ovary had to be removed.

Now bub #2 is due. Complication free pregnancy so Ob was happy to see if she went into labour naturally, but warned she would have to have a textbook labour and birth otherwise a c-section would be required because she has a larger scar than normal on her uterus. Bub is posterior though, but Spinning Babies was suggested in an attempt to turn bub before birth.

She had her last check-up today and he performed an internal and told her that there is "No way she will have this baby before Friday, or be able to birth it naturally" Apparently her cervix is still high and she has a 'tight vagina' :o He also told her that she had a greater risk of rupturing her uterus, and hemorrhaging from forceps use to turn bub, and that it could result in a full hysterectomy. He has also said after this he would prefer if she has no more children. Now I know there are risks involved, and I know that they do this for a profession, but geez! I can't believe she is being told this.

This Ob is quite popular as he is the only one in the area and people will travel over an hour to see him, and generally you are waiting more than an hour over your appointment time to get in. But from what I've been told, he likes to play it extremely safe and opts for the easiest option... I'm guessing he wouldn't be a big supporter of active labour, waterbirths or homebirths.

Sorry if this is a ramble, and in the wrong section Mods, but I am just looking for some support for her as she was keen for a natural birth as she didn't get it first time round.

WTF?????/?
u have told her to rid herself of thisman and to [ut her feet up and relax and enjoy the time till bub is born????

I know!! I wouldn't be happy if he were my Ob but he is better than some of the ones you can end up with - 2 cousins ended up with bowel and bladder complications from c-sections :o

Wow thats crazy - she has a tight vagina? So do I! (well maybe before Eden..LOL..) I was a bit scared of having a natural birth for the same reason because I bleed during sex... but as my midwife said to me - your sex vagina is TOTALLY different to your labouring vagina. They are supposed to expand and let a baby through, its what it does!

What a very unsupportive OB of VBAC's.. makes me very sad actually.

wow he sounds awesome!! NOT! lol if it were me i'd be taking my chances with an ob on duty!
get her to read kawazuki's birth story, half an hour after her ob check saying she was still long, not effaced and closed, she had her baby!
just because she's like that now doesnt mean things wont do their thing b4 friday

Yeah Mel, I think we all had a tight vagina once upon a time :lol: and i'm pretty sure someone shoving their hand up there to do an internal isn't something that makes it loose. She wasn't worried about having a vaginal birth except that she would actually experience labour pains this time round
Skybie that is exactly what I said, just because her cervix is sealed up tight now doesn't mean she couldn't go into labour tonight, nor that bub definitely won't turn before birth etc

I dont know whether its an option or not, but can she not be induced?
I was 11 days over and the dr said my cervix was not favourable at all. It was long and tightly closed. The middy gave me the gel and my baby was born a few hours later. Maybe a little kickstart is all that she will need and if worse comes to worse and things go horribly wrong then she can have a csec.
He should at least give her a chance.
Oh and for what its worth, i bet anyone would tense up and have a tight vagina if they had a hand poking around. It was probably cold too ...

i didnt think u could be induced with a VBAC ubba???

i had obs trying to tell me 'theyve seen so many women like me' and i probably woudlnt go into labour for two days as my cervix was long and close, and they were pushing me for induction, but i stood my ground and went into labour within about 4hrs of that battle with them (I just had faith that all would be well and it was) and I was a bit of a shock for the Dr's as I didnt fit their 'textbook' picture, so it CAN change dramatically and very quickly. i also had obs tell me that other women have ended up with a hysterectomy because their labours have gone on too long.. but i chose to go with my instinct which said everything would be fine.

Nope induction isn't possible as he said the extra intensity of the contractions could rupture her scar... Not sure if it's true or not :shrug:

What annoys me is that this guy is a part of a major IVF group, numerous societies in relation to obstetrics, gynaecology and fertility, and is interested in the continuing development of medical education...

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Nope induction isn't possible as he said the extra intensity of the contractions could rupture her scar... Not sure if it's true or not :shrug:

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It is a major risk for a VBAC woman, so he is right there. Also leads to continuous monitoring, which in turn leads to a greater chance of having a repeat c-section.

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It is a major risk for a VBAC woman, so he is right there. Also leads to continuous monitoring, which in turn leads to a greater chance of having a repeat c-section.

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Why would monitoring lead to a chance of cs?

because they jump when a bub decells, which can be normal, also limits movement which can stall things, meaning this is taking too long in their eyes, which we alsoknow can be normal, but a longer labour i think can increase ur rupture chances...not 100% on that though

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i didnt think u could be induced with a VBAC ubba???

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My OB said that there is a small amount of women that will be able to be induced after a previous C section, he said i could be one of them as i was fully dilated prior to needing the EC. but this would need to be done very very slowly but he would be happy to do this should i need to (eg mec in waters)

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because they jump when a bub decells, which can be normal, also limits movement which can stall things, meaning this is taking too long in their eyes, which we alsoknow can be normal, but a longer labour i think can increase ur rupture chances...not 100% on that though

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Oh ok. Interesting. Always makes me appreciate the middies I had more and more whenever I find these things out! I was induced and monitored (I would have chosen to be either way for personal reasons) and the two middies I had followed me around with the stand thingy and held the monitor on my belly as I moved around. They were amazing.

Your poor SIL!
I've got a history of big ovarian cysts too (but not PCOS related) and my obst said they wouldn't cause any probs during labour and delivery (and he was right, I didn't have any probs at all with birthing my babies). Wonder why her ob was worried about them?

Hope everything works out well in the end for her x

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i didnt think u could be induced with a VBAC ubba???

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Thanks Skybie, i dont know much about vbacs, just thought it could be an option :-(

Agree we all had tight vaginas on before birthing vaginally before.

The only thing I would think perhaps increases her risk is the surgery to remove the ovary with the c/s. I would imagine the best thing to do at the time would be to do the c/s, close the incision then take the ovary out so her risk would be no greater then the next lady who has had a c/s. If for some reason they didn't perform the usual lower segment c/s or the incision was much bigger then normal then her risk would be greater but its not like they can remove the ovary from the inside of the uterus so I can't see why her incision would be any bigger then the norm.

Where I work they do induce for VBACS. The only thing they don't do is use the prostins gels but they still occasionally use a catheter (also not common) and they do use syntocinon and ARM. I think it all depends on stupid hospital policies and having the support from the Ob which clearly she will not.

I hope your SIL has a very positive birthing experience and gets the support she needs.

What your SIL has told you sounds very dodgy to me. However it is worth remembering that the OB may have access to more information than us which is making him wary of encouraging the pregnancy to continue beyond Friday. The tight vagina comment is just laughable though. How does your SIL feel? Is she unhappy? If she is it is very important she seeks a 2nd opinion so she can be confident with the decision she makes, whether that be to refuse consent to the CS, or go ahead with what the doctor has recommended.

I wish her all the well in whatever she decides.

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Bub is posterior though, but Spinning Babies was suggested in an attempt to turn bub before birth.

He also told her that she had a greater risk of rupturing her uterus, and hemorrhaging from forceps use to turn bub, and that it could result in a full hysterectomy.

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You can birth a bub that is posterior (my LO came out this way), it's not as comfy but doesn't require forceps to turn bub. Also, bub can turn during labour if they haven't turned before.

Does your sister have a midwife she can chat to?

Perhaps the OB is just erring on the side of caution as rupturing could lead to a very sad outcome of all. My sister was booked in for a c section at 38 weeks because of risk of rupture with second pregnancy. Unfortunately this did in fact happen at 37 weeks - sadly resulting in the loss of her daughter and a hysterectomy for her. She lost 4 litres of blood and nearly her life and was on life support for two days after.

So although your SIL is wanting a VBAC it may not be the best and safest thing.

I hope she gets her longed for birth, complication free with a healthy bub.

Cheers Trea

Thanks for all the replies. The Dr is known for taking the cautious approach at the slightest hint of anything. Hopefully all goes well for her tomorrow

Trea, I'm sorry to hear about your sister's outcome :hug:

Thanks UA - even though it was 10 years ago it still hits me when I least expect it and the memory of holding her and thinking she just looks like she needs to be warmed up is something I will carry forever.

Please let us know how your SIL goes.

Cheers Trea

Belle - Will started out in labour as posterior, then turned around during the final stages of labour - EG at an hour before he arrived, he was still facing the wrong way. So they do turn during labour, but I think the mum has to be able to move around a lot to do that, and if they are monitoring her that may not be easy. Also I don't think they can monitor while in water? which is where I did all my moving.

Good luck to your SIL and hope she gets a healthy self and bub after delivery. However she has the bub.