Time taken for emergancy c/s

Hi there,
I had an appointment with my ob yesterday and we had a lengthy discussion about my VBAC birthplan. The only thing that is bothering me after our talk is what he said about a realistic time to get an emergency c/s.
I have read in VBAC studies that 20 minutes is the ideal time for a c/s if a uterine rupture occurs. My ob says that it would be unrealistic to claim that you could achieve this with any kind of regularity in any hospital in Australia, and that if it was an actual requirement then noone would be able to offer VBAC. He said that it would be safe to say that you could be in surgery inside an hour. I don't think he was trying to put me off, just being honest.
I don't want to focus too much on this as it is the worst case scenario but it is playing on my mind. Is an hour an ok length of time if my uterus ruptures?

I had an emerg c section but only due to getting to 8 cms and not being able to prgress so not the same as you - but from the time we decided on the c sec from the time Bella was born was 46 mins all up so fairly fast - that included signing of forms and getting me dressed and getting DH dressed as well... I guess if it was a huge emergency like a rupture then it would be faster than that!?!

HTH
Kate

Its quicker with a uterine rupture. Hopefully Nai will pop in here cos she just went through it.

With a normal c-section in "normal" emergency situations (eg failure to progress) they do have a bit of time up their sleeve - with uterine rupture - they don't. I'm pretty sure that most of them knock you out too, to save time with worrying about the epidural and stuff.

Well, thats what was explained to me anyway.

I have just had that experience with a uterine rupture and I was in theatre and the baby was out within 20-30min BUT I was already in the hospital and it was the Royal Women's in Melbourne. Also I identified to the OB that I had a pain across the front of my uterus that was not subsiding with the contractions and she correctly identified a uterus that was about to rupture. When I was cut open she just touched my scar and it burst open so she thinks we probably only had 5 more minuted before I ruptured in labour.

However - the hospital does about 600 VBACs a year and has about 2-3 ruptures a year so it is very rare - unfortunately I was one of them, fortunately I was in the right place at the right time for a good outcome.

ETA - snap Mel, you read my mind :D

Hi,

I'm due in 5 weeks and I'd planned to have a VBAC too but yesterday when I had my normal appointment I asked me OB what happened if the worst happened and I ruptured. She said that the hospital would have to call her and she would come in and assemble a team. My thoughts where the same as yours. Surely it's not safe to wait that long for her to arrive!?!? I'll be a the Wesley. Now I'm thinking that a c-s is the way to go....I've no idea what to do

I think it's important to understand that when it comes to caesareans, there are emergency caesareans....and there are true emergency caesareans.

An emergency c/s is classed as one that is unplanned and occurs after some labour. This includes "failure to progress", fetal distress etc. Most times in hospital it can be up to an hour before you will get into theatre because although it is considered an "emergency" c/s as per the definition above the situation is not immediately life threatening.

In a true emergency - for example a total placental abruption or a serious rupture - you would be in theatre much quicker than that. Sometimes in under 10 minutes depending on the seriousness of it.

It's also important to recognise that there are varying degrees of uterine rupture - yes there is the catastrophic kind but some ruptures are also small, or the uterus doesn't rupture the whole way through. So there are lots of variables.

But if it were a serious rupture you will be into theatre pronto. I think that this is a scare tactic. Ask your obstetrician what the hospital does when someone comes in to the hospital on short/no notice with life threatening injuries. They get their act together and get them into theatre immediately. This is a daily occurence in most hospitals.

KellH - the Wesley is notorious for poor support of vbac and has an extremely low rate of successful ones, not surprising for a hospital that has an excessive primary caesarean rate.
Watch out for the "bait and switch" - yes yes yes we are supportive of you having a vbac. You get to your last month and suddenly there's a multitude of reasons why you can't have it and you feel too trapped by being so far along to do anything about it.

I too think that it's a bit of a scare tactic but it's worked. I just couldn't bear it if something went wrong. It's so strange because until yesterday I was 100% sure that a VBAC was the way to go but after speaking to my OB and visiting a friend at the Wesley who had her baby on friday made me realise that there is a little person inside me and they are depending on me making the right decision and there is a little boy (2) at home needing his mummy to come home safely. I'm sorry but I'm starting to get a bit emotional about it all...

kell

Tobily - I asked her how many the Wesley sees and she said maybe 1 per fortnight. I didn't think to ask how may where successful. I was really surprised by this low rate too. I then started to worry about how much experience they have....in this day and age I would have thought that VBAC's would be supported and encouraged more than that!! Thank you for talking to me about it. All my friends had natural deliveries (or haven't gone for #2 yet) so there isn't really anyone to talk to about it.

Good luck berrme with whatever the outcome!!Exciting although nerve wracking time so all the very best to you hun and I hope you are able to achieve your VBAC, will look out for posts to find out...

I had a "emergency" CS 12 months ago my OB has stated in DS file that is was Failure to progress due to an abnormal shaped pelvis.???

From the time that my OB said to pull the pin on a NB it was roughly 40 minutesish. And they had to call in an anesthetist and pediatrician before they started.

Northwest Private in Brissy also has a 50% CS rate also. I was advised if I wanted to go VBAC for my next bubby to try at the RBWH but after reading Nai's post I think I move to Melbourne...LOL!!

Wow, thanks for all your fast responses.
Nai: It is good to hear from someone who had a rupture and it turned out ok!

My c/s was an emergency c/s due to preeclampsia. I was induced at 38 weeks but my blood pressure went nuts during labour so off to theatre we went. I think it was about an hour that time, but I was waiting in theatre for quite a while as they were waiting for my platelet count so they didn't have to give me a general. It is all rather blurry though.
My ob has told me that the only difference between me and a first time labouring mum is the small risk of rupture. I am at North West, but he has told me that while only about 10% of his patients attempt VBAC, around 2/3 are successful, and I have as good a chance as any. As long as the preeclampsia doesn't return. He has said that going to 42 weeks is ok and hasn't asked me to schedule an in case c/s date either which I have taken as a good sign.
He did also point out that not all emergency c/s were real emergencies and all that could be done to get me in there quickly would be done in a true emergency. Delays are generally due to getting an anaesthetist during the day as they are so busy. Apparently not all anaesthetists will work on obstetric patients as we are 'higher risk'. It seems that if I am going to have a rupture I should do it after hours as there is always an on call obstetric anaesthetist and empty theatres.

Do you mind me asking....Which OB at North West?

I had an emergency c/s due to pre eclampsia.i was 37 weeks 4 days high b/p,protein in urine, swollen ankles u name it i had it. a couple hrs later my baby born was born

My ob is Martin D'Arcy-Evans. I really hope you aren't going to tell me he is full of crap now! That would be very disappointing. He said that the other obs on his rotation roster had the same general view; there are risks involved but they aren't high enough to say that the patient can't have VBAC as an option, they just watch you closely.

KellH: I feel the same way about not knowing enough people who understand the decision we are making. Noone close to me has questioned that I should be able to do it, but I find myself explaining risks and benefits etc when it shouldn't be such a big issue. There just isn't enough knowledge in the general community! Most people look surprised when you say that there is an option other than another caesar. Not very helpful when you just need someone to reassure you that you are making a good decision.

Berrme - I think in the last day I've talked myself into another c-s. My partner is completely open to either option which is frustrating cause it would be nice if he made the decision for us!! I'll probably change my mind 100 times between now and my due date 9/4/09. I just keep coming back to what I've read on other forums that it doesn't really matter how bub comes into the world as long as they came safely. I just had such a rough time recovering from my c-s with my DS (he was breech) that I couldn't imagine looking after a toddler and a new born in the pain I was in. But having said that I'd take whatever pain was needed to ensure bub was safe and healthy. Sorry not being much help to you. It's just nice to vent to someone in the exact same position.:)

berrme, I saw Dr John Howland, No the only reason I ask is that a girlfriend of mine is seeing Dr Bob Watson and is quite supportive also. As is Dr Tuicolo.

I agree with what you said about lack of information but as someone said to me the odds are stacked against us (us as in women who want to attempt a VBAC....Including me!!) when to me that is just a joke, We need support, guidance and a whole bunch of "YOU CAN DO IT"attitude to get us through even when we think we can't.

I think contemplating the thought of a VBAC is an achievement in itself, But I think you have made a very brave and very empowering decision, I hope that you get the birth experience you are looking for. I'm sure we could rally up a little "YOU CAN DO IT" Have faith in yourself and your body squad if need be too..LOL. Ultimately it's your decision but I think...YOU GO GIRL!!!

My GP has told me that you have as much chance as a VB as a first time mum about 70% but yes there are risks. Pretty good stats if you ask me!!

Have you thought about a doula? there was a post about a week ago... I'll see if I can find it for you.

My DH keeps telling me he supports whetever I want to do. I would love him to make the decision for me too! I am in the process of printing out some info on VBAC for him to read himself instead of everything coming from me. Then he can tell me what he thinks for himself. It is his baby too, afterall.
I don't think I would be able to ask for an elective c/s unless there is something else wrong besides a scarred uterus. I also can't imagine not being able to pick up my 2 year old, or play like his mummy is supposed to. So many reasons not to have surgery! I just get a bit scared at the prospect sometimes. I am already feeling better about it than I was this morning. Having people point out how quickly hospitals can act when they need to has helped. They don't want my baby or me to die either. In the end we can only do what we are comfortable with, it would just help if everyone else was comfortable with it too!

I had an emergency c/s under general anesthetic. I was induced at 36+4 due to abnormal foetal movement and heartrate. About half an hour after having my waters broken (with meconium) and then her heart rate not recovering after contractions, I was rushed off for the emergency c/s. From the time the ob said c/s under general in the birth unit, it was literally about 15 mins before I was in theatre, then about 5-10 mins before they had her out.

If its a true emergency, which you would think a suspected uterine rupture would be, then they would have you in to theatre asap.

All the posts have gone out of order... weird.
Dr Watson is one of the other obs I could end up with if I am inconvenient and have my baby after hours, so that is reassuring.
I am feeling much more confident today. I spoke to my mum about it, and she made it sound so simple. You give a natural birth a go, if it doesn't work then it doesn't work. We have been through an emergency c/s before, we can do it again. And there is no reason to believe that I would not have birthed my baby without any problems if it wasn't for my bp, so why not this time? I remember very clearly my ob saying that it was a real shame that we needed to go to surgery as it was going along very nicely otherwise.
Thanks Deevine, that is very reassuring. I know they will do their best to get me into surgery asap and I shouldn't let the thought of delays put me off.

Berrme - Dr Watson is an EXCELLENT ob.. I'd highly recommend him to anyone. He is my sister's ob and I've met him and he is just wonderful. I hope you get him if you can't get your own ob at the time!

Good luck

I had an emergency c-section at the Mater mothers in Brisbane.

The cord prolapsed, then within 10 mins, I was taken into theatre, cannula in, under a general and bubs was out.

That is 10 mins flat!!!

Mind you this was in the middle of the night (only one operating theatre going but still, no planned c-sections to contend with.)

I was told if it had happened during the day it may have been different with two theatre's on the go the entire time I may have had to have waited to pull someone out of a theatre.

I am going to try my hardest to make sure that I have any issues after hours. I don't want to be fighting over theatre space and time with the scheduled c/s patients! :)

I think the best option is for me to plan to be one of the 70% of VBACers that is successful so I won't need to be rushed into surgery. Much less stressful than focusing on the worst case scenario.

berrme, The scheduled CS paitients will wait!! They will get pushed back. I was supposed to be induced the day I went into natural labour..I was told that afternoon that unfortunately the hospital was full so I'd have to wait until the following day because there were people ahead of me needing inductions etc and when I told John I wouldn't need the induction he just made a call and someone else had to miss out....Sadly for whoever that was but at the time I really didn't care. Northwest regardless of the CS rate is a fantastic hospital, they will look after you whatever time of the day or night...when you have your bubba VBAC....Your an inspiration, successful 70% here you come fingers crossed....

I've just seen this....Might of use to you

Hope I do this right....

https://www.bellybelly.com.au/forums...-brisbane.html

Eeeek doesn't look right...

Thanks Bronzdbebe, I was only joking about not wanting to inconvenience the elective c/s patients... and they were really great at North West last time so I have every faith they will look after me this time too. Of course I got my own room and milo and vegemite toast at midnight feed times as the midwives thought I needed rest and special attention after the PE and emergency c/s. If everything goes to plan I don't suppose I will warrant such special treatment this time. :lol:

I did attend a VBAC stats and facts night recently here in Bris. I didn't really learn anything new stats wise as I have read everything I could find on the web, but it was very nice being in a room full of people who also thought VBAC was a good idea. It also made me appreciate that my ob hadn't tried to talk me out of it after hearing stories about what some of the other women there had been told by their obs. Unfortunately the VBAC panel that I wanted to attend is a couple of weeks after I am due, so hopefully I will have had my VBAC by then.

What Milo and Toast....I got ripped off!! LOL!! Sounds like you needed it though. Walking to the shower though hun kicks that vegemite toast's sweet little butt!!!!!
I'm getting so excited for you. Sending you lots and lots of sucessful vibes....:D
That's awesome news about the VBAC night. I bet it was great to see all the other mums,very inspiring. I'll have to go to one of them when it's my turn. Really looking forward to hearing how it all goes. so make sure sure you keep us up to date. Good Luck!