I have been advised to have a planned C section next time due to a 'classical' incision last time.. Apparently there is a chance of uterine rupture which is apparently fatal if bub isn't out in 10 mins.. However the chance of rupture is 1 in 20 as opposed to the normal 1 in 200 with a normal c section scar.. I had such a traumatic birth with the twins, but to be honest never wanted a vaginal delivery (Or wasn't educated enough to think a twin pg with heart condtion mama was an option, through no fault of the hospital, mind you, just my own perception ) Now however I have done more research now than I did before or while I was pregnant and I would love a vaginal birth.. Trouble is do I risk it? Is it a risk, or do I just have trouble having faith in my body?
I think you really need to be in a big hospital where threatre is ready to go if needed, there are a few girls on here who have lost babies or come close this last year with uterine rupture, maybe you could trial labour and if it is'nt progressing well in a certain amount of time then go with the section.
Good luck with your decision.
Teagz I agree with you definately, but I also have a 1 in 20 chance that my children could have a heart defect passed down from me (they are the odds I was told) and I had 2 babies with perfect hearts.. (Would have been if not premmie)
TBH I think I am just traumatised and disappointed with the whole outcome, but definitely a healthy bub is no 1 priority and I would be happy just to have a live baby no matter how it got here.. Just wanting other peoples thoughts..
I think that is too difficult a question for anyone except you to answer, mate. Personally, with a previous classical incision, I think the odds are too high... but then I have had two great births, so it's easy for me to say.
I think you should have a chat with an experienced midwife or an OB who is pro-VBAC. They can't tell you which decision to make, but they can go through all the possibilities with you.
The other thing to consider (particularly if you decide you are going to have a repeat c/s) is that you can make it a better birth even though its a c/s, KWIM? You can decide exactly what you want from the birth and find the OB (and hospital) that will give it to you (e.g. having baby with you in recovery, etc). All the best for your decision.
Hey hun. Depends if you're the gambling type I guess - concerning the odds I mean.
Ultimatley your body will do for you what it needs to. I'm a true believer of that.
I didn't have the traumatic expereince you did with the twins, but I did have an average first birth. I wanted a VBAC the second time around. Like you I had done my research.
My waters broke - and then my body did nothing. In theatre they found out I had a uterine rupture. One that they think happened at 24 weeks preg. Nate wasn't born until 39 weeks. My body knew exactly what to do to preserve his and my life.
There is lots of research and lots of stories, but none of them are written about your body. FInd a great obstetrician and weigh it all up with your cardiologist. Good luck and I truly hope you get everything you want.
Difficult decision, although if it were me I'd be willing to source the facts/research to substantiate your Ob's claims - which may be fair, but I also don't think it is fair to scaremonger a woman into a c-section. Obs are surgeons, and are known to favour c-sections, as this is their specialty. In any normal instance a vaginal delivery is safer for mother and child, so I'd want to be really certain that this information is not biased/flawed. Especially as a second c-section may increase the risk of uterine rupture and miscarriage in a subsequent pregnancy.
My mother had a 'classical' c-sect cut in her first pregnancy, and went on to have 3 perfectly normal vaginal births. Her vaginal births were encouraged by her Ob and she never spoke of a 1 in 20 statistic for uterine rupture - which makes me a little suss...
I would be seeking the opinion of one who specialises in normal birth, such as an independent midwife. Chances are they may have dealt with this particular issue/risk on many occasions with positive outcomes.
Best of luck with your research - although I do agree it is a decision which may become easier with time as your pregnancy progresses. If you feel as though everything is going well and your baby is thriving - you may feel more comfortable and safer attempting a natural labour, if this is what you truly desire for you and baby. The means will be there for you to have a c-section at any point regardless of your decision.
Just make sure you feel supported in your desision and do not let anyone berate you if it is a well informed decision. You may also wish to check out calmbirthing and hypobirthing methods/courses - I believe they would be of great assistance to you (and your heart!) regardless of which way you choose.
PS - I am really sorry for your loss. Your wish for a healthy baby born from a natural labour have been added to my prayers...
XX
Last edited by JellyBean; September 11th, 2009 at 06:28 PM.
: added info
I had two very tramatic c-sections and when it came to bubs number three I was desperate to have a vaginal birth. i don't think I would have coped having another c-section. I didn't have the higher risks (with the scar) but if I did i would have attempted a VBAC anyway. The reason I would have attempted a vbac with those odds is because I would never have been able to forgive myself if I didn't try. I had PND with first two bubs (I believe due to the c-sect experiences) and really struggled. So I had a vbac.
But thats me. Ask yourself how u would feel if you didn't try a vbac. would u be happy with a c-sec? There are women out there who have fantastic c-sect experiences. I guess it really comes down to what U want and what risks you can comfortably take.
I was happy to take the risk of not monotoring during labor (against obs reccomendations) but I wasn't comfortable to birth at home. Maybe u would be comfortable to have a trial of labor in a big hospital where they can have you in surgery within minutes. Or maybe you just arn't prepared to take the chance at all. Really your the only one that can make the decision..... I guess what i'm trying to say is - there are lots of factors that you can consider. Its not just c-sect or vaginal. u can look at monitoring during labor or u can request to lift your baby from your tummy (when having a c-sect) and onto your chest. If having a c-sect U can also state that u want bubs straight onto your chest and in recovery with you. It really depends on what is important to you.
I hope i've made sence
Before you even answer this question take time to evaluate, reflect and research. If you don't have to make a choice now then don't as by the sounds of it there is a fair bit of fear in the way right now and a whole heap of trauma.
For me I had to go into some serious couselling and debriefing before I made up my mind to try VBAC as I had many issues that ranged from fear my body would not work the way I thought it should to fear of something happening to my baby. The biggest thing though is that your supported in your choice wither that be an OB, midwife doula etc. I would say talk to people, see another OB who is pro VBAC or even chat with an independent midwife who has helped women birth after trauma and loss.
Take time to nurture yourself as at the end of the day fear is what drives us to make choices we might not truly want. It is also what allows us to let others talk us into things we might not want.
I am not sure the statistics but when looking into VBAC (after classical C/S) that it is important to remember a classical C/S at 24weeks (although with two bubbas in there would be higher) is different to a classical C/S at term or there abouts so these statistics might be different if looking at your average VBAC after C/S (classical)
Because the uterus isn't fully stretched in late 2nd trimester/early 3rd trimester the area which is cut is often the middle of the uterus and the higher up the incision the greater the risk of rupture as its the top section that contracts during labour. The later the C/S is performed the lower the incision generally is which makes the incision in the area of the uterus which has less strain. This is the same with a lower segment C/S and a classical. The larger the uterus the thinner it is and the smaller the scar tissue will be when the uterus is healed.
Classical C/S were the norm years ago and to my knowledge VBAC was encouraged by almost everyone (back in the 50's) now people meaning Drs, midwives are less likely to take the risk due to litigation changes so we are not seeing as many. Same with elective breech vaginal births. They are so uncommon. If we were having this conversation 20years ago I am sure it would be definaly VBAC. Its definately achievable if thats what you want. I am sure when the time comes unless you get someone nasty you should be well looked after in what ever birth you choose.
I just wanted to add after looking at your site for your boys that I think you are an incredibly strong woman and I honestly think that by the time comes to bring your next little one into the world you will be an empowered, strong birthing mumma. Go gently and take the time you need I say to do what is right for you.
I too have visited your site and have prayed for joy to come to you.
I had a c-sect at 36 wks with a very small bub (1.6kg) who had significant heart disease. I am now in pre-labor with bubs #2 and am planning to go to our major, public, tertiary hospital (where my son was born and has had much treatment) with my private OB for a VBAC. I had the lower scar c-section so my chances of rupture are smaller than yours but to offset the risk I am going to have a jelco in as soon as I get to hospt, we are going in when contractions are 10 min apart and I will be having CTG monitoring on for 30min on and 30min off.
I did my research, worked through a lot of fear with a counselor and had many talks with my OB who I TRUST. And now I feel ready to birth this baby.
You will need time to work through this. It is obviously going to be huge for you since the birth was traumatic and you lost your boys. You will come to a decision that is right for you, your DH and your baby when you are ready to.
Just wanted to ask are the stats you've been given relating to "natural" labour, or do they include induced labours? Many studies have shown that there's a greater risk of rupture with inductions, so perhaps that has skewed these statistics?
I ruptured with my last pregnancy and lost my daughter. The risk is 100% if you are the one who has lost your child.
Hindsight is a wonderful thing and if I had gone for the section, I would be nursing her now and not visiting her grave.
But it is a personal choice and you have to have weighed up pro's and con's and your emotions either way.
Good Luck with your decision,
What beautiful boys you had, forever in your heart.
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1 in 20 are they good odds??
) Now however I have done more research now than I did before or while I was pregnant and I would love a vaginal birth.. Trouble is do I risk it? Is it a risk, or do I just have trouble having faith in my body?
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