Getting over rupture risk - how did you do it?

[RoyaUK]

Hi there,

I'm currently 35 weeks and in a dilemma. I have previously had 2 'emergency' c-sections and second time round i ended up with an inverted t-shape scar (unknown size).

I have been very passionate about wanting to go for VBA2C but now having spoken to a very pro-VBAC OB and reading on vbac.com that the risk of rupture of this type of scar is much higher (estimated between 4 - 9%) than a straightforward VBA2C i don't know what is the best thing anymore.

In my head i turn this around, as did the OB, saying there's more than 90% chance that nothing will happen and whilst I can accept this in my non-labour state, I'm worried it'll be all i think about when labour starts. Also my DH is obviously concerned too and doesn't know how he will be able to give me 110% support when he's thinking about this risk.

I'll be having an independent midwife at home and then transfer to hospital when appropriate and she's very supportive.

What did you do to give yourself & your DH confidence? Did the risk play on your mind when in labour?

[RoyaUK]

bump

[julie_ann_jules]

Hi!
I had a VBA2Cin March 09
It is totally normal to have times during your pregnancy and labour where u doubt yourself! When I was pregnant I had days when I though that the worst things possible were bound to happen to me Those were the days I chatted with my independant Midwife or read positive birth stories. So it IS normal to wonder and worry about the risks and wether or not you are making the right decision. I looked at the stats and decided that I had a 95% chance that I was making the right decision...... 95% chance that I wouldn't rupture and all would be ok. I then had to decided if I was willing to take that 5% risk. For me my caeserians are still very painful memories. I don't think I would have coped emotionally if I had an ecective c/s. I needed to know that I wasn't broken. I needed to know that my body knew what to do. I needed to try. That 5% risk I took was completly selfish. It was for ME! I had PND with my first two bubs and I just knew it was linked to my c/s. I am not saying that you are broken if u have a c/s or that u should have a VBAC..... that is TOTALLY your decision, I'm just trying to share my thought process

I read lots of info on uterine rupture. I memorised the signs and symptoms of rupture and would have told my IM if I had any of them. There are lots of decisions u can make. Personally I chose not to have continuious monitoring. I have read many birthstories where women had continious monitoring as they wanted to know how their baby was coping and if anything was going wrong. Maybe you would be prepared to attempt your VBAC if your IM kept a really close watch on bubs heart beat. Maybe that is something that would make you feel more comfortable? Maybe you would be prepared to attempt a VBAC in a hospital setting rather than at home? Maybe you would like to have an IM and doula with you for the extra support? I guess what I am trying to say is...... its not just black and white. A homebirth with an IM is not the only option. Yes it is the ideal option to suceed with your vbac. But u need to be comfortable with the decision that u have made. You need to do what feels right for you.

When I was in labour the though of rupture did enter my mind. It was early on just before I went into active labour. When I was in active labour I could hear everyone around me and I knew exactly what everyone was doing but I wasn't thinking about anything really. I was really spaced out. With each contraction I was repeating in my head to relax. At one point the contractions were so horribul I didn't think I could do it. I wasn't scared of rupture but I just didn't think I could do it. Looking back I was in transition. So those thoughts were completly normal. They were no different than a first time mother in transition (or a 4th time mother )

My VBAC was an AMAZING experience. I still get tears in my eyes when I think about it! i really hope u have the birth of your dreams
Jules

[Hannahbanana]

I had a VBA2C in july after 2 elective CS.
First was for breech. My second CS was my choice because I was scared of the risk of rupture. I did not educate myself about VBAC and could not see past the 'chance' that I might ruputre.
Before being pregnant with #3 I asked myself the question "will I regret not giving myself the opportunity to VBAC". After thinking about it I decided to get educated about VBAC and also the birth process.
Informing myself and educating myself took all the fears about rupture away and I knew that for baby #3 I would be having a VBA2C.

I think that educating yourself about VBAC is very important in any VBAC attempt BUT learning about labour and how your body works to bring your baby into the world is essential. If you educate yourself about the process of birth and what your body should/will/is doing during your labour then that knowledge gives you the confidence to believe that your scars are strong and your uterus will hold up to contractions and birth.

I had never experienced labour and had no idea what 'normal' was, but rupture was not something I worried about while I was having contractions, I was too busy trying to just get through them one at a time. I did think about it in the early stages for a moment when my labour started but then when things ramped up it never entered my mind again.

Has your DH read anything about VBAC and birth?? I know it is not always possible but, I made my DH read everything I read so he was as informed as I was. The IM will be invaluable to you and also help your DH if things are taking a while or if he is starting to get concerned, so make sure you have a discussion with her about ways to help DH help you. I was a bit worried about my DH freaking out if I freaked out so I discussed it with my IM and she sat down with us and we talked about everything that could happen and how she would deal and help us deal with anything like that. One of the big things the IM said to my DH is that if I wasn't coping and it didn't seem like the IM was listening to me or doing anything for me, not to get upset or angry about it because even though it may not seem like it she would be doing things to help me cope, if it be a position change or a queit word in my ear to help refocus me or whatever, she was never just ignoring me. I think that helped my DH to know that the IM would back him up and give him tools to help me and also take the pressure off him at times too.

When I was researching VBAmultpileC on the net I came across a site that had birth pictures of central or south american women (cant remember which exactly) who had had CS's and some of them had had the inverted T shaped incisions and you could see their scars. I have no idea what the site was called but some of these women were tiny women and they had no trouble birthing after having multiple CS's. The midwife was a man too. I'll have a look and see if I can find it but it was about 18 months ago now.

Anyway, watch some positive VBAC's on youTube and read heaps of VBAC birth stories so that you can get the positive vibes flowing. Good luck!!

[MummyTummy]

The others have given you some great advice, but the other thing that my Ob mentioned to me when talking about the risks was that not all ruptures are fatal, and in a hospital in Australia the risk of it being fatal are actually quite slim. That being said there are just no guarantees either way and you just have to do what is right for you. Only you can decide on which path(s) you are willing to take. It sounds like you are surrounded by a great supportive team - i wish you the best of births!

[blackduckies]

I had 1 VB birth then a CS, I wanted to VBAC and the thought of rupture did'nt enter my mind...I think because eveything went smoothly until 8 cm then bubs got into distress so off for another CS.
Next pregnancy I was determined to try again and i felt focused until I went into labour, I think a lot depends on how smoothly things progress, i had a lot of pain and a lot of blood with each contraction and it just plain scared me..I guess prepare as well as you can, which it sound slike you are and don't take unnessecary risk, that will help alvieate your fears..
I am going back for another try in 11 weeks and i feel all of these emotions.