Actual medical evidence shows that the difference in risk of uterine rupture (the big bogeyman and justification for the insistence on the CS) from 1 previous CS to 2, (so long as we are talking about Lower Uterine Transverse Scar) is negligible, so if it is acceptable to go through a trial of scar after 1, there is no reason not to try after 2, or even 3...... I am 38 weeks and going for my VBA2C.... and no ob has been able to give me any medical reason not to, they mumble and say that they are not comfortable with it. Well, that is their bad luck!! The increased risk of hysterectomy is bigger once you have had multiple CS, but then that increases whether the CS are voluntary (elective) or emergency so again is not a reason to factor in. As Henci Goer says, just say no, unless the risks of not doing the intervention outweigh the risks of doing it. When they say they don't have the facilities, they mean that they may not be able to give you an emergency CS within 30 mins of a rupture occuring, but with any birth things can go wrong, from memory the WHO's stance is that a reasonable CS rate in a developed country is about 7 or 8% (please correct this if I am wrong) which means that in any birth you may need to have a CS quickly, is the hossie saying that they cannot accomodate this, so they cannot manage this % of their maternity patients, and you are only potentially 0.9% of that!! I hope I make sense, good luck with it however it goes!! I"ll post my story on once I have had bub!!
Kate