after u/s appt. also posted in VBAC forumI had my appointment yesterday. I found out the following:
My Placenta is anterior and ends about 3-4 inches above my previous scar - so if I did have a rupture it has a high probability of adversely affecting my placenta and its attachment.
My uterus measures about 1.5mm about an inch above my cervix and 1 mm a bit above that. I'm not sure how accurate the ultrasound is, but I was able to see the muscle wall in the location that had 1.5mm and it was nearly invisible at the 1mm location and the dr. said that I could already have a window in that spot. Since he could not really measure the myometrium at the place where it was 1 mm, he also measured all of the layers in that area from the myometrium and the bladder wall and all of that measured 3mm. I know that studies show that at 3 mm the measurements are way more accurate. I can't say for sure what all of the numbers really mean based upon accuracy. But I did see the different layers with my own eyes and it was not encouraging. Studies I have been reading that correlate rupture and uterine thickness show a higher percentage of rupture (like 18%) for women who have a measurement by u/s of 1.6 or less.
He did say that statistically, I could very well have a successful vbac, but if he were to say if he was to guess if I was a good candidate he would say no.
Thanks to my research and the support and information provided by all of you online community mamas I was really able to get all of my questions answered. I think that he was prepared to intimidate me, but when he saw that I was really interested in the facts, he gave them patiently as I asked. I really saw a turn in the appt. as a result of being educated and being treated like an educated adult and not a new victim to be intimidated. He was not really interested in the beginning about trying to get a good read on my scar and began to make excuses as to why we can't see it, but after he saw how important it was to me and how it was the major factor at this point in my decision, he worked really hard to get the baby out of the way so there were no shadows. He showed me internally and externally where he the thin parts were, so that I would have security that he measured the right place. I know that he was still biased, but I know that the numbers that he received were the actual numbers and felt that I had enough understanding to interpret them for myself. I was able to see everything for my self.
My AFI is 22, so I was disappointed that I am still carrying so much fluid since it will also contribute to stretching out my uterus. He assured me that it was inconsequential and normal, but I know how it has affected my uterus and labors in the past.
So, after asking all of my questions and thanking him for spending all of that time with me (I know they are not in the habit of spending alot of time with patients), I got dressed, went outside and cried with my mom and husband. I knew that my uterus was thin, but I had hoped that it would be at least 2 mm. Considering the window that I had last time, I knew that I could not afford to take the risk of VBAC if my scar measured less than 2mm.
I still feel kind of frustrated, because I feel like if there are women that VBAC after a dehiscence why can't I. What is the difference between them and me? Then there are equal numbers of women who vbac after a dehiscence and have catastrophic ruptures and I think why does that have to be me? Can't I be different than them? But I think that I am not. I think that all of my research has pointed out that I am more similar to the women with catastrophic ruptrues who have gone before me - and to whom I feel very grateful that they shared their stories and made me look into and research my body and the information very deeply.
The baby was beautiful and looks just like my husband. I want this baby and I'm not willing to risk his life with the same math mathmatical chance as russian rullet. I am going to schedule my c-section today at my appt with my ob. This journey has led me to understand that I can have my c-section be as much like a birth as possible. I want to see my baby with all of the blood and vernix. I want to see my placenta. I want to cut it when I am recovered. I want to see my baby come out of me this time. I want my baby skin to skin in my arms as mine this time - I don't want my baby given to me wrapped in a blanket - I want it in all of its new born glory.
I do secretly hope though that I miraculously dilate to 8 cm without know it and go to the hospital with my baby crowing and push him/her out. So please send those vibes my way. I'll be in touch. Thanks for everything. Feel free to give your two cents, even if you disagree with my decision. I am really grateful to all of you and I am excited because - I'm going to have a baby!