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VBAC after 4 csects?

post #1 of 18
Thread Starter 
I just stupidly consented to a csect that was not neccesary when I had planned a vbac after 3 csects. I was already going in to labor when I stupidly consented, at least I think I was. The doctor told me that the baby was too big and not engaging because of his size so I consented to the csect. Stupid stupid stupid of me. I was not IN labor, but rather had had definite bloody show a week before and then the day before. So the idea was that the baby was too big and not coming down and I should have gone in to labor because I had the bloody show. They did sonograms every week for the last weeks of my pregnancy and they showed this huge baby.

But when the baby came out, despite what the perinatal doctor said, there was no thinning of my uterus (I am glad the doctor was honest with me about this) and the baby was pretty much the same size as my daughter, who had been a very successful vbac. I immediately went in to a depression and could not even sleep that first night as I kept waking up in panic and anxiety attacks over the csect.

I am 39 yrs old so if I am going to get pregnant again, it will have to be soon, as in, within a year, less than a year. The doctor did concede to me that a vbac would have probably been better. She told me my uterus and my scar was in excellent shape.

I read the post (the link posted) on someone else's post to vba3c+, and it looks possible to do a vbac after 4 csects. Thing is, I am 39 yrs old and always wanted a big family, so I wanted to just never use birth control again and let things go how they go. If that means one more child, great, but if that means 5 more children, great too. These CSECTs are ruining my body!!! I had horribly complications after my last csect where I only found out after that I could have died, I did not know that until I was out of the hospital. I do not want another csect and I do not want my ability to have children taken away from me by a doctor chopping me open.

I am only 3weeks6days postpartum. So, my last postpartum checkup will be in 2weeks 1 day. I am not wanting to go on birth control then. I am exclusively breastfeeding, but have gotten pregnant before while exclusively breastfeeding.

Thank you in advance for your help.
post #2 of 18
Congratulations on your new little baby! I am so sorry that you are having second thoughts about your c/s, that is a hard decision to make and I'm sorry you regret it so much. There is a lady on here who did vbac after 4 c/s, I will try to find the link to her birth story- amazing and inspiring! I consented to 3 c/s that I regret and it is so hard to come to terms with the fact that I have limited my family size because of it. It makes me a little angry personally for the doc to say that maybe a vbac would have been better. Why couldn't they have said that while you were in labor? It sure doesn't help anything that she told you that! I'm so glad that you know that your uterus and scar are in good shape- that is some good news! The evidence does support waiting 2 years, maybe you should look into that a little before you decide. Statistically a 5th c/s carries higher risks, much higher than the risk of rupture that every one frets about. There is a lot of support for vbac- even after multiple c/s. Do the research- you'll find you're not alone! As to your panic attacks, there might be a physical reason for them, often it is a physical problem and not just a psychological problem. I had a LOT of trouble with my adrenal glands after surgery and it caused me to have major panic attacks. A naturopath doctor can help you diagnose and fix a physical problem causing panic attacks. My med doc didn't do anything for it except offer sedatives/antideppresants. I hope you will take it easy on yourself. It is hard enough being a mom without taking on the guilt of what hindsight shows you. For now I recommend that you not worry about the next pregnancy for a little while, easy advice to give but not easy to take! Inhale your baby and just concentrate on getting your body back into good working order, even c/s without complications are traumatic and require a lot of recuperation. Lots of direct sunlight helped me cope- emotionally and physically. I'm so sorry and I hope that you find that you can try another vbac. Lots of hugs and inhale your baby for the best healing!
post #3 of 18
PS... I just googled vba4c and found several places to read vba4c stories. Be encouraged... You're not alone! I didn't have a successful attempt and ended up with a c/s but I really think it can be done and should be attempted as long as someone has done the research and feels very comfortable with the natural way a body works.
post #4 of 18
Thread Starter 
I see I forgot to mention that I am 39 years old. I do not have the option of waiting 2 or more years to conceive if I want another. I could start the IVF and freeze the embryos, but there are no guarantees they will survive freezing anyway. I do not have the best egg quality, but I think normal for my age. I have had troubles ovulating and conceived this baby through fertility treatments. Therefore, if I wait too long, having another probably won't be possible. But, it could be possible, meaning, maybe, if I am lucky, I will still be able to have another baby in 2 years. See what I am saying?
post #5 of 18
Thread Starter 
Quote:
Originally Posted by momm-i-o View Post
PS... I just googled vba4c and found several places to read vba4c stories. Be encouraged... You're not alone! I didn't have a successful attempt and ended up with a c/s but I really think it can be done and should be attempted as long as someone has done the research and feels very comfortable with the natural way a body works.
I will go google that too. I felt so confident this time. And it had been over 5 yrs since my last csect. Now I worry about getting pregnant within a year and then trying a vbac after 4 csect. In reality, my first vbac, I had my daughter only 17 months after my csect. So, there was only 8 months between pregnancies.
post #6 of 18
My doctor gave me the go-ahead to get pregnant again 3 months after my c/s. This baby will be born right on the border of 12-13 months from my section. However, I've only had one section, so I don't know how long it would be recommended to wait after having multiple.
post #7 of 18
The problem is finding a care provider who will take you on for a vba4c. I know this, b/c I'd love to have one myself. My youngest is 2.5, though, and I'm not even pregnant yet so I don't have the close spacing issue to worry about --on top of everything else!

The thing is that a vba4c has it's own set of risks, but so does 5 surgical births. I hate that you have to choose between the two options (and that I do, too).
post #8 of 18
Thread Starter 
I do know a doctor who will take me after 4 csects. Problem is, he is not the one I would want if I had to go the surgical route. This means, if I end up in another csect anyway, I would rather be with the doctor I am currently with. But the doctor I am currently with, while she was okay with me doing a vba3c, she was clearly not comfy with it. This is what led to my giving in and doing a 4th csect. So I obviously need to go the more supportive route for the vba4c.
post #9 of 18
If you don't have a dr who will support you in a vbac, you won't get one.
post #10 of 18
There was a mother who posted here in 2007 about her HBA4C. I remember it because it was right after my VBAC.
post #11 of 18
there is an OB in atlanta that does VBA#C. He recently attended a successful vba5c. there are providers out there, but they are hard to find.

If you are anywhere near a teaching hospital you might have some luck finding a provider - or at least someone on the staff that while they aren't very supportive you would at least get a shot at going into labor on your own.

have you given ICAN a shout yet? your local chapter could hlep you find a CP or maybe the national list will know some names. At the minimum you'll find birth stories for VBA#C that are inspiring.

Please don't beat yourself up over your c/s. You made the best decision you could with the information you had at hand.
post #12 of 18
The risks of a RCS after 2 previous CS are similar to the risks of a VBA2C. I suspect this may also be the case with an RCS after 4 CS vs. VBA4C. But I'm sure there is NO literature on that topic since there are so few women who do it. If it were me... I'd try and find a doctor to do it and I'd do it in a hospital because of the greater risk for problems (I would assume similar or increased risks w/ VBA4C as with VBA2C)

From a recent publication, here are the risks assoc. with VBA2C and RCS (cut and paste from abstract):
"Main results VBAC-2 success rate was 71.1%, uterine rupture rate 1.36%, hysterectomy rate 0.55%, blood transfusion 2.01%, neonatal unit admission rate 7.78% and perinatal asphyxial injury/death 0.09%. VBAC-2 versus VBAC-1 success rates were 4064/5666 (71.1%) versus 38,814/50,685 (76.5%) (P < 0.001); associated uterine rupture rate 1.59% versus 0.72% (P < 0.001) and hysterectomy rates were 0.56% versus 0.19% (P = 0.001) respectively. Comparing VBAC-2 versus RCS, the hysterectomy rates were 0.40% versus 0.63% (P = 0.63), transfusion 1.68% versus 1.67% (P = 0.86) and febrile morbidity 6.03% versus 6.39%, respectively (P = 0.27). Maternal morbidity of VBAC-2 was comparable to RCS."

Congratulations on your new baby and good luck w/ any future pregnancies!
post #13 of 18

Who is the OB in Atlanta who supports VBA3C?

post #14 of 18

Dr. Joe Tate

post #15 of 18

Dr. Mark Landon at Ohio State attends VBAmC (has attended at least VBA2C and VBA3C). You have a previous successful VBAC, right? That should make you a better candidate. I am sorry someone strong-armed you into your recent c/s.

post #16 of 18

Quote:

Originally Posted by Drummer's Wife View Post

The problem is finding a care provider who will take you on for a vba4c. I know this, b/c I'd love to have one myself. My youngest is 2.5, though, and I'm not even pregnant yet so I don't have the close spacing issue to worry about --on top of everything else!

The thing is that a vba4c has it's own set of risks, but so does 5 surgical births. I hate that you have to choose between the two options (and that I do, too).


Yup, not finding obstetric support locally for VBA2C.  The hospital doesn't have a specific policy against it, but the OBs just don't do them.
 

 Quote:

Originally Posted by kltroy View Post

The risks of a RCS after 2 previous CS are similar to the risks of a VBA2C. I suspect this may also be the case with an RCS after 4 CS vs. VBA4C. But I'm sure there is NO literature on that topic since there are so few women who do it. If it were me... I'd try and find a doctor to do it and I'd do it in a hospital because of the greater risk for problems (I would assume similar or increased risks w/ VBA4C as with VBA2C)

From a recent publication, here are the risks assoc. with VBA2C and RCS (cut and paste from abstract):
"Main results VBAC-2 success rate was 71.1%, uterine rupture rate 1.36%, hysterectomy rate 0.55%, blood transfusion 2.01%, neonatal unit admission rate 7.78% and perinatal asphyxial injury/death 0.09%. VBAC-2 versus VBAC-1 success rates were 4064/5666 (71.1%) versus 38,814/50,685 (76.5%) (P < 0.001); associated uterine rupture rate 1.59% versus 0.72% (P < 0.001) and hysterectomy rates were 0.56% versus 0.19% (P = 0.001) respectively. Comparing VBAC-2 versus RCS, the hysterectomy rates were 0.40% versus 0.63% (P = 0.63), transfusion 1.68% versus 1.67% (P = 0.86) and febrile morbidity 6.03% versus 6.39%, respectively (P = 0.27). Maternal morbidity of VBAC-2 was comparable to RCS."

Congratulations on your new baby and good luck w/ any future pregnancies!


I also have read/heard that the risks for RCS after 2 c/s are comparable to risks associated with VBA2C.  I can see how OBs would maximize risks of VBAmC and minimize risks associated with RCS.  I don't believe there are large cohort or even meta studies that adequately assess the risks either way.

 

Hmm, regarding the rates you've posted above - the "widely" agreed-upon UR rate for VBA1C is .4%, so that leads me to question the design of the study above.  How many of these VBACs were perhaps induced or augmented or allowed an epidural.  IMO, these are all (generally) contraindicated for VBAC and would contribute to an inflated UR rate.
 

post #17 of 18

You are *NOT* stupid! We're programmed to obey Doctors and being pregnant we are stressed and hormonally challenged. Please don't beat yourself up b/c you trusted that what you were told was true.

 

Dr Tate is aawesomeee- I crossed state lines to deliver with him, the long drives were worth it. He does vag breech and multiples too.

post #18 of 18

I am in the same type of situation , you are in , I STRONGLY believe , 2 of my 3 cs were unnecessary . And after extensive studies and research , as well as talking to different people about the whole subject , I´ve come to the conclusion , that in most circumstances , with very few medically validated reasons , a vaginal birth is the safer way to go . 

The biggest problem I have , is that people always tell you about the risk of rupture and the risk of you and/or the baby dying . Yes , of course , that risk exists , BUT the same risk exists with cesaean , as a matter of fact , the percentage is about the same .

However , for some reason , a lot of people seem to believe , that vbac is absolutely , horribly dangerous and a cs is easy , simple and virtually pain-free , plus it has no side effects .

But the truth is , in my opinion , that most of the time , it´s just more convenient for the doctor , after all a planned surgery fits so much better into their schedule . Not that they care about , what happens to our bodies afterwards , the risk with another cs , the potential forming of scar tissue , and so on ...

Plus , I absolutely love the reason , some hospitals bring for not trying "we don´t have the facilities to do a emergency cesarean , if the need arises "

Well , I´ve got news for you , then you shouldn´t have any deliveries there at all , since you never know , when the need arises .

All I can tell you , is , fight , have somebody clear-minded with you , when you go in , that will stand up for you when you can´t , believe that you can do it and if you feel , it can be done , DO NOT let anybody discourage you , you know your body best , no one else .

Plus , the added benefit is , if you succeed , we have another success story to slap into their faces thumb.gif

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