Help me help my friend..

[Famatigia]

I have a great friend who is currently 32 weeks. She has not had any prenatal care. Here's why. She's had two c-sections, one less than a year ago. She desperately wants a vbac and is afraid if she settles into prenatal care, she will be destined to have another section.

Anyone know any doctors near Greenfield, WI who might take on a vba2c?

Secondly, she is considering a UC, thinking its her last resort. I support UC, but what, really, are the risks after 2 c-sections. Do the risks outweigh having another c-section?

Throw it out there for me.

[AustinMom]

I would say, of my very limited knowledge on VBA2C, there is a slightly higher risk of rupture compared to one previous CS. Yes, a repeat IS much riskier, especially a third CS vs. a VBA2C.

ACOG just came out with new guidelines stating that a mom with 2 prior CS should still be given support to VBAC, they are the most strict orgs when it comes to VBAC, so that is saying a lot.

I don't know your friend, so I have no idea if she is generally unhealthy, but I would assume having prenatal care would be a perk for anyone, even if it's just you doing it yourself.

VBACfacts.com is a great site. Is there a local ICAN group she can become a part of? If not, ask her if should would feel comfortable just calling the chapter leader to get more info. They can also maybe suggest some supportive care providers. Of course direct her to www.ican-online.com for more VBAC questions and answers. Also, they have a page somewhere on there about if you HAVE to go through a hospital, what your rights are.

[Mom2M]

I had a VBA2C with a large OB practice and it was wonderful.

Did your friend ever deliver vaginally? If she did, it is definitely recommended now to try for a VBAC as long as there are OB's available 24 hours/day to provide an emergency C section if needed.
So, if she can find an OB that supports VBAC's, I think now that the new guidelines have come out it is easier to make a case for a VBA2C. Because of the requirement for having an OB in the hospital at all times during the labor, it might be easier to go with a practice with more than 1 OB.

You're right that it might be trickier because her last c section was less than a year ago. I think I actually would not feel comfortable with UC because of that.

I don't have a problem with UC but I don't think it is a decision to be made out of fear of being railroaded into a c section. If she really wants to do UC, she should do research to be ready for it and have a real plan, not just saying she wants to avoid the hospital.

It's really hard at 32 weeks to be calm and rational when you have had 2 c sections. I was so afraid of another one and would have been in a panic if I didn't have a plan and a supportive group behind me.

Good luck, I will be thinking of her, I hope everything goes well.

[AustinMom]

Just a quick thought on time line, as it's commonly misunderstood, when they put a 'time limit' on spacing of CS, it's not between previous birth to current pregnancy, it's birth to birth, and that rec. is between 18 months. So if you had a CS, and got pregnant 9 months after, assuming you go the typical 9 mo pregnancy then you are in the clear. If you don't have a typical 9 mo pregnancy, then you are probably birthing in a hospital anyway, and one with a high level NICU and Obstetric floor. So rupture is not near as scary.

There really isn't much difference in the date of 18 mon limit and 12 mon limit, that's why most areas stick with the 12 month limit between CS if they are really really going to stick with one. Everyone else, I feel, should give a little, and let the mom make her own decision.