Talked to OB about VBA2C-don't do it/midwife HB-do it- what to do?! Updated :) - Page 2

[neveraim]

Of course!  No one else is as wonderful as him!!! 
 

Originally Posted by Lisa1970 

I bet you were with the same doctor I am with now. Dr C.
 

 

[lawmama1984]

My MW *raves* about Dr. C. I am in Austin and will attempt an HBA2C for our next, but if for any reason I risk out before I went into labor (I do have a history of high BP, although I was able to control it in my last pregnancy and had a great HBAC attempt), I will absolutely travel to birth with him

[Cheer]

I have had three children. The first was a C-section. The second was an attempted VBAC homebirth that ended in a transfer to the hospital, delivered vaginally by forceps. The third was a successful VBAC homebirth in water. I don't know the reasons for your initial c-section or your overall health and those factors are important. I was committed to having a VBAC as I felt my first c-section was unnecessary. I would not go back to the hospital for this reason, so found amazing midwives and backup doctors that was in total support of my VBAC.  I am also a proponent of being in excellent physical health.  My last birth was the most amazing experience of my life and, for me, could only have been done in my home with my midwives and my husband. You are the only one who can make this decision and need to trust your instincts. If you do choose the VBAC road, surround yourself with a birthing team that is totally supportive--not one that is saying "we can try but..." 

[Katielady]

Here's a great tidbit from Henci Goer with stats on this. You have to scroll down to read her response:

http://www.lamaze.org/OnlineCommunity/AskanExpert/tabid/363/aff/14/aft/112/afv/topic/Default.aspx

[mama2soren]

I thought I read somewhere that 5% of ruptures end in fetal death.  Maybe the doc is mixing up her stats?  So, that room of 100 she was talking about would be more accurate if it was a room of 100 women who all had uterine ruptures.  Five babies in that case would die.  If the rupture rate for VBA2C is more like 1.5%, the death rate from a rupture would be more like .075%.  One is much more likely to have a life-threatening cord prolapse, but doctors don't seem to panic whenever they have a patient come in for a vaginal birth because of the "dire" risk of prolapse, you know?  But, they make VBAC labors out to be dangerous operations that almost always lead to catastrophe. 

I hope you find a solution you feel safe and comfortable with.  

[Lynann]

My midwife just gave me a copy of her conference statement from last years VBAC conference by the National Institutes of Health, and it has some pretty good statistics in it. They focused on comparing stats for VBAC v's RCS.

One of the most interesting ones for me was maternal mortality. 3.8 per 100,000 for women who undergo trial of labor after c-section (regardless of actual outcome) v's 13.4 per 100,000 for elective repeat c-section. At term the numbers change to 1.9 per 100,000 for TOL v's 9.6 per 100,000 for ERCS. Now that is a stat OBs will never tell you.

It also shows the dramatic increase of risk of needing a hysterectomy with each repeat c/s, again something that is rarely admitted by OBs. Overall risk of hysterectomy for TOL v's ERCS is 157 v's 280 per 100,000 respectively, increasing with the no of RCS to 900 for 2 RCS, 2,410 for 3 RCS, 3,490 for 4 RCS & 8,990 for 5+ RCS each per 100,000 live births.)

For the dreaded Uterine Rupture the stats are: 325 per 100,000 for TOL v's 26 per 100,000 for ERCS. Having labor induced increases the TOL no to 1, 500 per 100,000. Of these ruptures only 6% will result in perinatal death, making the overall risk of intrapartum fetal death of 20 per 100,000 women undergoing trial of labor  This is then halved for those with term pregnancies to 3% & 10 per 100,000 respectively.

All of these stats are from "NIH Consensus and State-of-the-Science Statements Volume 27, Number 3 March 8-10, 2010" NIH are part of the U.S. Department of Health and Human Services. Their web address is http://consensus.nih.gov

Hope these stats can help to put the risks into some perspective.

[mama2soren]

Thank you for this!

Originally Posted by Lynann 

My midwife just gave me a copy of her conference statement from last years VBAC conference by the National Institutes of Health, and it has some pretty good statistics in it. They focused on comparing stats for VBAC v's RCS.

One of the most interesting ones for me was maternal mortality. 3.8 per 100,000 for women who undergo trial of labor after c-section (regardless of actual outcome) v's 13.4 per 100,000 for elective repeat c-section. At term the numbers change to 1.9 per 100,000 for TOL v's 9.6 per 100,000 for ERCS. Now that is a stat OBs will never tell you.

It also shows the dramatic increase of risk of needing a hysterectomy with each repeat c/s, again something that is rarely admitted by OBs. Overall risk of hysterectomy for TOL v's ERCS is 157 v's 280 per 100,000 respectively, increasing with the no of RCS to 900 for 2 RCS, 2,410 for 3 RCS, 3,490 for 4 RCS & 8,990 for 5+ RCS each per 100,000 live births.)

For the dreaded Uterine Rupture the stats are: 325 per 100,000 for TOL v's 26 per 100,000 for ERCS. Having labor induced increases the TOL no to 1, 500 per 100,000. Of these ruptures only 6% will result in perinatal death, making the overall risk of intrapartum fetal death of 20 per 100,000 women undergoing trial of labor  This is then halved for those with term pregnancies to 3% & 10 per 100,000 respectively.

All of these stats are from "NIH Consensus and State-of-the-Science Statements Volume 27, Number 3 March 8-10, 2010" NIH are part of the U.S. Department of Health and Human Services. Their web address is http://consensus.nih.gov

Hope these stats can help to put the risks into some perspective.