What is the true risk of UR in a VBA2C...?

[danalyn]

I just read the thread about the risk of UR with a VBAC.  Could someone tell me what the "real" risk is of a UR after having had 2 c-sections.  As I've written before, I have never gone into labor naturally/on my own.  My first 4 vag births were induced, 2 after 14 days,babies #5 & #6 were CS.  I am 24 weeks along with #7.  I have my mind set on "natural labor".  I just began going to an awesome chiro, I'm hoping that I'll be able to do accupressure (sp?), I'm BELIEVING that i will go into labor.  Please tell me the true risk of UR with a VBA2C?  thanks ....! 

[littlethingstx]

I am 38 with four children... all caesareans... pregant now with 7 weeks to go... attempting VBAC with this birth.  I have found I get a lot of varying "opinions", but what has been great for me is to read about it in birth books.  I have especially found that "Ina May Gaskin's Guide to Childbirth" was very empowering for me to read.  I am reading my fourth book on childbirth in the last month and they all pretty much say the same thing in regards to uterine rupture.  The risk after one c is 1 in 1000 and it increases with each c you have had.  However, and I think this is very important to note, it is very likely that this statistic is based on hospital births with varies interventions that can cause harder contractions that are not normal or natural for your body (example is the use of Pitocin and prostoglandin gels).  In the third book I read there is actually a statement that says that the risk of maternal death for c-section is 1 in 1,000.  So, the odds are the same.  For that reason I am going to take my chances with a VBAC.  If you decide to VBAC educate yourself and those present for things to closely watch for.  Some things to watch for that are signs are (1) a drop in the baby's heart rate, as well, as a rapid heart rate (I believe the norm for labor is 120-180, but YOU research it... don't take my word for it), (2) bleeding or passing of blood clots (some light bleeding may be fine, but not clots... research it), (3) certain abnormal pains near your incision sight (and I have read this is not a good thing to judge by, but it is worth noting).  Those are the main things, but there are others I am sure.  The more you can move, squat, stand, kneel the better, so if you will be doing a hospital birth then try to do it without being on your back.  Hope this is helpful... I know I went way beyond your question.  ;)

[littlethingstx]

One more thing.... You said you have never gone into labor on your own.  The medical community views a mother as "overdue" after 40 weeks, but the normal length of pregnancy varies for each woman.  39 to 42 weeks in the normal and some women go a little over that.  Again, I say research it.  ;)

 I am a victim of this 40 week theory.  I was c-sectioned at 40 weeks and one day after a failed induction.  I was told I was overdue and that my body just did not know how to go into labor and if we waited longer my baby would be too big... yada yada yada... Anyhow, I spent a lot of time believing that my body was defective until I actually went into labor with my 3rd birth (which was immediate cause for emergency c-section).  That is when I started rethinking all this and wondering about VBAC. 

[jenniro]

The "real" risk is different for everyone.  You can look at the studies.  The UR risk for VBA2C is 0.9%, Landon 2006.  The UR risk for VBA2C is 1.36%, Tahseen and Griffiths 2009.  There are other studies out there, and the valid ones put the risk around 1%.  There are risks to a 3rd section:  infection, hemmorhage, hysterectomy, death.  So the stats only answer some of your question.  The risks of a VBA2C are acceptable to some, like myself, but others are more willing to accept the risks of repeat c-sections.  You've had previous vaginal births, so you're more likely to succeed.  As far as never going into labor on your own, maybe you've never been given the chance.  Going past 42 weeks is not unusual.  HTH!

[tonttu]

I had two c/s , one necessary , one not . 2 years and 4 months after the second I had a natural delivery , it took a long time , but I felt , that my body knew , it needed to go that slow and it was fine .

2 years and 8 months after the nb , I had another natural , again w/out any problems and last time , 8 months ago , I ended up with another c/s due to (real)fetal distress after being in (forced) induced labor , where the doctor didn´t care that I didn´t want induction , simply because I was 41 weeks , after all I was fine and so was baby , so he broke my water without my permission .

And all the meds didn´t work well , but what I want to say is , it had been 12 years since the last c/s and even though I was in labor for 3 days with medically induced contractions , I dind´t feel anything on the scar and I was actually reading somewhere afterwards , that every successful vb lowers your risk of rupture , whether they were before or after cs .

I guess , it has to do with how well your uterus is toned already from going through labor successfully . 

I think it was on www.ican.org , some study they had published about that , very interesting , I´ll try to find it , since I am sure , that many women here would like to read about it as well .

[danalyn]

Well, thank you for the replies, thus far!   I have to say that *as of right now* I am feeling very  motivated to "wait it out"...... meaning, not be in such a hurry, once I hit 39 or so weeks.  I know that's fairly easy to say now,  at 24/25 weeks!    I am, after all, going to schedule some sort of consultation with a doc at the hosp. an hour away, that is "ok" with vbacs.  (so they say).  When I say nt be in such a hurry" I'm meaning that I will *hopefully* not be so quick to give up and go in for a c-section.  I recognize that it is NOT safe to induce with Pit or prostoglandins (sp?), but I understand that membrane sweeps nd a foley bulb might be a possiblity.  So, my "plan" right now is to find and meet with a doc in Duluth, and talk to hi/her aboutnduction methods that would be "okay" if need be  I AM ALSO GOING TO A CHIRO (which i've already started), AND DOING ACUPRESSURE.  So, I'm excited.  Another thing that is motivating me to VBAC is the fact  when I have this baby, my   youngest will be only *22 mos old* & still very much in need of mama quite a bit ,At least that's how *WE* are. :)  I can't imagine leaving him for 4 days and staying in the hospital, or 5 days.  One thing I did want to add, in case I haven't mentined it, is that my babies are BIG, usually.  MY babies & their sizes were as follows: 

#1)  Boy, 8.3 lbs, not sure if hewas late/early/ on time but my water broke, no contractions *ever*, PIT started, birth was 24 hrs after water broke.  doc *almost* called for a CS, cant believe he let me go so long.  #2)  Boy, 14 days past  EDD, had a midwife in a hospital, she would induce til 2 weeks over, baby was 9.13 lbs  #3) Girl, induced on her EDD, 8.9 lbs.  #4)  Girl, failed induction on her EDD, tried 14 days later and "it" worked, 8 lbs.   #5) CS baby, born at 38 weeks, girl 8.3 lbs.  #6) CS baby boy, on EDD, 10.3.  So, waiting 14 days or so past the EDD with this one could easily put the baby at 12 lbs!  Oh  boy!  Thanks everybody for your replies!  :)  Yes, I am and will continue to watch my sugar.....  :)