VBAC & Risks

[leahestey]

I have had a second c-section 5 years ago. The records say that the low uterine segment was "quite thin" and they did figure-of-eight sutures. I had a IUD for 3 of these 5 years. I heard that these IUDs thicken the uterus wall. I am currently 23 weeks pregnant and hoping for a vbac. I know the risk of a uterus rupture is 1% for 1 c-section and slightly high after each c-section.

[Ms. B. Sprout]

Hey there! I am also a VCBA2C mama. I looked at this NIH white paper on VBAC, and there was a statistic in there that put the risk of rupture after 2 sections at either 1.8 or 1.9%. I don't remember which number it was. You should read it for yourself. There is LOTS of good stuff in there that will help clarify your thinking about risks. That paper is from March 2010.

Also, as of July 2010, AGOC supports allowing VBA2C mothers to have a trial of labor. (Their paternalistic language, not mine )

Now, I have had 2 different OBs in the past month look me in the eye and lie about both of those things (ACOG position and rupture rate). It is quite insulting to be lied to about such verifiably false things. So beware and do your research! There is lots of misinformation out there about VBA2C, and much of it is floating around the obstetric community.

Here is a recent thread in this forum on thinning of the uterus.

Best of luck in making your decision.

[leahestey]

I actually did a TON of research on VBAC. A thin uterus would be another "reason" for my ob doctor  to deny me of a VBAC. Let's just say before I did my research, my doctor flatly said no to a VBA2C. I just never heard that a thin uterus could affect a VBAC negatively. But I agree, there isn't enough information on it to determine anything.

I found this:

http://wellroundedmama.blogspot.com/2009/02/ultrasound-measurement-of-cesarean-scar.html

[Ms. B. Sprout]

I'm sorry for implying that you hadn't researched the risks you posted about. I don't have anything specific to offer regarding a thin uterine wall. Maybe someone else will pop in with a study or something.

Best of luck in your research and your VBA2C!

[leahestey]

They have done studies but there weren't enough participates and the studies' results were not similar. Anyway, thinness is subjective. I just needed help to "prove" to my ob doctor that this was NOT a solid factor in a VBAC. There isn't much support in my area. ICAN asked me if I wanted to make a chapter in my area. I haven't decided yet.

I do want to thank you for the paper link. I like numbers.

[LiLStar]

The rupture risk is really closer to .5% after one low transverse cesarean. A thin lower uterine segment is normal late in pregnancy, particularly if you labored a while before surgery. Have you tried posting in finding your tribe to see if anyone had recommendations for an OB/midwife in your area who will be supportive of vbac?

[AlexisT]

The stats I saw were 0.5% after 1 CS, 0.7% after 2, without augmentation or induction.

[leahestey]

Tribe? No, but I have being asking EVERYHERE with little luck. One practice is too far to drive and the other doesn't want to take me because they say I'm too far to monitor closely. I'm highly considering a homebirth if my ob doctor continues to say no.

[leahestey]

I actually went in labor by myself with both pregnancies.

[Ms. B. Sprout]

AlexisT, the NIH number that I cited for VBA2C is derived from a review of the studies, so I don't doubt it skews high.

LilStar, we are talking about VBA2C. I don't doubt that .5% is a pretty accurate rate for plain ol' VBAC.