Told can't have VBAC at 27 weeks...

[GnarlyKarli]

I am much need of some advice PLEASE!! My midwife told me today that I was too risky to try for VBAC because I had an infection with my c section incision. Should I look for a new midwife that it willing to work with me? I just don't know if I should give up hope or not. I am 27 weeks and am running out of time!

[sweeetpea]

Well, this is an anecdote, not medical evidence, but a good friend of mine had a horrible incision infection after her c/s (for breech), and went on to have a rapid, easy VBAC a couple years later.  

Was it the incision on your uterus itself or the muscle/skin that was infected?  Does she think the infection compromised healing?  What actually does she think the risk is?   Can you call another midwife or two, preferably ones recommended by your local ICAN group.  Time for you to ask some informed questions and get some real answers.  Be glad she dropped this on you at 27 weeks rather than 37 weeks!

[GnarlyKarli]

Thank you for advice, good to know that it is possible. I did think 27 weeks was bad but you are right, it could be a lot worse. Thanks again!

[Ms. B. Sprout]

FWIW, and goodness knows I am always learning new things, but I have been living in the VBAC world for over 4 years now, and I have never heard of prior c/s incision infection as a future risk factor for any complication. It is not mentioned, if I recall correctly, in the NIH white paper on VBAC risk.

Does she have evidence to back up her concerns? Regardless, if she's not 100% behind you I would change providers if possible. I am so sorry, mama. What a hard thing to have to navigate.

[AlexisT]

I do know someone who had this problem, but IIRC, her infection was way more complicated than just an infected incision--she spent a week in the hospital with a drain and when they did a 3D SHG later they found something wrong with her scar. (I really don't know all the details--I know it sounds sketchy this way, but I know her OB, and he's pro-VBAC, and the SHG was actually done by her RE who was afraid it had caused uterine scarring.) I had a regular infected and separated incision and no one has ever brought it up in relation to a VBAC--and my OB is well aware of it as my postoperative complications are a major reason I want a VBAC this time.

So I'd say it's possible for an infection to cause problems, but unless you know of special circumstances it shouldn't be the case for you.

[cinderella08]

I had horrible, horrible issues with my scar.  Separation, re-sutured, packing, had to have it chemically cauterized.  Horrible infection.   That was never even brought up in regards to my VBAC though...  I'd seek a 2nd opinion.

[GnarlyKarli]

Thank you so much ladies for your advice! I really appreciate it. I met with a different doctor at a different hospital today and she told me there is no reason I shouldn't be able to have a successful VBAC. I am so happy!!! Thanks again all of you for your reassurance!

[labortrials]

I have read in a few places that it supposedly does raise the risk of rupture.  However, this shouldn't necessarily risk you out.  I think knowing as much as you can figure out about this infection will be helpful for you (and for a future CP).  Oh, and you have plenty of time to switch CPs - I switched @30w this time.

I too have a friend who had problems with her primary c/s - like exposed guts and stuff.  She went on to have a problem-free VBAC a couple of years later.

Sorry I can't remember the specifics about what I read, and I'm not sure what my search strain was at the time - my 'scary' issue is the 'thin LUS' diagnosis I previously received.  <sigh>