VBAC after 2 c-sections?

[Jen McMannamy]

I've had both my babies via c-section, the first was emergency and the second was failed VBAC.  I'm getting a bit scared to have a 3rd cesearan, but it's already scheduled and my doc says I have no choice, surgery only.  Is this true or should I change my plan this late in the game (34 weeks already!) My second child will be 15 months old when I'm due for #3... 

Any thoughts would be appreciated...

[~~Sarah~~]

If you stay with that care provider - then his/her answer is the one you pretty much have to go with. 

Why not look for a second opinion?

[*farmergirl*]

I just had a VBA2C 2 weeks ago. I was also told by my former OB that surgery was the only way to go however the hospital an hour away from does VBACs and had just changed their policy about more than one previous section. I would look for another opinion asap. On the other hand having more than one previous section does carry additional risks as does having less than 18 months between the last section and this labor as the scar has less time to heal. You also don't mention why the attempted VBAC failed but that can make a difference too. But why not talk to someone and find out what your risks really are for a VBAC vs another c-section.

[Gracie0509]

I'm not sure if you're still deciding what to do, but I am plannign a VBA2C and just found a supportive provider.  Mine will be 14 months after the 2nd c/s, and she said the 18 months is more of a recommendation than a hard fast rule, and that at 14 months there is not much of an additional risk (or at least not enough to concern her). 

Farmergirl is right- much of the risk and chance of success of a VBA2C is determined based on the reasons for your past c/s and definitely on your type of scar.  This is just a suggestion- contact L&D at the VBAC friensly hospital where you are hoping to deliver.  See if you can find an experienced L&D nurse (as in, practicing since before 1999 when the VBAC bans started) to give you recommendations on a care provider.  Younger nurses may not have much experience with VBACs. That's how I found mine :) 

Good luck!!

[dlm194]

Have you contacted ICAN for a suggestion? 

It's possible that having had 2 c-sections and being only 15 months out from your c-section will increase your risks somewhat.  The problem is that there are too many variables associated with the studies that suggest your risk is increased (types of sutures used years ago, inductions, use of pitcon, etc).  Going into labor naturally and laboring without pitocin will decrease your risk.

[kltroy]

It's not too late to switch care providers, though you may have to pull some strings to do so.  ITA with prev posters: if you stay with your current provider you are having a 3rd c-section it sounds like.  Current ACOG guidelines specifically state that a VBAC attempt is fine after 2 c-sections, but the challenge that we are facing as a community is in getting doctors to actually practice evidence-based medicine!  (sounds simple, but this is often beyond their comfort level).  I would contact your local ICAN group ASAP (as in: call or email the leader, or the nearest leader if you have no local chapter.  And if you need help finding out who that is, PM me with your city and state and I'll find them for you).  If there is a supportive doc or MW in your area who will attend VBA2C, they will know who it is.  Unfortunately, not all communities have someone yet.  I hope we can change that.  One strategy that can help when you talk to a potential care provider is to mention that you want lots more children.  Like 10.  Seriously.  Because the risks of complication go up exponentially with each repeat c-section. So if you're looking at a VBA2C versus another 3 c-sections, suddenly that VBAC seems a lot more appealing for your long term health.

If you decide not to "officially" switch care providers, you can still have a VBAC, it will simply involve showing up in a local ER well into labor.  If you opt for this strategy I would do a little research to identify the most VBAC-friendly hospital in your area and show up there.  Since the risks associated w/ VBA2C aren't much greater than with VBA1C, I don't think this strategy really has any safety concerns.  Again, your local ICAN group can help you find a VBAC friendly hospital, and also all states have to maintain some sort of a hospital "report card" with these statistics (check the dept of public health) but someitmes they are difficult to find.  Best of luck. 

[MeesterMama]

Never too late to switch!! I found a VBA2C supportive provider FINALLY at 33 weeks.  It was a long journey but SO worth it!

http://www.youtube.com/watch?v=HzsT9q1AVW8