Uc after cesarean
The only problems you'll want to look for is problems with the placenta, really. You are at a very slightly higher than normal risk of uterine rupture too, but it is quite rare unless drugs are used to augment labor contractions. I would personally drink a lot of raspberry leaf tea, as it will strengthen your uterus.
And if you end up having a placenta that is attached to your uterine scar, worst case scenario you need to transfer to the hospital after the baby is born to get it removed. You are also at a slightly higher than normal risk of having placenta previa, but usually this can easily be diagnosed with bleeding during pregnancy or labor, in which case you would want to get it checked out (especially if you are in labor).
I had a primary c/s with my first daughter, then became a certified childbirth educator and doula. I also lead a local chapter of ICAN, International Cesarean Awareness Network. I planned a UC (went UP) with my second child. I tell you this so you know that I have some knowledge and experience from which to speak.
Your c/s was for FTP- or as I call FTW (Failure to wait). But was the c/s a low transverse uterine incision? How long since the surgery? Any other births? I don't think there are any magic indicators of success or safety, but some will believe that the longer you have to heal the better, or that a vertical incision on the uterus would be a reason for VBAC to be contraindicated. How is your general health and diet?
I do not agree with the pp that you only have to worry about previa if you see blood. Many previa can proceed without symptoms during pregnancy and frankly, while I am a firm believer in birth being as safe as life gets and a supporter of home birth, I would never shrug off a previa figuring I will just transfer during the birth if I start to see too much blood. Previas are serious business and the life of your child is compromised greatly if you have one. With a surgery on your uterus, you are more at risk for many things, previa being one of them. To even consider UC, I'd want to rule it out. You can do this reasonably well if a midwife or skilled layperson can pick up accurate placental tones that are no where near the cervix (can be tricky and may be botched if you pick up mums heartbeat or artery or echo instead), but you would be safest ruling it out with u/s. (I hate routine u/s use, but if I were wanting to rule out previa for UC VBAC, I'd go for it.) This can also help you know you have no interference with your uterine scar.
I believe you, and those who attend your birth, also have to be very knowledgeable about the signs and symptoms of uterine rupture. For me, this would include needing to listen carefully to heart tones during labor, since deep decels can be indicative of a serious problem. A rupture can be silent, with no obvious symptoms, or you can have one or all symptoms present. I believe statistically the chance of a catastrophic rupture are nearly as low, or lower, than getting struck by lightening, but if you are on the other side of the numbers, it is no fun. Good to be prepared (educated).
How far is the birthing place from the hospital in drive time? How prepared is the hospital? These might be considerations.
Just some ideas to get you started if you have not already thought of them. And please share your thoughts, reactions, fears, questions if you have any.
I agree with ariahsmum.
And I said previa can *usually* be diagnosed with unexplained bleeding (and bleeding doesn't always mean previa). I was going to say something about having at least one ultrasound done to make sure you aren't running into any of those problems, but I was running short on time and didn't want to assume that you are okay with getting those tests done.
Do you think rupture rates increase with more than one CS? Just curious.
If you already had vaginal births and only 1 c-s, then you really have nothing to worry about. As long as you avoid any kind of hospital interventions. They are the main cause of uterine ruptures for all women, not just women with previous c-s. Wait to have your ultrasound until after 30 weeks to be sure your placenta is where it should be. So many women who have had multiple c-s's have successful HBAC. I am planning my HBA3C this july and I have no worries. I take uterine strengthing herbs and eat healthy, do yoga etc. Yours will be a piece of cake. I highly recommend "The Natural Pregnancy Book" Lots of good info and herbs and such you can take. Also Spinningbabies.com can help with position stuff. No worries mate. If I didn't find a MW I would be doing UC and I will with my next.
I like tea with red raspberry leaf, nettle, oatstraw, red clover tops. Yum!
While I am super supportive of UC and VBAC, I cringe when I hear "no problem, you have nothing to worry about" etc. Even though the risks related to VBAC are not super high- if we are talking about UR or previa- the numbers are elevated over an unscarred uterus. I truly think you need to know the "signs" of any of these risks, and more importantly, pay attention to your instincts. Sure, have no worries, but do your homework, rule out previa or other possibilities, and if you have any doubt, get thee some help. If something seems not right, transfer- even if it means losing your dream birth.
I'm all for positive thinking, but not denial. Your body is strong, and has an amazing capacity to heal. Sure you can do this, but pay attention. It is possible for any number of things to come up that need assistance, and by and large some sign will alert you to it.
I've had a UBAC and planing another for this baby as well unless something strange develops during pregnancy.
with a low incision, and 2 years between babies you are looking good so far. if you can I would check your c/s records and find out if you had a single or a double suture closure. It's a much better idea to know that you've had a double and i personally feel that one u/s is really important essp. if you are planing to go UC so you can be sure of where the placenta is and that everything looks okay with baby.
red rasperberry / nettles / alfalfa tea is fantastic for vit and minirals and uterine toning. I also really like the bone flesh & cartilage formula from John Christopher's school of natural healing to apply to my c/s scar. I also would recommend having at least one birthy person there. a doula would be good but a friend who is a birth junkie would do :)
oh and ps. YES chances of uterine rupture does increase with each c/s . along with every other possible c/s complication.
I really agree with ariahsmom!
I just gave birth unassisted in October. I saw a dr(no midwives here)for my pregnancy but planned to have an unassisted waterbirth with just my husband and kids. My first two children were born by cesarean, the first for surprise breech presentation and the second for pre eclampsia. My third was born at home with a midwife. All of my children are about 2 1/2 years apart.
I educated myself and felt very comfortable with my decision. Good luck deciding if UC is right for you:)
My first was a Cesarean. The second was a homebirth VBAC with a midwife. The third was UC but our provider came after the birth to check everything, tie the cord, and get measurements on the baby. I'm glad that I had the experience of having a vaginal birth with a trusted provider present for the second birth and I think that gave me a lot of confidence for our UC with the third.