Originally Posted by Viola P
I know a woman who was doing an hbac for her second birth and her uterus ruptured from the scar. She made it to the hospital in time and her and babe are totally fine. It's my understanding that uterine rupture is very rare but that when it does happen you'll probably be fine if you're close to the hospital.
The rate of uterine rupture is somewhere between .5-1% for VBA1C and up to 3-4% for VBAMC. It's about .07% for all births.
One of the larger and more rigorous studies showed a neonatal death rate of around 2.6% when ruptures occurred in the hospital. This went up to 6% when the rupture occurred outside of the hospital.
Another study looked at outcomes based on the time between rupture and delivery. There was a very, very clear correlation between delayed delivery and bad outcomes for the baby. Babies who were delivered within 18 minutes did pretty well. as a group. All of the cases where babies suffered serious brain damage occurred when there was a 30-40 minute delay.
Here's the kicker: the clock started when fetal distress was detected through a monitor. A lot of people think that uterine rupture is really obvious, but it isn't. The first sign is cardiac decels. That's why most OBs will want to use continuous monitoring for a VBAC. In a UC environment it's quite likely that substantial time will elapse before it becomes clear that a rupture has even occurred.
Even if you catch it immediately, I have a hard time imagining that you're going to get from your living room to an OR in less than half an hour, even if you're 5 minutes away.
This is obviously a highly personal decision, and I understand why some might find the risks acceptable, but, speaking personally, UBACs scare the heck out of me.