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Single layer suture vbacs?

post #1 of 16
Thread Starter 
As they were wheeling me into the or they were promising me a double layer suture. My medical record says they did a single layer. I guess they figured I'd never know. I know this increases my risk of rupture...anyone w/single layer stories or links about single layer sutures?
post #2 of 16
Well, I don't have any links for you, but what I can say is that I just had a beautiful complication free hbac with a single layer suture and had no problems. there are studies that show it to be both better and worse and I have to say that I honestly believe that no one knows for sure which is better. I think there are advantages and disadvantages to both. I wouldn't let studies regarding this dictate your decision on whether or not to try. Just believe and have faith that your body is healed and you will do fine. I agonized over this exact thing for the last three months of my pregnancy, but when push came to shove, I just came to the conclusion that this baby was coming out regardless and I needed to be at peace with the situation.

Ok, more than you asked for I know, but this is something I battled with a lot as well.
post #3 of 16
I'm planning/hoping for a vbac in less than 2 months and have a single layer suture. My OB said she's not convinced that a double layer makes that much difference since the uterine tissue has been through so much (stretching, engorgement, contractions) just prior. She's perfectly willing to attempt a vbac with me but did say she makes an effort to give women double layer sutures if they require a c-section because she doesn't want another doctor or practice to use that as an excuse not to support a future vbac.
post #4 of 16
Quote:
Originally Posted by Noisette's_Maman
I'm planning/hoping for a vbac in less than 2 months and have a single layer suture. My OB said she's not convinced that a double layer makes that much difference since the uterine tissue has been through so much (stretching, engorgement, contractions) just prior. She's perfectly willing to attempt a vbac with me but did say she makes an effort to give women double layer sutures if they require a c-section because she doesn't want another doctor or practice to use that as an excuse not to support a future vbac.
I think it's more important to get one to avoid the excuse factor than actual medical risk. The study that showed a difference had a higher than normal ur rate overall and used pitocin willy nilly, so it's hard to put too much stock in it. In Europe they use mostly single I think and VBAC just fine.
post #5 of 16
Quote:
Originally Posted by aprilushka
I think it's more important to get one to avoid the excuse factor than actual medical risk.
I totally agree.

And I also am sure that there are OBs and midwives out there who think for themselves and would attend a single suture VBAC. You might have to look hard starting now (I started saying "friends don't let friends choose birth attendants while pregnant" b/c making decisions was just SO hard with the hormones running rampant), though.
post #6 of 16
Oh, and nosy, may I be nosy? I know in my records the wording is confusing, and if I skimmed I might think there was only one suture. Are you 100% that the wording says you had a single?
post #7 of 16
Thread Starter 
Juliesma, congrats on your new HBAC babe! Good to hear a positive story about a single layer suture.

Mollyeilis, my midwife went over the surgery records with me at my 6 week appt and confirmed it was single layer.

My new DS is only 7 weeks old, and I don't even know if we'll have another pregnancy, so I really have no business worrying about this. I agree though about figuring out your provider before pregnancy.
post #8 of 16
Quote:
Originally Posted by Noisette's_Maman
I'm planning/hoping for a vbac in less than 2 months and have a single layer suture. My OB said she's not convinced that a double layer makes that much difference since the uterine tissue has been through so much (stretching, engorgement, contractions) just prior. She's perfectly willing to attempt a vbac with me but did say she makes an effort to give women double layer sutures if they require a c-section because she doesn't want another doctor or practice to use that as an excuse not to support a future vbac.

She sounds like a wonderful OB!
post #9 of 16
What exactly does single layer and double layer mean in regarding to stitiching? I am aware that this is a stupid question.
post #10 of 16
Hi ladies,

I was fortunate enough to go to a LLL conference in October where Ina May Gaskins was the guest speaker (she is awesome!). Her point/major concern about the single layer suture has to do with WHERE the new placent attaches! If the placenta should attach where the single suture is, there could be major problems (whereas uterine lining is slick, the lining BEHIND it is not - if you can imagine that!). I have not check out her website, but you might want to go there to get more info. She really is VERY, VERY concerned with the future of VBACs because of this!

Good luck,
Natalie
post #11 of 16
Quote:
Originally Posted by 2Sweeties1Angel
What exactly does single layer and double layer mean in regarding to stitiching? I am aware that this is a stupid question.
It literally refers to whether the incision was stitched once (single) or twice (double).

And honestly: There are no stupid questions!
post #12 of 16
I had a VBAC with a single layer suture in Jan. 05. Planning on having another in August.
post #13 of 16
I was recently asking my OB about single vs. double layer sutures. (I did have a double layer with my csec).

She said: The studies that are out there do not show a difference in rupture rates between double vs. single layer. The second layer, if you have a double layer, is an embrocation (sp?) stitch, meaning that it isn't really holding the uterus closed. Instead, it's really just grabbing the very top layer of the uterus, and not structurally important. They usually only do them, if the incision is still oozing blood after they stitched it up. It's really meant to stop bleeding, not to prevent future ruptures.

Now, I haven't really looked into the differences between single vs. double layer myself, since I did have a double, but I really don't think there's much difference. I think that the biggest problem is an OB using it as an excuse to not participate in a VBAC.
post #14 of 16
Have had 2 Hbac and planning another. I have a single layer suture talked with a few doctors about it. The doctor's are not worried about the suture I found most North American doctors will say they are against all homebirth, not just hbac. The doctors i have talked with all think single layer is better over then double, with a double the c-sec is longer, the risk of infection goes up, and infection can make the scar weaker.
S
post #15 of 16
I know this is an old thread, but do any of you have any studies or specific sources I could give my midwives' back up ob? She just found out yessterday that they won't do single suture vbacs, I'm 34 weeks and do not want another c-section. I already had an appt scheduled with the back up ob on friday and I want to go in with as much support info as I can.
thanks, Meryl
post #16 of 16
http://www.ncbi.nlm.nih.gov/entrez/q...&dopt=Abstract

I actually ordered this entire article from Midwifery Today before my c/s. It pretty much decided me to get the single layer.
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