vertical incision (classical) c-sections and preemies

[kondonis]

most of the moms of micropreemies I know had the classic c-section. Our perinatolgist said to me that I can never have a traditional birth (vbac) since the risk of tearing is 1 in 10.

I posted on the vbac board about this wondering if anyone went on to have vbac after a classical csection, and got a few yes's. though, I admit, I am not sure I believe them as any doctor I have talked to (and I have talked to a lot) said they would never do it as the risk is way too great.

so, those of you who had classical csections, did you get the same warning? what are your feeling on it?

at first, I mourned not having the choice - and I mourned not being able to experience what so many women before me had throughout history - and not being a part of that sisterhood. I've pretty much moved past it, but I still have a bit of me that is sad of never going into labor again, and having it in MY control how my child is born.

what do you guys think about it - ?

[Amys1st]

I know exactly what you mean. As Maggie was being born my Dr said to me:
"Amy I know how you feel about c sections but understand, you will always have to have a c section again when you have more children."

He is not c section happy like some OBs in my area and that is his last option when doing this. Unfortunelty, the events leading up to this c were life threatoning and thats the way it went.

I also had the c section you mentioned.

I have already had a tradional birth and I wanted to do a natural birth this time around- heck the day of my section my "husband coached childbirth" came in the mail . but I am not the best at carrying babies and my two prgncies can vouch that I am great when the babies are out, but I do not do good w prgncy. So we have closed the factory and we count our blessings. Besides if any of these things happened again, I dont think I can do that pain again.

BUT,
many women have gone on to have full term births with their next babies. It may not be the ideal situation, but you will get a great prize at the end. Actaully a mother in my area who delivered one of the smallest babies ever born in IL went on to have a normal prgncy and a full term baby.

[Kathi13]

I had the vertical incision with DD (28wks - frank breach position). I was told at my post-natal appt that I had the vertical and that I could never have a VBAC. I'm seeing the same group this time that I was transfered to for DD - still no VBAC and he doesn't even want me approaching labor. I pushed as far as I could so our scheduled c/s date is 37.5 wks - OB wanted to go a week earlier - he absolutely refused to wait one more week for 38wks.

My OB said chances of uterine rupture were 1:20 for vertical incisions - which is about what I've heard other places. While I truly would love to have a VBAC and deliver naturally (definately would refuse induction drugs for VBAC) I also don't want to be in the position of having something happen to baby or myself and have to live with that.

Now if I had the normal transverse incision it would be a whole different story....

[jkpmomtoboys]

Originally Posted by Kathi13

My OB said chances of uterine rupture were 1:20 for vertical incisions - which is about what I've heard other places. While I truly would love to have a VBAC and deliver naturally (definately would refuse induction drugs for VBAC) I also don't want to be in the position of having something happen to baby or myself and have to live with that.

Now if I had the normal transverse incision it would be a whole different story....

Ditto. I had a vertical incision at 29w and had another, planned c/s at 38 1/2 weeks with ds2.

Though it wasn't the natural birth I would have liked, it was much closer to a "normal" birth than #1 (hey at least I was awake for #2!)

So, even though you may not get your vaginal birth, there can be a lot of positives with a planned c/s and a lot of ways you can be engaged--definitely talk to your doctor about that!

Good luck...

[ksera05]

I had a classical c-section - a horizontal cut would have been unsafe due to her breech position. The surgeon, who I really like but I think believes very strongly in informed consent (maybe a little too much considering it was an emergency c-section? : ) made sure that I knew before he did the c-section that he had to do it that way to save both her and me but I'd never be able to have a VBAC because of the risk of uterine rupture and if we ever had another baby, they'd have to monitor me closely to make sure the placenta didn't attach over my incision and if it did, other not so good things could happen.

I haven't done the research yet on the placenta part, but I did look up the statistics on classical c-sections and rupture and the number was somewhere between 4-9% depending on the study. That's way too high for DH and my comfort.

So, if we ever have another baby, it'll be a planned c-section. Which is something that will take me a very long time to get used to because until I developed pre-e and HELLP syndrome we were going to have a homebirth.

[sehbub]

Sarah, how was Sydney's weekend? I've been following your story on LiveJournal.

Also, since my first name is Sarah and my middle girl's name is Sydney, I feel a special kinship.

[Kathi13]

Originally Posted by ksera05

So, if we ever have another baby, it'll be a planned c-section. Which is something that will take me a very long time to get used to because until I developed pre-e and HELLP syndrome we were going to have a homebirth.

Your Sydney is beautiful - I peaked at your photos. I hope she is doing well. My DD used to hold on tight to her NG tube also - and then she started pulling it out....

It was a very hard decision to have another child (PreE also). I knew it would be a c/s which was hard for me because although I was not planning on home birthing DD, I was planning on going as natural as DH was comfortable with (means in Hospital with a non-intervention happy OB).

[ksera05]

Originally Posted by sehbub

Sarah, how was Sydney's weekend? I've been following your story on LiveJournal.

Also, since my first name is Sarah and my middle girl's name is Sydney, I feel a special kinship.

That's awesome about the names!

She had an okay weekend. Not great, not bad. (I really need to post an update over there... ) Basically she's not getting any better in the breathing department so the doctor decided to buy some time before starting steroids by doing a 3-day course of lasix yesterday/today/tomorrow. They're hoping that maybe she'll pee off some of the extra fluid in her lungs and be able to breathe better. If that doesn't work, we've pretty much agreed to let them go ahead and do a one-week course of Decadron. Keith and I are hoping it doesn't come to that but we also hate seeing her struggle to breathe.

So far the lasix seems to be working though!!! ::knock on wood::

Kathi - are you having to go with a high-risk doctor this time around? We were told that if we ever decide to have another baby I have a 40-60% chance of developing pre-e again....and I know what you mean about c-sections and it being hard knowing that you're going to have to have another one...plus, for me, among my group of friends you practically have to duck once you mention that you wouldn't have a VBAC...I can't help that Sydney was a c-section, it saved her life and mine.

[ApplePieBaby]

Originally Posted by kondonis

so, those of you who had classical csections, did you get the same warning? what are your feeling on it?

My incision is the bikini cut, but my uterus was cut up & down... I was told I could never have another vaginal delivery...
I am angry about it, but Elora was transverse breech, and she is our last baby, so it's something I have to let go of. She was supposed to be my homebirth

[Kathi13]

Sarah - I hope the lasix works and Syndey gets rid of the fluid!! (speaking of names - Syndey was going to be this baby's middle name if we ended up having a girl).

Originally Posted by ksera05

Kathi - are you having to go with a high-risk doctor this time around? We were told that if we ever decide to have another baby I have a 40-60% chance of developing pre-e again....and I know what you mean about c-sections and it being hard knowing that you're going to have to have another one...plus, for me, among my group of friends you practically have to duck once you mention that you wouldn't have a VBAC...I can't help that Sydney was a c-section, it saved her life and mine.

Yes I'm seeing the Maternal/Fetal specialists that I was transfered to when I was diagnosed with PreE and who delivered Molly. I really like the OB partner I'm seeing - he has been very open and talked with me about any questions I've had. He tested me for some blood clotting disorderds (they had found a blood clot in Molly's umbilical cord in the biopsy) of which I have 2 - so I'm on some anticoagulants this time around. Yes they did say I have a much higher chance of developing PreE again as it was such an early onset with Molly. So far so good - 31 wks and BP seems stable 130/74 (higher than normal for me but still good) and no protiens, no swelling etc....

I know what you mean about mentioning VBAC....I've even been told on these boards when I asked a question about Birth plans and c/s that I should go to a mainstream board because the women here don't approve of c/s....

[Rachel J.]

My first was born early at 34 weeks but at least I was able to have a vaginal delivery and do it naturally. This one was going to be different, doula, possible homebirth which is what I really wanted. Ended up with a 29 weeker and the classic C-section. I guess I'm just thankful I got to experience "normal" once and if we have another one I'll be slightly relieved not to have to make the decision between "risking" a VBAC or scheduling a C-section. I know I'd want the VBAC but think I could sabotage it with subconcious fears about the risks.

[intorainbowz]

Hi from another Sydney mom....

I was spared the vertical incision, by my OB, a very talented surgeon. I went into the surgery knowing she would make the final decision while in there.

About the placenta..... You could end up with what happened to my pregnancy. The placenta attached on scar tissue from a uterine septum resection. Basically, I had poor blood flow the entire pregnancy. As I already have a good portion of my uterus as poor implatation zone (namely the top) I was lucky to be spared the classical incision. Placentas attached over scars have a VERY high risk of placental abruption as well.

When we were concerned about the possibility of a 25 weeker, they were pushing me to have a amnio, to see if there was a chromosonal problem incompatible with life. Had there been one, I would have let the pregnancy continue without intervention. Since there was not, we had tons of monitoring, etc, with the c/s at 34 weeks. I'm not going to even risk a VBAC, even without the classical incision, due to the septum and I have a heart shaped uterus. After the septum resection, I was told that I had a less than 50% chance I would be able to deliver vaginally because of the septum, the RE told me I would fail to progress and have a c/s. Hope I'm not thread jacking, just thought I'd answer the question about placental problems.