Single layer closure - Very bad day! - Page 2

[ericswifey27]

That's great news! So glad you found a supportive place! Keep us posted

[hxcmama]

I just had to deal with this today, and I am still shaken by it. I interviewd an independant birth center (because no local hospitals will consider vbac, but I don't want a hospital birth anyway) and things were going great, they have a 100% sucess rate with vbac but because it is NH and midwifery is regulated, they have to agree to risk out people with single layer. My face just fell because even though my records say nothing about the suturing, I asked the OB at the time and he told me it was closed single layer. Since there is no record of this I don't know if they would risk me out as quickly, but still, it was extremely discouraging. It also set the seed of fear in my mind - if they take vbac and have so much success but won't even consider just because of the suturing? I don't need to doubt myself! Unfortunately single layer is becoming the standard.

[annekevdbroek]

hxcmamam - Well, the thing is that the vast majority of research on single vs. double layer closure doesn't indicate any increased risk. The ACOG position statement/practice guidelines also make no recommendations regarding VBAC after single vs. double layer closure. So, it is up to the individual practioner to decide what they are going to do. The new OB that I saw yesterday was like "Why wouldn't we do a VBAC after single layer????" Her attitude is significantly different than most OBs I've encountered so far.

All I can say is - keep looking. Try to find out the VBAC rates for hospitals in your area (e.g. state average in TX is about 10%) and call the better one's labor and delivery departments and ask a nurse which docs/midwives are doing VBACs. Then call those people and ask about closure.

Also - be sure to get a copy of your surgical record so you know for sure what type of closure was done.

Best wishes!

[cancat]

Originally Posted by warrior mama

I have a single layer closure and no-one has mentioned (both MD and MW) problems with it. I do believe that single layer is the standard these days. Arm yourself with research and keep fighting. Some providers are just looking for an excuse, IMO.

I was given a double-layer closure by the OB last time and was told that this was so it would be easier to VBAC this time...and that this was the standard currently : Either way, my midwives were happy it was double, but wouldn't have refused me if it hadn't been...

[Mrs. B]

This happened to me at 36 weeks. It was horrible. My mw was ok with it, but the back-up OB was not, nor was the hopsital. After about 1 1/2 weeks of worry, they finally agreed to do the VBAC, but my mw couldn't accept new patients with single layer sutures. The risk of rupture increased about 4% from a double layer (still less than a 4% chance overall, though) and I was supposed to sign something extra, but never did. Apparently, single layer sutures were the standard of care until about 1-2 years ago around here.

I ended up with another c/s, but the OB told me she did a double layer while we were in the OR, so I hope that means she is ok with VBA2C!

[juliema]

The whole suture debate really annoys me. I feel like it's just another excuse for ob's not to have to perform a vbac. I also have a single layer suture and thankfully my midwife was fine with it. There really is no definitive evidence that I've seen yet that double is any better than single. I think they both have their pluses and minuses. From what I've read, In addition to increased infection with double layer suture, it leaves more scar tissue so the risk is increased for future placental issues as well, and healing time is supposedly faster with a single layer as well. I personally am fine with my single layer. anyway, glad you found a supportive provider. That's no easy feat in Texas. I tried and ended up with a midwife at home because I couldn't find anyone supportive enough for me.