interesting vbac stats

[julie128]

When I was interviewing a doctor, she told me an interesting statistic. The vbac rupture rate is 1%. The vbac rupture rate when on pitocin is 4%. If the rupture rate is four times higher with pitocin than without, why the heck do they give it to women who have had Cesarian births?! Let the buyer beware, or something like that. I suppose the moral of the story is to refuse pitocin when attempting a vbac.

[pamamidwife]

Ah, but what is more frightening is the liberal use of prostaglandin gel and cytotec with vbac mamas - much more scary than pitocin! At least w/ Pitocin, you can turn it off!

Many studies place the rupture rate at less than 1%. It really depends upon the study.

Most of the cesareans that are done are due to interventions based on the belief that a due date is an expiration date. Most of the ruptures occur when the same scenario is repeated - whether it's for the due date myth, the "big baby" fear, or convenience. It's an ugly cycle.

None of the three hospitals in my area will do VBACs. For women in my area, it's an hour drive north or south, typically with "encouragement" to start labor for fear of delivering on the highway (although if that's the worst thing that happens to you when planning a hospital VBAC, I'd be giddy!) due to the distance. I'm seeing more and more VBAC women approach me for homebirth....I'm also seeing more first-time mothers approaching me to avoid that first-time cesarean.

[wwhippetcrazy]

Our hospital is pretty good here.
When I talked to my dr about wanting to VBAC, we talked alot about the rupture rate etc....she said that in there would be no interventions (pitocin, gels etc) as it increases the rate.
She had a successful VBAC with her second (born a couple weeks before my dd) so I'm very comfortable with her and her hubby!

I wish that all hospitals were like that! In fact the covering dr, that will cover when my dr's go on vacation (July 20th) said that the he loves VBAC's! And in his training he delt with a tonne of VBAC's in all the hopsitals he did his residency. Maybe the younger dr's are learning?? I hope so!!

Jen

[theflower]

Actually, I'm wondering where you ob got her stats.

The uterine rupture rate with spontaneous onset of labor is between 0.2%-1.0%, generally acknowledged to be about 0.5%.

The uterine rupture rate with pitocin induction is about 0.7% according to the big NEJM study.

The uterine rupture reate with prostaglandin induction is over 2% also according to the big NEJM study.

The uterine rupture rate with a repeat c/s is about 0.2%.

It sounds like your ob is inflating those statistics.

Interestingly enough, the 0.5% spontaneous labor uterine rupture rate includes labors that were augmented. It makes you wonder how low the UR rate would be with no chemical inducers at all during any part of the labor.