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worst case scenario UR- how long do you have before c-section? - Page 3

post #41 of 44
Originally Posted by g&a View Post
Of course, I am staunchly for birth center for peace of mind reasons, and DH (who thinks his MDC name should be "The Voice of Reason") is now thinking that birth is so inherantly dangerous (not just VBAC) that we ought to be in the hospital at least, if not the OR (ok, I am being sarcastic here, get it, Mr. Reason?).
I understand wanting to make this decision together and many women certainly feel that if their partners aren't together with them on the decision that they won't go a certain way. As much as I love my dh, I have told him many times that I will do what I feel is best for me and baby whether or not he is on board. Since I'm the one who will be dealing with the long term ramifications of whatever decision is being made and I'm the one who will be on the operating table should it come to a c/s I just don't feel comfortable either way.

I used to hate the "No vagina, no vote" sentiment that so many have expressed in the past, but now that I'm pregnant again and drawing ever closer to going into labor I know even more so why so many women say that.

Luckily for me dh has always been on board since the very beginning and agrees that a home birth is our best option (I think the c/s affected him every bit as much as it did me). I know that's not always the case for everyone, but I'm thankful never-the-less.

All of this just to bring out (yet) another perspective on the decision making process.

Oh, and Human_Being, very well said!
post #42 of 44
I was discussing this thread with my DH last night, and he of course had a similar reaction... we're not pg so it's all hypothetical anyway but he was shocked (I think it was the graphic idea of baby floating in abdominal cavity... it's a scarey, scarey thought).

But I guess the part of the conversation that summed up how we REALLY see it is this. Catastrophies happen to people. There are many kinds of catastrophies - car accident, plane crash, untreatable cancer, death of a child, and there's no way to predict whether or not you're on that "list" of people who are going to experience a catastrophy. There are ways to shortlist yourself though - driving a car you know is unsafe, smoking, and IMO signing up for almost certainly unnecessary surgery is a way to shortlist yourself for catastrophy (of course erc is not what we're talking about here, I know, I'm just following the train of thought through). I guess the question really is, are you likely to have a successful vbac in hospital (with your MW certainly ups your chance of success)? If I had this option, and all else being equal, it is probably what I would do.

But, I'm in a similar situation where there is no perfect solution. The hospital where my MW has priviledges demands that MWs transfer care of all vbac clients to the on-shift OB upon arrival. So I don't have the option of MW-attended hospital vbac, despite that this is what would fit for me. We also have no birth centres, and will be living at least 40 minutes from the nearest level III hospital by the time I'm pg again. So I believe I will be forced to find a way to become comfortable with an UBAC (because I have precipitous births, it's likely the MW won't be there yet), which is not a choice I would have made in any other set of circumstances.

But, when I come back to it... if I'm on that list of people to whom catastrophies are going to happen, well, I'm on that list and I can't do anything about it. I believe that walking into that knife-happy hospital to vbac and getting turned over to an OB is little different from signing up for erc, and I believe that THAT would be shortlisting myself, so to speak. so unless things change - we'll be staying home. (and then of course there's still teh precip birth factor to add in for me... could we get to the hospital, even if my MW could attend me there?)

anyway I'm blithering now... hope some of this is coherent!

post #43 of 44
Originally Posted by pampered_mom View Post
Here's the post turtlewoymn was referring to. I think it's also good to keep in mind that when the studies are done to come up with the risk for UR they include both dehiscence and catastrophic rupture.

Your chances of catastrophic rupture are significantly smaller than your chances of dehiscence which can often happen w/out any ill effects for the baby. Women who have had no prior uterine surgery also are at risk for uterine rupture and in those cases they are most usually catastrophic.

I only bring this up to put the whole ur discussion into perspective. I find that's helpful to me when considering my options.

I find it interesting that majormajor posted the scariest parts of the articles she found and did not reference other parts that are valuable to this type of discussion.

From the first link:
(emphasis mine)

I'd also suggest reading the ENTIRE study as the quote given by the pp is in the introduction whereas there is a more thorough discussion of it further in the study.

A few other sources:

From the second link:
(emphasis mine)

I'd be a little bit suspicious of your midwife. imo it seems more like she's trying to scare you into doing what she wants you to do. I'd ask her to prove it and provide you with copies of her evidence the five minutes.
yes yes yes yes and yes. ia agree and would link you to tall the same info she has. i could not have done a better job!
post #44 of 44
In the VBAC companion they state 17 minutes. I hadn't heard such a small time frame until reading that book (which I don't recommend btw) I have also heard 30 minutes from decision to incision, but I was just speaking with a midwife in my area about that and she said that more recent studies have shown that the moms and babies that took longer than 30 minutes from decision to incision had no worse outcomes than those that were within the 30 minute time frame. Actually some of them actually had BETTER outcomes. I feel comfortable listening to my body and talking it over with my midwife to see what she thinks.
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