Risks of repeat c/s vs. risk of rupture?

[Charmie981]

If a mom had two c-sections 16 months apart, then got pregnant at 3 months pp, would you be more concerned of the risk of rupture 12 months after the last c-section or the risk of having three c-sections in just over two years?

Just wondering

[Peppamint]

Charlotte- your siggie! CoNgRaTs! How exciting!

As for your questions... I'm going to bite though I'm far from being an expert. The thought that first comes to mind, is how healthy is the mom? Does she eat well and exercise? Is she willing to put physical and emotional effort into preparing for a VBAC/HBAC? If the answer to the above is yes- I would be more concerned about the effects of another repeat c/s. OTOH, I know a mom who has had five c/s (four of them in the last 4-5 years) and from what I understand she's been in such awful shape physically and emotionally that I have a hard time imagining her having the wherewithal to VBAC. Is that an awful thing to say?

I'm curious to see what others think... because I wonder if my train of thought derailed.

[sevenkids]

I'd be more worried about the risk of an accreta than a rupture.

[jeninejessica]

From what I've heard, general "accepted" policy is that there should be 12 months in between. My SIL had a C/S Sept 04, one Feb 07, and another planned for late June 08. Her OBGYN practically accosted her when she got pregnant again, and read her the riot act. She has been told that due to risk of rupture, she is to IMMEDIATELY head to the hospital at the first sign of labor, and will go directly into her section. They absolutely will not let her body labor at all. She is high risk to begin with, but this gives you a bit of an idea of how hospital staff may take it.

That said, I've seen multiple women have VBAC's after an emergency section, anywhere from 11-15 months +, with no complications whatsoever. The 11month difference was a woman who had an extrememly traumatic (and against her wishes) emergency section, and then delivered her next unassisted at home.

She has very good resources here

In an otherwise healthy mom, taking into account, like PP's said- her general fitness, diet, pre-existing conditions, I would personally be more worried about the risk of a third section.

[Jane]

Perhaps a third trimester ultrasound examination of the scar would be good information to have.
Also, I'd like to know what the operative report on section #2 said.
And of course, placental location.
On interest as well - why the primary section? Ducking here, but if she's likely to fail at VBAC, I'd be less likely to encourage her to try (anthropoid pelvis or something).