In what stage of labor is rupture most likely?

[Phoebe]

I'm just curious. I will be ttc soon and I've got alot of questions...this is one of them. Is there a stage that sees rupture more often. I guess I'm wondering because if I choose a hospital vbac (I may or I may go with home, not sure) I will want to labor at home until the baby is about to pop out if I can. But if the risk of rupture is at it's highest at the beginning or middle of labor then why bother going to a hospital at all. Actually, there is more thought behind that statement. I just don't have time to get into it right now...gotta put ds in the bath now. Just curious if anyone knows...

amy

[eleven]

Good question! I've heard that 1/3 of scar separations happen before labor even begins. Not sure when the rest happen.

More importantly, the risk of uterine rupture in an uninduced, unaugmented VBAC is .2-.4%. That is VERY LOW! Comparatively, the risk of cord prolapse is .5% and the risk of a placental abruption is 1%! (These are for any labor, not just VBAC.) Once I read those statistics, I totally stopped worrying about uterine rupture! After all, if I was going to worry about rupture, I'd have to worry about the others first and...well... that's a lot of worrying that I don't have time for! :lol

[Attached Mama]

I have also heard that you can rupture anytime during the pregnancy - even before labor. I am planning a vbac for next time and will do all i can to stay out of the hsptl. I think that docs are too scared and most will only give you a "trial of labor" before they decide you need another c-section.

I found a midwife who will do a vbac at home but has a doctor backup. My biggest concern was that the baby's heartrate would dip or something else that meant a hsptl would be safer "just in case" and I would end up having to choose between the safety of waiting it out at home or the "safety" of another c-section - since I wouldn't have a midwife with doctor backup. So DH and I are wating for #2 until we move back to PA. In our area of FL the only choice is c-section or home with no doc backup and if you need to go to the hsptl they treat you like crap.

Blessings on your birth - however you find is best for you!!!

[Phoebe]

Yeah, I think I have also heard that it can happen anytime during pregnancy. I wondered about that. Since once you go into labor, your uterus is as stretched as it is going to be. From that point on it will be contracting inward, right? Not expanding to where it would separate a scar. I mean, apparently it happens, if only a .5% of the time. I just want to be able to picture it happening I guess. For some reason rupture just doesn't bother me all that much...it's other things that freak me out more...like cord prolapse as Pease mentioned.

FWIW...I have a friend who works in a labor and delivery unit...needless to say we tend to argue. But she hasn't been there for a year and has seen a ruptured uterus...this was NOT a VBAC either.

Thanks for the replies ladies. It's gonna be a big decision when I am blessed with another pregnancy!

More questions to come I'm sure.

amy

[wifeandmom]

DH is in the medical field and has witnessed several ruptures while working L&D. Every single rupture he's been involved with happened during transition, somewhere between 7-10cm, in women who were on Pit (either induced or augmented).

Rupture rates simply are not that great IF you stay away from Pit (and any other induction/augmentation drugs).

In order to accomplish this in a hospital setting, you need a very, very patient provider unless you are one of the fortunate women who labors and delivers fairly quickly.

The rush to use Pit in an otherwise uncomplicated labor is disgusting IMO. The L&D units DH has worked on RARELY have women give birth vaginally WITHOUT some sort of augmentation.

It kind of makes you wonder how on earth they think women delivered babies AT ALL before Pit was invented. :irked: Then you end up with a woman who 'needs' a section, who then 'needs' a repeat section or has a horrible time finding a provider willing and/or able to attend a VBAC for her future pregnancies.

[pumpkinsmama]

:eyes :notes: