Vertical Incision C-Section - Mothering Forums

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#1 of 17 Old 04-05-2005, 03:38 AM - Thread Starter
 
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Hi. I've had 3 previous C-sections and had all horizontal incisions. 2 in the same place and the third by itself. All low right above my bikini line. The last one was over 11 years ago. So I'm pregnant again (surprise surprise) and have been going to this doctor's office with 3 doctors. Each time I go, I see a different doctor. They schedule it this way on purpose. I've seen each doctor one time each so far. The first two never mentioned me having to have a vertical incision. But the third doctor did. I'm 18 weeks pregnant. I've had no problems so far this pregnancy. I have had one ultrasound and am having another one on the 27th. I just had the triple screening test and it all came back negative. I don't want a vertical incision! I hate my stomach enough as it is and really do not want a vertical cut from my belly button down to my bikini line. The doctor said I had a lot of scar tissue and they would most definately have to do a vertical incision and didn't the other doctor mention this? No, he didn't. Should I go to another office and doctor and get a second opinion??
I would really like to have a vbac but the doctors have advised me against that saying it's too dangerous and may cause uterine rupture. Ok, so that's out. Has anyone been told that they'd have to have a vertical incision after having horizontal incision(s)?? I really don't understand the reasoning.
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#2 of 17 Old 04-05-2005, 11:31 AM
 
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You shouldn't have to have a second vertical incision. My mother had 1 horizontal and 1 vertical and the doctor let her go into labor with my sister, but she didn't progress so she had her 2nd horizontal.

Did they do a vertical incision once thay got to the uterus? Sometimes thay cut the uterus vertical. You might want to ask your last doc.

Another thing, my mother later had an enlarged uterus and had a historectomy(sp?) her incision was again horizontal and as long as her last 2 incisions. It did take them hours to get to her uterus though.
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#3 of 17 Old 04-05-2005, 12:32 PM
 
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FIND ANOTHER PRACTITIONER!!!!!!

If you are interested in VBAC there are lots of mothers who have a had VBA3C's!!!! Even if you have decided you aren't comfortable with it, a vertical incision is really not neccessary. Find another practice that is up to date with their practice, and knows about VBAC. This practice seems way in the dark ages.
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#4 of 17 Old 04-05-2005, 04:58 PM
 
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I would really question why they need to do the vertical incision at this point. Now is the time to ask all of these questions and get it in your chart for when the time comes around for the surgery. (Unless you VBAC). I've only had vaginal deliveries so can only say I've know women who have had 4 and 5 kids all with the horizontal (bikini) cut. Yes, there will be more scar tissue than the first time when there wasn't. So your doctor will have to have the patience to take the time to work his/her way through it. It won't be as quick as someone who hasn't had one previously, but that's the way it goes if they won't let you VBAC.

Michelle: wife to J, mom to M (2001), E (2003), C (2005), S (2007) and O! (2009) And someone new in 2011!
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#5 of 17 Old 04-05-2005, 05:28 PM
 
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I would switch to a different office and switch FAST! Even if you get it noted in your chart that you don't consent to a vertical incision, AND can get all the docs to agree, I STILL wouldn't trust them to not do it once they've got you in there and vulnerable.

I just don't trust docs at all.
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#6 of 17 Old 04-05-2005, 06:53 PM
 
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Yes!! If you have other options for care, please do get more opinions!!!
There are lots of moms here who have had VBACs after multiple c-sections, and I'm sure they'll have some good recommendations for reading/resources.
http://www.mothering.com/discussions...splay.php?f=21
Also, are you familiar with ICAN ?

If you do plan for another c-section, it's hard to imagine a scenario in which a vertical incision would be a good idea! Our uterine muscles are shaped like bands that go around us horizontally, and the reason modern medicine favors the horizontal cut is because it can sort of slip between those big strong bands of muscle, compared with the vertical cut that severs through them, making for a much more complicated suturing process, and a much more painful, slow recovery. The risk of rupture during any future pregnancy after a vertical incision would be much more of a concern than the three horizontal scars you have now!

Talk to another practice, please!
Your existing docs sound a little

And by the way, Welcome!!!!!!!

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...missing Mothering Magazine...
 
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#7 of 17 Old 04-06-2005, 09:31 PM
 
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ITA with everyone, you need at least a second opinion but in reality you should find another doctor or midwife. Did he explain why he thinks you would need a vertical this time? Unless he knows something we don't I don't understand, I have known women who have had like 5 c-sections and all of them were horizontal. Also what is it about your past that leads them to say it is too dangerous for a VBAC. You need to ask them that too. If they just give you the standard answer that VBAC is always dangerous then run. But maybe they have a reason particular to you when they look at your history. I don;t know, but you need to ask them those questions and find out exactly where they are coming from. They might have a point or they might just be total idiots. But you need to sort everything out now so you can go into this with a providor you trust. SO far I wouldn't be trusting them, they haven't explained their position to you deeply enough IMO. Good luck and let us know what they say!
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#8 of 17 Old 04-06-2005, 10:09 PM
 
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get a copy of your records. read them and do your own research. There is absolutely no reason for a vertical uterine incision. A vertical incision on your skin doesn't mean anything about the incision on your uterus. Get a care provider you trust, who will talk to you and answer all your questions.

I have had four abdominal surgeries (one of them a cesarean). When I had my last surgery, the incisions that were on top of old scars took forever to heal, and hurt really bad for a long time afterwards, when before it only took a few days to a week for the outer incisions to heal up. This might be part of their reasoning. If they cut where the scar tissue is it may take much longer for you to heal (on your skin, I'm not talking about the uterus, because the uterine muscles heal so well they are not likely to even know where the previous incisions were). Also, when I had my cesarean, one end of the incision did extend into some scar tissue from a previous surgery, and that end of the incision opened up and took a really long time to heal. So I can see why they might not want to cut right on top of the old incisions, but it still doesn't make much sense to me that they'd want to do a vertical cut. Why not a horizontal cut parallel to the old scar(s)? That's definitely something to ask your care provider about.

Anyway, do some homework on your own. You should never rely on your doctor to educate you. I also want to mention that vba3c is not unheard of, if you think you might want to go that route, it's definitely something to think about and look into. Good luck!
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#9 of 17 Old 04-07-2005, 12:46 AM
 
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I think you should do more research on VBAC yourself instead of taking their opinion on VBAC. Uternie rupture is highly unlikely and you should have the option of making an informed choice.

Mom of a 7 yr old, 4 yr old, and 1 yr old. Wow. How did that happen?
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#10 of 17 Old 04-07-2005, 07:19 PM
 
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Quote:
Originally Posted by soon2bemotherof4
I would really like to have a vbac but the doctors have advised me against that saying it's too dangerous and may cause uterine rupture. Ok, so that's out.
Be informed! I would research it if you can. I think-from what I have read-that you could have a VBAC and that you should. There are more risks (know the risks~lots of doctors won't tell you about them unless you yank it out of them~ to the baby and mother with another c-section than there would be to have a VBAC...VBAC is perfectly safe. If you do choose to change doctors find one that has a 70% VBAC rate, b/c lower means that they are likely to do c/s again... my $.02

Quote:
Originally Posted by soon2bemotherof4
Has anyone been told that they'd have to have a vertical incision after having horizontal incision(s)?? I really don't understand the reasoning.
Sorry I can't help but I would think that you should bring this up to the other doctors to see if they all agree on this. Again ITA with pp's go elsewhere!
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#11 of 17 Old 04-15-2005, 10:22 AM - Thread Starter
 
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Thank-you all for your replies. I have been getting the same responses from people I've talked to in my hometown. So I'm wondering what is up with the doctor who told me this? Frustrating...
I have an appt. on the 27th after an ultrasound and then an appt. with a new doctor on the 29th. I will be sure to bring this matter to their attention and get their opinions. I am going to tell them I absolutely refuse to have a vertical incision! Also, I am going to inquire about VBAC3 with the new doctor, although I have a feeling he is going to advise a C-Section. But at least I will give it another try.
Again, thank-you!
TC
~Dawn
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#12 of 17 Old 04-15-2005, 12:03 PM
 
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don't expect a different answer if this new doc is in the same practice. If I were you, I'd seek a second opinion from a direct-entry or certified-public midwife instead.
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#13 of 17 Old 04-15-2005, 12:42 PM
 
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Please find a new practice. I don't post much but I felt like I needed to add my 2cents. There is no reason for a vertical incision. I have been an OB nurse for 8 years and the hosp I work at does tons of c-sections. Bikini cuts are done the majority of the time, even if it is the lady's 5th section. Usually the doc "removes" the old scar at the start of the surgery to promote better and neater healing after.

You may be able to find someone who will let you vbac. I think that it would be hard to find a doc tho. Too much legal liability crapola.

I wish you the best of luck!
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#14 of 17 Old 04-19-2005, 01:20 AM - Thread Starter
 
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I just remembered that the doctor said something about having to do the vertical cut because they don't want to accidentally cut the bladder. Then she said something about only having one bladder. I was already lying down waiting to hear the baby's heartbeat when she was talking about the vertical cut and I couldn't really hear her and couldn't see too much of her face since she was still standing my my feet and facing the student nurse and not me. So, does that make any more sense? Why might they accidentally cut into my bladder with a horizontal cut but not a vertical cut? I've not had any bladder problems that I know of.

One more week until I go to the new practice. Thank goodness!

The appt. I have next Friday is with a new doctor at his practice. The place I've been going to has 3 doctors there in the practice and I don't much care for any of them. I've heard good things about this new doctor I will be seeing from women who have gone to him, or are going.
I really hope I like this one.
Thanks again for your replies!
~Dawn
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#15 of 17 Old 04-22-2005, 11:46 PM - Thread Starter
 
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vertical c-section due to not wanting to cut into bladder?

I just remembered that the doctor said something about having to do the vertical cut because they don't want to accidentally cut the bladder. Then she said something about only having one bladder. I was already lying down waiting to hear the baby's heartbeat when she was talking about the vertical cut and I couldn't really hear her and couldn't see too much of her face since she was still standing my my feet and facing the student nurse and not me. So, does that make any more sense? Why might they accidentally cut into my bladder with a horizontal cut but not a vertical cut? I've not had any bladder problems that I know of.

One more week until I go to the new practice. Thank goodness!
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#16 of 17 Old 04-23-2005, 12:34 PM
 
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Have you read your post op reports from your other csections? Is it possible they nicked your bladder last time? Or maybe you have lots of adhesions (I sure did)? They aren't telling you something, and it's your right to know what is going on. get your records and read them! If there's stuff you don't understand, ask them. Bring a list of questions with you when you see this new doctor, and stay there until they are all answered to your satisfaction. Don't let them rush you out the door until you get some answers.
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#17 of 17 Old 04-29-2005, 11:15 PM - Thread Starter
 
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I saw the doctor Wed. (after having a terrible experience with the nurse who was doing my ultrasound...she was rude and rubbed me so hard that I have a 5" raw area that bled on an old C-Section scar. My baby kept on moving and she was sighing in exasperation. I wanted to know the gender and she snapped at me that she couldn't get a good shot of anything. She did not give me any sonogram pics neither...so that was just one more reason to leave this practice: rude nurses!) and asked him about what his colleague had said about me having to have a vertical. He said I did NOT have to have a vertical incision, that she probably said that because it just takes more time cutting through the scar tissue. So does that mean he was implying that she is lazy? lol
Doesn't matter.
I went to a different doctor. He has no colleagues. He's the only doctor at this place. His nurses were awesome, he was awesome.
When I asked him about a vaginal birth, he said no.
He said yes if only after one C-Section, maybe after 2, if I insisted, but not after having 3 previous C-Sections due to the risks of uterine rupture and plus the fact that people in WV like to sue doctors left and right with malpractice suits. But I was pretty well used to the idea that I wouldn't be able to have the VBAC, so I wasn't too disappointed in his answer.
When I asked him how he would do the incision, he said horizontally.
When I said that I had a lot of scar tissue, he said that he would just cut through it and that it would have to be something really out of the norm for him to have to do a vertical incision. So that was the clincher.
I'm staying with this doctor.
Thank-you to all for your replies and support!
~Dawn
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