I will have a hospital birth & ob will be avail should anything go wrong (this is law in NJ). The midwifery practice I am using claims a 95% success rate with VBAC, and is very supportive.
So, anyone have success stories to share with me to ease my mind? Or any thoughts at all?
Thanks so much!
I've read alot of mixed info about the double layer sutures. Some studies show that they are not beneficial and actually cause more scar tissue to form, in turn making the scar weaker and more likely to rupture. A thicker scar does not necessarily mean a stronger one.
Blogging my way through grief. Look in my profile for link.
Two things about the op have me raging and not at the poster. First of all, all the scientific studies point to absolutely no difference in rupture rates, meaning some studies say its increased with single layer and some say its increased with double layer. Secondly, the rate of uterine rupture for vbacers is somewhere between .2 and .5%, nowhere near a whole 1% and it most certainly doesn't double based on your scar type. Even the studies that show an increase in rupture with a single layer closure don't show it doubling. Double layers are considered a stronger seal, but they don't stretch as much. I hbaced my son with no problems after a single layer suture. I hate the misinformation out there about this and I also hate that Ina May keeps supporting the idea that single layer sutures are "a ticking timebomb" Good luck with your vbac and don't let your layering concern you. Its much more important that you had an infection free recovery from your original surgery than what layers you had.
I had a successful HBAC 10.5 months ago, no problems with my single layer closure.
I had several MWs refuse to attend me "under the table" (AR law prohibits MWs attending HBACs, but many will do it anyway b/c they don't agree with the law) due to the fact that I had a single layer closure. But I could never find any real, definitive information saying a single layer was worse.
I even asked my OB (with whom I had concurrent care) if he'd sew me back up with a double layer closure in the event I had another c-section. He told me that when you create a double layered scar, you are folding in part of the uterus that wasn't in that area to begin with, if that makes sense. He would be sewing the original cut, and then folding in more of the uterus (a part that wasn't cut) to sew together as well.
I have no idea if I described that well. I'm having trouble articulating what exactly I mean.
Wife to an amazing man , mommy to 3 wild dudes: ds1 (5/23/05 @ 30 weeks), ds2 (3/5/09) , and ds3 (9/26/10) . Part time librarian, full time mommy, occasional chef and maid.
I labored for 41 straight hours on a single layer suture. You can read my birth story here. (I'm hoping it's not "my" midwives that quoted you that risk. I'd have to mention that to them. They know I can quote this stuff in my sleep!!! )
Just an fyi.... here is a link to summaries and criticisms of suture studies:
studies favoring double layer sutures
studies showing no difference between single and double layer sutures
Thank you, everyone, for your feedback. Clearly, I'm not as educated on all the studies and information out there, so I'm glad you can help me.
In all seriousness, check your surgical report (or if you gave it to them, just ask) to see what your c-section suture material was made of. It will say something like 0 Chromic or 1 Vicryl, etc. If it's chromic, you may have a slightly higher risk but it means you need to avoid induction or pitocin use as much as possible (which shouldn't be an issue with them anyway). If you have vicryl, then there is absolutely no reason to believe that your risk is in anyway elevated vs a double layer suture. And you can tell them crazy VBAC Dana said that. Their old back up doctor used to require single layer suture VBACs to have an IV in. During my visit with him, I went over the studies and explained why I disagreed with calling me a higher risk. I told P&L I was going to do that ahead of time so when I was talking to him, Louise walked in with my chart and winked at me on her way out. He was really nice about it though and didn't say anything about an IV so I just had a saline lock in place. After my big conversation, he still quoted my risk as 1%.
Bottom line is that you don't even need to worry anyway. They are super patient and if they have any concerns about an increase risk of UR with a single layer suture, you won't see it in them during your labor. I know of at least 3 women who VBACed with them on single layer sutures. My labor kept stalling so I used nipple stim to keep the contractions going. One of my friends (who is on here as well) opted to use a little pitocin since her water had been broken well beyond 24 hours and they kept it a very low dose (as opposed to many providers who will increase the pit dose every 20 minutes).
Jennifer, LPN and nursing student, Doula, CPST, and VBAC mama x3 to
AJ (5/03), Evan (12/04), Ilana (11/06), Olivia (2/09), and Unity (8/2012)
FWIW, I had a VBAC w/ a single-layer suture 18 months ago and everything was great (birth story here). I had even told the doctor who did my c/s that I wanted a VBAC with my next pregnancy, and to "sew me up good" and he *still* did a single-layer. I think the Ina May book, while otherwise wonderful, did us VBACers a disservice by scaring us into thinking we *had* to have a double layer suture. The evidence just isn't conclusive.
Mom to James ( 5/2006), Claire ( 6/2008), furry kitties Calvin and Bob, and wife to Dennis.