quick question- time after c/s vs. vbac - Mothering Forums

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#1 of 9 Old 02-23-2010, 05:42 PM - Thread Starter
 
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Hi. I am wondering if anyone knows if there's a connection between the length of time from the c/s and likelihood of successful vbac. (vs. rupture, etc. and ob willingness to trial labor, etc.)
as in, if i had a c/s 6 months ago, am i likely to get a vbac if i am pg now;
if i had a c/s 12 months ago, is it more likely that vbac is successful?

I hadn't come across any information about age of scarring impacting strength, etc. I do know that it's recommended by many ob's to wait 12 months before another pregnancy, but that's generally for another c/s, i would imagine..

Is it getting lonely in the echo chamber yet?

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#2 of 9 Old 02-23-2010, 05:53 PM
 
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There are a couple different theories out there that I know of.

-18 months between pregnancies
-12 months between pregnancies
-12 months between births

According to Birth After Cesarean, it's something like 42 days or so for the incision to heal, so according to his opinion, anytime after that, it doesn't matter.

I would think success would be more so determined on the reason for a c/s. If you had one for a breech baby, your chances are higher than for "failure to progress". But, a lot of times, "failure to progress" was usually do to a malpositioned baby, that wasn't assisted in rotating.
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#3 of 9 Old 02-23-2010, 07:06 PM - Thread Starter
 
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that's good to know.
I'm not pg yet, not actively trying, not even sure about pp fertility, just am older and wondering how bad it would be if/then..
c/s b/c water broke, labored 12 hours at home, no dilation, had pitocin, maxed it out at 12 more hours, STILL not even all the way effaced, was then 24 hrs since water broke, had declined the strep test earlier in the pregnancy, and we were afraid of infection plus the hospital had a policy...
hopefully that won't happen this time. not sure about finding a supportive doc this time around too, but we'll see. i liked my ob/gyn but don't know his views on vbac. he is pretty reasonable otherwise (as in supporting the decision not to do the strep test and being ok with me laboring so long this go round).
thanks for the info. i feel a little better.

Is it getting lonely in the echo chamber yet?

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#4 of 9 Old 02-23-2010, 07:33 PM
 
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The general rule that my OB used was 18 months from c/s til VBAC. Although I know some women that their OB/midwife knew that was what was recommended, but allowed a shorter time between, one specifically was 17 months apart, the other 14 months apart. I knew that 18 months was a good idea in my case, just so there weren't any reasons to sort of "question" me and my ability to VBAC.

But, like the previous person said, I think success has more to do with situation. Luckily, my OB said phoey to that....I was a "failure to progress", IMO to due being induced, water manually broken at 2cm, and a baby that just plain old wasn't ready...not to mention an impatient OB that put me on the clock for pushing....luckily, my new OB was a little different...so, I got my VBAC.

I think providers have a lot more to do with success than things like time between c/s and vbac and reason for c/s and so on!

Me (30), DH (31), DS (3.5 yrs - 5/07), DD (1.5 yr - 2/09) via VBAC!!! DS (newborn - 11/10) via natural VBAC! 2 angel babies - 06/06 & 04/08
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#5 of 9 Old 02-23-2010, 08:18 PM
 
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A lot of providers like to see at least 18 months between c/s and VBAC.

I believe that your choice of provider and your provider's commitment is one of the most important factors in VBAC success. Time between pregnancies is something that can control. If you aren't pregnant yet, it is a good idea to aim for that spacing. Finding a supportive provider can be difficult and the 18 month spacing is a very common requirement. Even if someone agrees to take you on with less time between pregnancies, they may not be as comfortable and may not work with you as well towards the end of the pregnancy and in labor which can effect your success.

If they are nervous they may be more likely to push a c-section towards the end, put time limits for going into labor on your own, push induction, be more restrictive during the labor, be quicker to declare failure to progress, etc. during labor and move for the c-section. Now, you can try to fight your way through that, but it is better if you don't have to. Some might argue that if the spacing is important to the provider, the provider isn't truly supportive, but in many places in the country, you just don't have a lot of choices so if you aren't pregnant already, there are benefits to waiting a few more months.
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#6 of 9 Old 02-23-2010, 09:35 PM
 
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This is how I view VBAC, it's the same a vaginal birth, only you should be more aware of your body, so even more reason to avoid pain relieving medications and medications that can interfere with "listening" to your body. So you are more likely to notice a "rupture". IMO, I'm very anti augmentation in almost any situation. In your, I would have waited up to 36 hrs or so before going the pit route. Studies show that the chance of infection goes up 24 hrs after the first vaginal exam after the water has broken. So as long as you were home, with no exams, I'd say wait it out as long as you can.

So, I'd say, if you have a CP who insists on this or that, or recommends anything special only because you are a VBAC, I'd say get a different CP, or stay with them and refuse the "treatment".
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#7 of 9 Old 02-23-2010, 11:18 PM
 
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I haven't seen any data on the *success* rate of VBAC being related to pregnancy spacing, but I have seen a reasonably good paper on pregnancy spacing and risk of UR. In a nutshell, less than 12 months between births was associated with a higher risk of UR. 12-18 months was significantly higher but not by much, and after 18 months there was no significant difference. (See http://www.ncbi.nlm.nih.gov/pubmed/12439503) The main disclaimer about this article is that the data are from 1988-2000, so it contains many inductions so the UR rates are generally high.

Mom to James (ribboncesarean.gif 5/2006), Claire (vbac.gif 6/2008), furry kitties Calvin and Bob, and wife to Dennis. 

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#8 of 9 Old 02-24-2010, 07:09 PM
 
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There is so much conflicting data out there.... so many 'studies' which depending on how the information is gathered, give such varying results.

Personally, I am currently planning a VBAC with a 12-13 month interval between c/s and my upcoming birth. My doctor didn't even think twice about whether or not a VBAC would be the best route to go. She very much thought that a planned c/s would not be a good idea, and has reassured me time and time again (when worry has gotten the best of me,) that a VBAC even under these circumstances would be best. I have had two natural births previous to the c/s, so I am aware that this is in my favor for having a successful VBAC as well.

Mom to three girls and a BOY: (2003) (2007) (3/25/2009 - 4/10/2009) (5/2010)
Blogging my way through grief. Look in my profile for link.
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#9 of 9 Old 02-24-2010, 08:30 PM
 
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I just had a wonderful VBAC 15 months after an emergent cesarean (ripped open under general anesthetic in 8 minutes - a crazy dramatic c section!). It was the single most healing experience of my entire life, apart from, of course, having my daughter here to love every day! The doc checked my incision from the inside afterward, manually, and it was completely intact - no evidence of any dehision whatsoever, not even a slight separation. The cesarean was on 10/10/2008 - the VBAC was on 1/12/2010.


Mama to Josie , lost 10/10/08 at 37.4 weeks .
and my rainbow baby, Isobella Mai ...born 1/12/2010 ! in profile...
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