OK like some of you know we are planing on moving back to Europe (Germany), I already started looking into providers and their stats...I am not amused I just found a stat that the Obstetricians rely on in regard of VBACs and it says that...rupture risc of one a vaginal birth after two c-sections compared too one is not significant, 1.1% compared to 2% which is a good thing.
But here is whats gonna haunt me again...the stats also say that the rupture is increased depending on how much time is between the last c-section and the next birth. It puts me at a pretty high risc, what do you think??
Here are the stats, sorry they are in German, but you can tell by the numbers..LOL... What do you guys think?? 4.8% as in less than 12 months between pregnancies that is high right?? Not sure what I should do now Any advice??? Or thoughts, not 100% sure if I fit in the 4.8% or 2.7% but its much higher than I thought now arrrrr so frustrated I am not sure if I want to risc that much
Here this what I copied from the German Deutschen Gesellschaft für Gynäkologie und Geburtshilfe (DGGG)
Ruptur nach wiederholtem Kaiserschnitt (RUPTURE AFTER RCS)
= 2 x Sectio 2 % vs. 1.1% nach 1 x Sectio (kein signifikanter Un-terschied) NO SIG DIFFERENCE (III, 6)
Ruptur nach Abstand zur vorausgegangenen Sectio /RUPTURE TIME SPACE TO LAST C-SECTION
< 12 Monate: 4,8% (IIb, 11)
13-24 Monate: 2,7% (IIb, 11)
> 24 Monate: 0,9% (IIb, 11)
That is, if you trust the stats at all. The rupture rate of the third stat, .9%, is higher than the rate that is usually used for VBACs in general, which is .5%. Also, you have to take into account that the second stat, or really all of the stats, might include women who are higher risk then you (like women who have had many babies or women who are not healthy).
I am not sure anymore if they are talking about 18 months between births or before trying to get pregnant, or as in the stats 12 months or less between pregnancies or births, but I been reading that your scar heals while you are pregnant too so it must be included
Anyway. I don't really have any information. My mom works as an OR nurse at a - German - hospital and she said that they usually section after two previous c/s. I don't know what other options you have in regards of midwifes or homebirth in Germany. I have had two children in the US and everybody I know who had kids in Germany (classmates, friends etc) always went with an OB.
The thing about stats is that they can be made to say whatever you want them to depending on how they are compiled and how they are interpreted. Stats that include random samplings of all types of pregnancies, but that doesn't break that down further are pretty meaningless, only stats based on your type of circumstances over a large sampling would be meaningful, but still not an absolute predictor of how it will work for you.
Don't let the stats discourage you. Hope you get the VBAC you want and it all goes smoothly.
Lyn, wife to Rob & Mamma to "Moredcai" 12wks July 09, Aiden(6/1/10) and Seth(9/7/11) New blessing Megan(5/9/13)
I know that they also have new guidelines in Germany for OBs that say a VBAC after 2 c-sections is not much more of a risc than a VBAC after 1. So they begin to change a little, not sure how many hospitals have implemented these guidelines.
If I do not find any provider/hospital that is willing to support me with a VBAC, I will be screwed cause my husband will never be on bord with a HBA2C if this option is even given to me.
Although I do not agree with it... I *understand* OBs pushing repeat c-sections... for whatever reason. However, I do NOT agree with OBs pushing a repeat c-section if you are planning in delivering in a freaking hospital. Arguing for c-section vs. UBAC.... I don't agree, but I get it. Arguing for repeat c-section vs hospital trial of labour? Absolutely not. It's ridiculous.
Tristian, vegetarian wife to Matt, intactivist, UC supporting mama to my little earth-child-in-training, Ginny (4), and my sweet boy, Finnian (2). Due mid-July with our third little one!
And on a personal note, my first VBAC was just 14 months after my c-section.
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Now, according to the NIH, they say that rupture rate is less than 1% for a mom VBACing 18 months between births, much lower than the stat listed. I am assuming, but I *THINK* the US is probably more likely to use induction and augmentation vs Germany, so I would venture to guess that the VBAC rate for your case, with your timeframe would be even less than that.
Personally, of what I have read it's about 42 days from suture to healing, according to Vaginal Birth After Cesarean. You may want to check that book out, it's pretty good and goes over rupture pretty well.
I wouldn't worry about complications with rupture, especially if you are in a hospital like a PP said. I think it's something like 0.05% of the time a VBAC is dangerous for the baby as in life threatening. So I wouldn't worry.
I do not know if it became clear, but I had 2 c-sections and no vaginal birth
So from the 2nd c-section to the next birth will be 15-16 months...most doctors feel different about having had 2 c-section but on top of it the short time frame I will have to fight my butt off to get the birth and support I want!
Its just last time when I was going for my VBAC I was not worried about a rupture or any problem at all. Why is it that I feel so anxious this time?? It seems like its so much harder to fight for it this time not sure why there are so many stats that say its more of a risc after having two c-sections and less time between birth