VBAC after uterine rupture - Mothering Forums

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#1 of 10 Old 10-27-2012, 12:36 PM - Thread Starter
 
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My DS was born in 2008, and only having "What to Expect..." as my pregnancy reference, I had no idea that it was perfectly normal for a pregnancy to go past the "due date", or to disagree with your OB.  So, on my "due date", my OB told me that he would give me a week.  A week later, my son still wasn't born, so he scheduled a c-section.  I was disappointed that I didn't have a vaginal birth, even though I was planning for an epidural, etc.

 

Fast forward to 2009, I found out I was pregnant again, and that my DD's due date was pretty much the same day my son was born, just 2 years later.  I was thrilled, but REALLY wanted to try for a vaginal birth.  I went with a CNM this time, and thought I did everything right.  I actually gained a LOT of weight during my pregnancy, and on my daughter's due date, my CNM checked my blood pressure and it was really high.  He sent me into the hospital for monitoring and a couple of tests, and they diagnosed me (without having 100% confirmation) as probably having pre-eclampsia.  They gave me 2 options, repeat c-section or induction. Looking back on it, the hospital staff really scared me into having the baby that night. Since I really wanted a vaginal birth, I chose the induction.

 

My midwife inserted a foley bulb, which came out on its own, and I was given pitocin and later an epidural.  At around 4-5 cm., my labor stalled (surprise?), so my midwife broke my water.  Maybe an hour later, I was in a lot of pain, and I knew something was wrong.  I had the epidural, but it almost felt like a hard contraction that wasn't letting up.  I was rushed in to the OR and given a c-section.  The OB who operated on me told me that my old scar had opened up about the size of a quarter, and the pain was coming from the fluid that went out of the hole into my abdomen, irritating my organs.  So it wasn't a catastrophic rupture, and it wasn't even very large (but heck yes, it was painful).

 

The OB also told me that if I were to have another baby, it would be a definite c-section, which would be scheduled for a date as soon as an amnio test proved the baby's lungs to be mature.

 

The thing is, we are planning to have another baby in the near future, and I would love to get one more chance to have a VBAC. I don't want to be reckless and stupid, but I honestly think that the circumstances surrounding my uterine rupture really were a "perfect storm", so to speak, that really decreased my chances of a favorable outcome.  Being obese, eating poorly and not exercising at all, plus being induced were all problematic.

 

Do you all think it's crazy talk for me to consider a VBAC after a uterine rupture (and 2 sections)?  

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#2 of 10 Old 10-27-2012, 02:42 PM
 
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hug2.gifI couldn't read without posting, but I don't know what to say because I haven't been-there-done-that.  I don't think it's crazy to want a VBA2C&R. And my first thought on reading your story was that the induction probably contributed greatly to the rupture and if you avoid induction next time you might have success.  I hope you get some better responses. shy.gif


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#3 of 10 Old 10-27-2012, 06:11 PM
 
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Hi there. Your story is so similar to mine except that I chose to use a CNM for an hbac and did end up with a catastrophic rupture and my baby boy died. I managed to escape a hysterectomy. We were told that any future pregnancy would be very high risk: any contractions preterm would have to be controlled immediately, and - same as you - I woul t go past 37 weeks because of the risk if labor and the speed with which I could lose another baby. There's no way I would risk a vbac, obviously, but in your case I would get at least two OBs opinions. The other things to consider are how big your baby was, how close your pregnancies were and how well you heal in general. I dot want to scaremonger, and I know others will disagree, but I wouldn't want to risk rupture in your case. An RCS is most likely to be a much safer option for your baby, even though there are increased risks of complication or you. Were you hoping or more than two children? That's obviously another factor to bear in mind. I really wish you the best of luck, and I hope everything goes more smoothly with a future pregnancy: rupture is a scary, horrible, and in my case, devastating thing.
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#4 of 10 Old 10-27-2012, 06:26 PM
 
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I'm another one that hasn't gone through that and I can understand wanting a vaginal birth.  I don't think I would try for one in your situation though.  IMO, the benefits of a vaginal birth don't outweigh the risks.


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#5 of 10 Old 10-28-2012, 12:51 AM
 
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From everything I've heard from women on mothering, as well as random internet research, having an induction after a c-section is actually unwise. Here is a link to an article on the subject http://www.guttmacher.org/pubs/journals/3328701b.html

 

I have only had one baby (via c-section), but I think that if I had a failed vbac due to being induced, I would probably try for another vbac. Of course, you might want to talk with your OB or midwife about that.

 

Another thing, I've read that during ultrasounds the scar tissue from c-sections can be seen and assessed for thickness compared to the rest of the uterus. Apparently the closer the scar and uterus are in thickness, the better your chance of a vbac. Not sure how true that is, but I have every intention of having my scar checked out during an ultrasound the next time I get pregnant.

 

You might want to check out ICAN, which is a group dedicated to spreading awareness on the issue of cesareans. A lot of women here talk about ICAN helping them get vabcs. http://ican-online.org/
 


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#6 of 10 Old 10-29-2012, 09:10 PM
 
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First, if I could avoid it I wouldn't go to the same OB that did your induction on a VBAC. Research, ACOG everyone says that's a huge no no. When they did your c/s with the rupture did they go through the old scar or did they cut a vertical one? Many times in situations like that they'll cut vertically. It would be wise to know. I'm not sure what I could choose in your situation. I would make sure you research your options and your providers, get your old records from your previous pregnancies etc. I think one thing you have going for you is that it wasn't a huge opening. 


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#7 of 10 Old 11-04-2012, 11:21 AM - Thread Starter
 
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I actually had a midwife for the induction.  The OB only came into the equation when my uterus ruptured.  I also had a horizontal incision for both sections.

 

After considering everything, I am almost certain that I will get a repeat c-section for the third baby.  I'm *fairly* certain that my third baby would also be my last, though I'm not 100% sure on that yet.  I had my 2 kids so close together that (they're almost exactly 2 years apart) that the prospect of having 4 kids frightens me a little bit. lol

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#8 of 10 Old 11-04-2012, 09:23 PM
 
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Hi Rosie,

Man I'm sorry to hear about the rupture. I think if I were in your shoes I would go for the repeat C-section, but might do as another poster suggested and talk to a few OB's and midwives first. I'm not far from you, by the way!  I'm in Pgh.  I hear the midwives in the strip district are great, and they do hospital births at Mercy for us VBACers, in case you decide to go that route.

I was so scared of uterine rupture before my 2nd birth (which was a VBAC) so I did lots of visualizations- I would visualize my uterus as being made out of chain mail! Fine-linked, flexible and supple, yet supremely strong. Anyway, happy incubating...

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#9 of 10 Old 11-20-2012, 08:59 AM
 
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Rosie: I'm so sorry for your rupture. I had one, too. I'd pushed so hard for so long (after an induction) that when the OB cut into my uterus it just kind of ripped open even more. My CNM told me not to attempt a VBAC. I've really had to grieve that loss, and now that I'm expecting #2 I really go back and forth about attempting it or not. I doubt anyone in my red state town will even try it, anyway. ...I just wanted to let you know that I empathize. Natural birth was on my bucket list and I'll never get to experience it. :,(

 

LoveIsla: Thank you for sharing your story. I'm so very sorry for your loss. 


Janie, wife to Chuck and Mama to sweet Zoe Kate (12/09) and loving every minute of it.
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#10 of 10 Old 10-05-2013, 02:52 PM
 
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It makes me heartsick to see so many of you downplaying the risk of uterine rupture. My niece-in-law just attempted VBAC after a caesarean two years ago. Unfortunately, her uterus ruptured at home with midwife present. They live 10 minutes from the hospital. They could hear the heartbeat before leaving for the hospital but the baby was dead when they got there. My niece-in-law ended up with a total hysterectomy, therefore all future dreams of having a child are gone. They baby was four days early and was over 8 pounds. She had a semi-traumatic birth the first time after laboring at home for some time with no results.
If you really think uterine rupture is not a risk, go ahead, but be sure you are not just building a home delivery up in your mind. Statistics show many more deaths on home births than in the hospital. So much of the data is twisted to encourage moms to stay at home. It is the long term with your child that is important, and please do everything you can to bring the baby into the world with the least trauma possible. This is the hardest thing we have ever done, and seeing and holding a dead baby that we all were so excited about is certainly something that will never leave me. Heartbreaking.
Now that we have gone through this, I am hearing so many families who have had the same experience. Please please please protect your baby by being in the hospital for your VBAC.
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