Was my 2nd c-section medically necessary and would you have made the same decision? - Mothering Forums

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#1 of 3 Old 07-17-2013, 02:09 PM - Thread Starter
 
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I was wondering if my c-section was necessary. I had a c-section with DD 17 months ago, and was going to have a VBAC with DS this time around, didn't quite work out that way.

I was on my way to my 38 week check-up when I got into a minor car accident. No real damage. Doc said go to the hospital to get checked out. Ultrasound shows nothing abnormal but my belly feels tender where my seat belt would have tightened, fetal monitoring shows nothing abnormal, but blood tests show that there are fetal blood cells mixing with my blood. This raises the suspicion of placental abruption. My doc consults with a high-risk doc who says that it can be normal for some women for various reasons, and they decide to redo the blood test the next day to see if the amount of fetal blood cells mixing with my blood is increasing, steady, or decreasing. If it increases, we all agree that a c-section would be best because that means that there is an active bleed somewhere, probably from the placenta. I am admitted and put on constant monitoring all night. Still no sign of fetal distress. Blood gets drawn again next morning and it shows that there is twice the amount of fetal blood cells mixing with my blood. I'm hooked up to an IV, 30 minutes later my son is born via c-section. Doc sees no sign of placental abruption, and sends the placenta off to pathology. Got the results today... everything looked normal.

So, do you think my 2nd c-section was medically necessary? Since pathology showed everything was normal, doesn't that mean that I could have gone for my VBAC and everything would be okay? Would you have made the same decision to opt for a repeat c-section at that point instead of waiting it out for a VBAC?
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#2 of 3 Old 07-17-2013, 03:02 PM
 
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You have to act with the information you can get.

The increasing number of fetal blood cells in your blood was a red flag - red flags aren't certainties, they're warning signs. A high risk ob could probably break it down for you in terms of risks and percentages - I don't know what the numbers were in your case, or how far you'd feel okay letting the numbers tip, and the certainty you have now (that the placenta was fine) wasn't available until after the birth.

While it is possible that you'd have both been fine waiting, there was no way to know that then. "Medically necessary" doesn't mean you'd have died without it. Sometimes it means the best guess at the safest thing.

OB is supposed to be about getting the baby out with minimal injury to anyone involved. They hate risk, and when it was my baby on the line, I hated it too. I would not have held out for a VBAC in your place.
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#3 of 3 Old 07-17-2013, 03:56 PM
 
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I agree with meepycat, the doctors can only work with risks and percentages, not absolutes. There was no way to know for certain if there was an issue with your placenta, all they had to go on were red flags or lack thereof. Since there was a huge red flag, this made having a c-section the best choice. To expect anyone to know for certain that it was needed shows that you're not aware of medical limitations. This was a need based on the red flags that were probably created by the car accident. I would accept it for what it is--medically necessary given the information available to the doctors and i personally would have no regrets given these circumstances.
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