"More Moms Dying from Cesareans" Why would you NOT VBAC???? - Mothering Forums

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#1 of 59 Old 09-01-2006, 11:15 PM - Thread Starter
 
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A recent study that shows the rate of death from cesareans is triple that of women who give birth vaginally. What this new study really shows is that the deaths were not from pre-existing conditions. In fact , these deaths, mostly from infection, blood clots and complications with their anesthesia.

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#2 of 59 Old 09-01-2006, 11:16 PM - Thread Starter
 
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Be sure to check out the What to do if You're Denied a VBAC
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#3 of 59 Old 09-02-2006, 12:29 AM
 
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"More Moms Dying from Cesareans" Why would you NOT VBAC????
...never mind.


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#4 of 59 Old 09-02-2006, 05:26 AM
 
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Like Marsden Wagner says, if women are choosing c-secs someone is lying to them. Sadly most women don't actively choose, they get a bad system and then a worse anti-vbac system. Once you have the HUGE list of potential problems from surgery in front of you and the very small list of potential problems for the normal physiological process it seems pretty clear which is safer for you and your baby.
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#5 of 59 Old 09-02-2006, 05:38 AM
 
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Comparing vaginal delivery to c-section is different when it's a VBAC compared to ERCS. The stats simply aren't one and the same.

More women die from ERCS vs. VBAC attempt.

However, more babies die from VBAC attempt vs. ERCS.

Perhaps women are choosing to take the risks of ERCS for themselves to lower the risk of death to their baby?

Off to find handy chart of stats from the NEJM study published just under two years ago that studied this very thing.
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#6 of 59 Old 09-02-2006, 05:52 AM
 
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Here we go, just posted this last week. If you like, you can register for free to have access to the entire research article, including all of the tables that were truly fascinating, from this study.

The first number is risk during VBAC, the second is for ERCS.

So, VBAC vs. ERCS stats were found to be as follows:

UR: 0.7 vs. 0

Dehiscence ('windows', but are NOT life threatening): 0.7 vs. 0.5

Hysterectomy: 0.2 vs. 0.3

Thromboembolic disease: 0.04 vs. 0.1

Transfusion: 1.7 vs. 1.0

Endometritis: 2.9 vs. 1.8

Maternal death: 0.02 vs. 0.04

Other maternal adverse events: 0.4 vs. 0.3

One or more of the above: 5.5 vs. 3.6

These are number for MOM, not talking about baby at all. Overall, mom experienced more complications during VBAC (5.5%) than they did with ERCS (3.6%).


Numbers for BABY looked like this, again VBAC vs. ERCS:

Hypoxic-ischemic encephalopathy (severe brain damage): 0.08 vs 0

Neonatal death: 0.08 vs. 0.05


In real numbers, they had 3 dead moms after VBAC, 7 dead moms after ERCS. So, yes, ERCS was found to be riskier for mom in terms of death.

In real numbers, they had 13 dead babies from VBAC, 7 dead babies from ERCS. So, VBAC was riskier in terms of death for baby.

So...again, maybe some women look at all of that and think 'They are all such small numbers, it's worth the risk to attempt VBAC even though more babies died as a result in this study.'

And that's a perfectly logical thought to have.

I don't happen to share that thought, as I'll take on the added risk of maternal death every day of the week and twice on Sunday to avoid putting that risk on my unborn child, no matter how small the numbers are.

BUT, the numbers ARE small, so really, either choice seems perfectly valid and certainly not something to be up in arms about or shocked over how someone else could arrive at a different conclusion looking at the same information.
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#7 of 59 Old 09-02-2006, 05:57 AM
 
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Originally Posted by JanetF
Like Marsden Wagner says, if women are choosing c-secs someone is lying to them.
Do you not believe the findings published in the NEJM? The study itself was set up using sound research principles, and the numbers don't lie.

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Sadly most women don't actively choose, they get a bad system and then a worse anti-vbac system.
This part is absolutely true. Many times it's not a choice mom GETS to make whether or not to VBAC, unless she is willing to do so unassisted. That's a shame really, as I am a big believer in choice, regardless of whether or not I agree with that choice.

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Once you have the HUGE list of potential problems from surgery in front of you and the very small list of potential problems for the normal physiological process it seems pretty clear which is safer for you and your baby.
If we're talking vaginal birth vs. c-section, sure. If it's a look at risks for VBAC vs. ERCS, it's no longer a 'normal physiological process' because the scarred uterus is no longer 'normal' and there are risks associated with that fact. I put the list in my previous post of actual complications found in women who attempted VBAC vs. those who elected for ERCS. The ERCS group experienced LESS complications overall than the VBAC group.

Again, the numbers don't lie, but it is crucial to realize that EITHER set of numbers is very low.
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#8 of 59 Old 09-02-2006, 05:44 PM
 
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Originally Posted by wifeandmom
So...again, maybe some women look at all of that and think 'They are all such small numbers, it's worth the risk to attempt VBAC even though more babies died as a result in this study.'

And that's a perfectly logical thought to have.

I don't happen to share that thought, as I'll take on the added risk of maternal death every day of the week and twice on Sunday to avoid putting that risk on my unborn child, no matter how small the numbers are.

BUT, the numbers ARE small, so really, either choice seems perfectly valid and certainly not something to be up in arms about or shocked over how someone else could arrive at a different conclusion looking at the same information.
Absolutely. DH and I came to the exact opposite conclusion. First, I would rather have no-one die, of course. But I believe it would be irresponsible incur the greater maternal death risk of ercs, with the ramifications of leaving DH with no parenting partner and DS with no mother. This may sound so so so horrible, there are people relying on me in this world and I refuse to take that risk. I guess that sounds like a decision that's selfish, but it was not made for selfish reasons. Free choice (between vbac and ercs) is a wonderful thing, because it can accomodate our different ways of appraching these issues.

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#9 of 59 Old 09-02-2006, 05:55 PM
 
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I believe it would be irresponsible incur the greater maternal death risk of ercs, with the ramifications of leaving DH with no parenting partner and DS with no mother. This may sound so so so horrible, there are people relying on me in this world and I refuse to take that risk. I guess that sounds like a decision that's selfish, but it was not made for selfish reasons.
Ditto that. I am sorry and I know it sounds terrible, but if there is a choice to be made between myself and my unborn baby, I am going to choose myself only because I wont leave my very young children without a mother, and my husband without a parenting partner. My choices may have been different the first time I was pregnant with no kids already but things are different.
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#10 of 59 Old 09-02-2006, 06:47 PM
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Originally Posted by wifeandmom
More women die from ERCS vs. VBAC attempt.
But what's the difference between VBAC and scheduled c-sections?
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#11 of 59 Old 09-02-2006, 06:51 PM
 
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But if the mom dies, then usually so does the baby.
How does that make an ERCS better?
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#12 of 59 Old 09-02-2006, 06:56 PM
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Originally Posted by DreamsInDigital
But if the mom dies, then usually so does the baby.
How does that make an ERCS better?
I would think that a scheduled c-section would be less risky than an emergency c-section....but I haven't seen any numbers.
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#13 of 59 Old 09-02-2006, 07:04 PM
 
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But if the mom dies, then usually so does the baby.
Not if the mom doesn't die until there are complications arising from her surgery (usually days later)
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#14 of 59 Old 09-02-2006, 08:37 PM
 
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Originally Posted by DreamsInDigital
But if the mom dies, then usually so does the baby.
How does that make an ERCS better?
Not according to this particular study.

With VBACs, there were 3 dead moms and 13 dead babies. There were an additional 13 or 14 babies with severe brain damage after VBAC.

With ERCS, there were 7 dead moms and 7 dead babies. There is nothing to indicate that the dead moms and dead babies were pairs, meaning if mom died, so did baby. And I'd think it incredibly unusual for that to be the case anyway since most women who ultimately die as a result of ERCS will do so well AFTER the baby is already delivered.

Mom is usually going to hemorrhage during the section, die of an infection or blood clot afterwards, or some such complication, none of which would affect baby in the least cause, well, baby is already out by then.
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#15 of 59 Old 09-02-2006, 08:45 PM
 
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Ditto that. I am sorry and I know it sounds terrible, but if there is a choice to be made between myself and my unborn baby, I am going to choose myself only because I wont leave my very young children without a mother, and my husband without a parenting partner. My choices may have been different the first time I was pregnant with no kids already but things are different.
It crushes me to even consider the three children I already have being without a mother. Truly, it does. I've broken down into tears just thinking of it...darn pg hormones don't help a bit.

BUT, I would die a million times over for any one of them. And that includes this baby growing inside me. She is just as much my child as the one's sitting on the couch reading books right now.

And I would hope that one day, each of them would understand that I would *never* have had it any other way. If someone is going to die during delivery, it dang well better be ME.

My father's mother died 9 days after he was born. He struggled with feelings of guilt for 50 years over this. When he was 50, I became a mother myself. We talked about the guilt he had felt all those years while I was pg the first time. I couldn't believe it had never occurred to him that his mother would have died for him a million times over willingly to know he was safe. I asked him if he would die for ME, his daughter, if it came down to it. Of course he said 'yes'. It was truly like a lightbulb went off in his head and he finally associated HIS protective parental feelings with what his MOTHER was likely to have felt.

This feeling of 'I'd rather it be my baby that dies than me' is odd to me, although I wouldn't call it selfish really. Our sense of self-preservation is strong, so strong as to make feelings like this possible I guess. And in the end, if it's how you feel, then you truly ARE better off statistically going with VBAC cause MOM is safer from death with that choice. Of course, overall complication rates for VBAC is higher, but mom ultimately dying...VBAC would be the safer of the two, although not by much (2 in 10,000 vs 4 in 10,000).
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Originally Posted by wifeandmom

This feeling of 'I'd rather it be my baby that dies than me' is odd to me, although I wouldn't call it selfish really. Our sense of self-preservation is strong, so strong as to make feelings like this possible I guess. And in the end, if it's how you feel, then you truly ARE better off statistically going with VBAC cause MOM is safer from death with that choice. Of course, overall complication rates for VBAC is higher, but mom ultimately dying...VBAC would be the safer of the two, although not by much (2 in 10,000 vs 4 in 10,000).
The thought of I'd rather have it be me and leave my children motherless rather than the unborn baby die is odd to me. I guess that is what makes us all different. My dad's mom died when he was little and he grew up with some terrible issues because of it- all sadly passed on to his children. I cannot imagine leaving any living children motherless. For me personally, it has nothing to do with self-preservation. It is more about not leaving my living children to grow up without a mother!
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#17 of 59 Old 09-03-2006, 12:50 AM
 
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For me personally, it has nothing to do self-preservation. It is more about not leaving my living children to grow up without a mother!
Thanks. That's what I was trying to say. The feeling of self-preservation never entered my mind when the decision was made. This was also DH's preference, 100%.

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#18 of 59 Old 09-03-2006, 04:32 AM
 
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The thought of I'd rather have it be me and leave my children motherless rather than the unborn baby die is odd to me. I guess that is what makes us all different. My dad's mom died when he was little and he grew up with some terrible issues because of it- all sadly passed on to his children. I cannot imagine leaving any living children motherless. For me personally, it has nothing to do with self-preservation. It is more about not leaving my living children to grow up without a mother!
I guess I just look at this baby growing inside me and think of her as my child, just as real as the ones I already have already brought into this world.

At what point would you say you'd be willing to sacrifice your own life, and thus your other children having a mother, for your new baby? I am assuming, of course, that if someone came in and made you choose between YOU dying and one of your existing children dying, you'd choose to die yourself? Or would you choose to allow your existing child to die, thus leaving the rest of your children with a mother?

And really, if your unborn child were dying inside of your body, would you refuse an emergency c-section to save that baby's life? Because an emergency section certainly carries greater risks (according to every other study out there at least) for mom than a scheduled one. Would you insist on continuing to deliver vaginally to avoid the risks of section for yourself, or would you be willing to take on those risks in the face of imminent danger of death or harm to your unborn baby?

I'm thinking the hesitation to assume the increased maternal risk of death with ERCS comes more from the fact that baby is not in imminent danger at the time of ERCS, whereas during emergency c-section, consenting at that point is because the unborn child IS at immediate risk. Does that make sense?

I guess for me, I personally couldn't live with myself if I knew that I chose myself over my child, and that includes children growing inside me. The only time I could see choosing my own life over that of my child would be if the unborn child in question wasn't viable to begin with, at which point it's not really a choice between my life and my child's life, as my child wouldn't live regardless of my choice.

Anyhow, I'm truly fascinated to read how others come to make their own decisions.
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#19 of 59 Old 09-03-2006, 04:38 AM
 
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Originally Posted by aran
Thanks. That's what I was trying to say. The feeling of self-preservation never entered my mind when the decision was made. This was also DH's preference, 100%.
So it's more about protecting your living children, not so much about protecting your own self. I can see that.

I just look at this child growing inside me as just as important as my living children.

I'd die for any of the three sleeping in my house right now, leaving all of them motherless, rather than choosing to allow one of them to die and keeping myself alive for the remaining two.

The child inside me is just as important, just as loved, just as significant and worthy of sacrifice as my other three. I'd do whatever it took to protect her, to keep her safe, just as I'd do all of these things for my living children.

The only thing I would NOT ever do would be choose between my children, much like whatever that horrific movie was during WWII...Sophie's Choice or something like that. We'd all have to die, cause I'd *never* choose which child lived and which one died.
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#20 of 59 Old 09-03-2006, 05:05 AM
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Anyhow, I'm truly fascinated to read how others come to make their own decisions
I find it fascinating also, especially those of you that seem to have come to such a strong conclusion regarding leaving your living children and partners motherless.
I dont believe anyone can make such an intense decision without it actually happening to you. Sure it is something to think about, but unless you know what it is like to have to bury your baby and then go on living without that person in your life... well like I just said, you need to walk in those shoes and then see what you would do.

Having experienced this first hand (failed vbac) I can say that I would much rather have died instead of my baby. Sadly I did not have that option, but believe me when it was happening if I were given the choice I would not have thought twice about it, "yes, please take me instead". My living child and partner and my baby would have been fine without me. Like some of you have already said, human survival instincts are very strong. Yes, my baby would have been fed formula but there are far worse fates then that.
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#21 of 59 Old 09-03-2006, 01:13 PM
 
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Originally Posted by wifeandmom
I'd die for any of the three sleeping in my house right now, leaving all of them motherless, rather than choosing to allow one of them to die and keeping myself alive for the remaining two.

The child inside me is just as important, just as loved, just as significant and worthy of sacrifice as my other three. I'd do whatever it took to protect her, to keep her safe, just as I'd do all of these things for my living children.
I was considering saying something about this, but I didn't have time to open up a long philosophical discussion. I would obviously take crazy risks for my DS and would die to protect him. But when I was pg with him, I didn't feel that way. It was only later, after he was born, and not even immediately. (I know I am not alone with this unfortunate feeling. Perhaps this is a biological mechanism to protect our species, which you might only believe, as I do, if you are a Darwinist.) Of course now, our bond is extremely close - to the point that strangers make comments about it - so I guess that less than picture perfect start was no problem. Anyhow, my point is that he didn't get the same level motherly emotional support from me in utero that he did once he was alive. Now that I have a DS and know what it's like to be a mother, maybe I will feel differently about a second child in utero. I can't say. Please - no flames - I hope I don't sound too callous - I really am not.

And rn I am so so so sorry I suffered an early m/c this year and as a result have spent time in the pg loss boards. I wept many times reading the stories of full-term losses and looking at photos. I agree that I am now making the decision in a vacuum - with no idea of how I would feel should the worst befall me. But one has to make the decision about birth without knowing in advance the outcome.

FWIW, I am sticking with the vbac plans. I guess I won't discuss this with anyone IRL, because from the sound of it, I would probably come off sounding like a selfish jerk.

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#22 of 59 Old 09-03-2006, 03:10 PM
 
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rn- you are correct- we are all making these decisions in a vaccuum and if it actually happens to us, we may make different decisions or regret our decisions. To me, I see this as a philosophical discussion and never intended to imply anyone's decisions were wrong or minimize the trauma of losing a child. We all come to different conclusions on these issues, but we certainly cannot ever really know until it happens to us.

As for my unborn baby not being important- that is not true. My first was an emergency cesarean- we had to make the decisions to get the baby out fast or suffer the consequences. We made that decision and of course are happy about it. We just now have a different set of issues to think about when we go for the next child. In an emergency again, we will probably make the same decision (go for the cesarean) because we are not about vaginal delivery at all costs. But, we wouldn't assume a greater risk at an ERCS knowing that we had a toddler or other children who could end up motherless. This we don't feel is acceptable for the living child- especially given my history of growing up with a father who lost his mother at age 2.
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#23 of 59 Old 09-03-2006, 03:13 PM
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I did a great deal of research about this issue, and whereas it's true that the rate of maternal death is higher, it's more like .0004% (repeat c) vs. .0002% (vbac) -- a negligible difference. What tipped the balance for me in the direction of a section is the fetal mortality rate. In a meta-study published in the New England Journal of Medicine in 2002, even when you adjust for things like emergency c, vbacs without drugs, et cetera, the fetal death/complication rate is substantially higher with a vbac than with a c. For me, a section was a matter of a slightly greater risk for me versus a substantially greater risk of the child dying or being permanently damaged. The ethical choice was clear.

FWIW, the data I've given you was provided by a link from an MDC mom -- not exactly a pro-section advocate. Also, my predisposition was far in favor of VBAC vs. C, so these figures and what they implied were rude awakenings.
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#24 of 59 Old 09-03-2006, 03:14 PM
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FWIW, I am sticking with the vbac plans. I guess I won't discuss this with anyone IRL, because from the sound of it, I would probably come off sounding like a selfish jerk.
I think that is good that you are sticking with your vbac plans. I have nothing against vbac and if I am lucky enough to have another child I would still keep a vbac as an option (yes, really), BUT not my only one. I think the buddhist philosophy of the "middle way" comes to mind for me as going to far to either side of the vbac or c section road seems to bring into play way to much arrogance on both sides. I think choosing to remain as humble as possible and allow whatever outcome occur is most important.

I agree that vbacs are mostly safe and well worth striving for, but like anything in life it does have its risks. Most people (myself included in the past) do not choose to even consider these thinking the statistics are too small to worry about. What can be frustrating is when I see titles to threads bashing mothers for "choosing" c sections and reminding everyone how unsafe they are. It frustrates me for two reasons. The first being, who are we to judge anyone for making any decision in life unless we are walking in their shoes? How can we judge anyone as we can never know all of the things that have led them to their choices? The second is I feel like the bashing of one with out bashing the other is unfair (well bashing either is unfair), they both have risks to mother and baby... any form of birth has risks. Taking "sides" is not the answer.
C sections are as safe as any other form of birth, vbac or "regular" vaginal birth in a hospital hospital at home with a midwife or unassisted. I feel it is most important to remember that birth is as safe as life itself.
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#25 of 59 Old 09-03-2006, 03:52 PM
 
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I have a question...

If VBAC is riskier for baby than ERC, is it because uterine rupture causes the risk? Aren't the risks to baby similar to that of a vaginal birth with an unscarred uterus? If I am correct, vaginal birth with an unscarred uterus carries more risk for baby than for mom as well...more babies die in vaginal child birth than mothers. So what is the ethical difference in choosing VBAC over ERC? I'm sure the stats aren't exactly the same in outcome for mom and baby in VBAC vs. unscarred uterus but they are both still more dangerous for baby than csection. So with that logic, why not just choose elective csection for ALL babies and moms?
And if baby perishes due to something like prolapsed cord during a VBAC, the baby's demise isn't attributed to VBAC (statistically speaking) is it?

I'm just wondering what I'm missing here...

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#26 of 59 Old 09-03-2006, 05:27 PM
 
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Originally Posted by rn
I find it fascinating also, especially those of you that seem to have come to such a strong conclusion regarding leaving your living children and partners motherless.
I dont believe anyone can make such an intense decision without it actually happening to you. Sure it is something to think about, but unless you know what it is like to have to bury your baby and then go on living without that person in your life... well like I just said, you need to walk in those shoes and then see what you would do.

Having experienced this first hand (failed vbac) I can say that I would much rather have died instead of my baby. Sadly I did not have that option, but believe me when it was happening if I were given the choice I would not have thought twice about it, "yes, please take me instead". My living child and partner and my baby would have been fine without me. Like some of you have already said, human survival instincts are very strong. Yes, my baby would have been fed formula but there are far worse fates then that.
I am so sorry you lost your baby.

I know when I was pg with my twins, there was ZERO hesitation in my thinking. None whatsoever. I made it VERY clear to my docs that if someone was going to die that day, it had dang well better be ME.

When I was pg the following year with my singleton, I struggled with guilt because my sense of dedication to that child simply wasn't what it was when I was pg the first time. I would look at my twins, then less than a year old, and think 'How could I leave them without a mother?'

However, during my c-section, I had one of those experiences where I was simply convinced I was going to die. No medical reason for me to have thought this, but I was convinced I was dying. And I was ok with that. My son was out, he was safe, and I knew that THAT was what was most important to me. I told my DH to make sure they knew I loved each of them desperately, and I was ok with dying.

I look back and wonder what on earth I was thinking that day, lying on the table with NO complications whatsoever, but you could not convince me that I wasn't about to die. And the only thing that made me sad about it was knowing my kids would hurt, but I knew they were all safe and they would all be ok. I wasn't freaked out about the thought of dying at all.

It was all a very surreal experience, but one I am glad I went through because it made me realize that all the guilt I'd had over wondering if I wasn't as dedicated to my third child as I was my twins ultimately proved to be unnecessary, as I knew without a doubt I'd do the same for him as I would have done for my twins.

I have not struggled with those feelings with this current pg. I *DO* think about how sad it makes me to consider leaving ALL of my children without a mother, but that INCLUDES this unborn child as well. I'm just as sad for her as I am for my other three should the worst happen to me. She's just as important to me, and I cannot imagine choosing myself over MY CHILD, which is exactly what she is.
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#27 of 59 Old 09-03-2006, 05:30 PM
 
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I'm trying to decide between a VBAC and section for my next baby... I'm interested in watching this thread. :
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#28 of 59 Old 09-03-2006, 05:53 PM
 
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I am strongly of the belief that I should prefer the life of any of my children to my own, and that a viable unborn child is morally equivalent to any other child. (In fact I find the use of "living" to indicate that the child is outside the womb somewhat offensive.)

But I am still planning to VBAC, for the following reasons. Primarily, I don't see an increase in statistical chances (that are infinitesimally small to start out with) as morally or logically equivalent to a direct choice that someone in the situation WILL die. Not the same thing at all.

Secondarily, barring truly extreme circumstances I will definitely get pregnant a third, fourth, perhaps even fifth or sixth time depending on my biological clock, so I have to consider the increased risk to future pregnancies from multiple c-sections. One of my strongest reasons for interest in the VBAC movement is that I will not allow the medical establishment to dictate my family size. Recently a relative, on hearing we (still) plan a large family, said "oh but they won't let you have more than 3 c/s." More striking than her "once a c always a c" misconception was her inability to morally question doctors "letting" people have children.

Furthermore, I think that some degree of preference for natural processes has to figure into the equation. Phoebe makes a good point about decreasing risk to baby through elective primary cesarean. Permanently consigning your reproductive life to interventive modalities wholly controlled by powerful professionals is physically, morally and spiritually risky. It is a choice to permanently subvert the body's natural function because technocratic medicine claims to be able to do it better. My vagina and the surgeon's scalpel are not morally equivalent objects. It is degrading to put the burden of proof on women's bodies in statistical competition with whatever intervention the system decides to come up with.
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#29 of 59 Old 09-03-2006, 06:06 PM
 
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Quote:
Originally Posted by Phoebe
I have a question...

If VBAC is riskier for baby than ERC, is it because uterine rupture causes the risk? Aren't the risks to baby similar to that of a vaginal birth with an unscarred uterus? If I am correct, vaginal birth with an unscarred uterus carries more risk for baby than for mom as well...more babies die in vaginal child birth than mothers. So what is the ethical difference in choosing VBAC over ERC? I'm sure the stats aren't exactly the same in outcome for mom and baby in VBAC vs. unscarred uterus but they are both still more dangerous for baby than csection. So with that logic, why not just choose elective csection for ALL babies and moms?
And if baby perishes due to something like prolapsed cord during a VBAC, the baby's demise isn't attributed to VBAC (statistically speaking) is it?

I'm just wondering what I'm missing here...

Amy
I've never seen an actual study that compared elective primary section to vaginal birth in terms of risk to baby. We certainly know that the section is riskier for mom, and I'd honestly THINK that the section would be safer for baby...BUT I've never seen any good, solid research on it, so I can't really answer your question about that.

I'm not sure about your last question either. If a baby dies of prolapsed cord during VBAC attempt, I can see why they might include that death in the VBAC death rate simply because that baby wouldn't have died from a prolapsed cord with ERCS. They already controlled for the babies that died PRIOR to onset of labor and/or scheduled section date (which would take care of any babies that died of prolapsed cord or abruption,etc prior to onset of labor or surgery date), so the number of dead babies in each group was STRICTLY once VBAC was attempted OR ERCS was performed.

I believe the only deaths they excluded altogether were of babies that would have died regardless of delivery method, such as congenital defects not compatible with life.

As for why women shouldn't just have sections for every baby if it's safer for baby....

Well, VBAC is a bit different because you KNOW going into it that mom is at a very much increased risk of a particular complication (UR). In the unscarred uterus, catastrophic rupture is VERY rare (1 in 15,000 or less). But once the uterus is scarred, it sky-rockets to 1 in 200, sometimes a lot more than that depending on particular interventions like induction/augmentation.

We also KNOW that VBAC results in more dead babies than ERCS. It also results in more complications overall for mom, although mom is still more likely to die with ERCS.

Other potential complications from vaginal birth often cannot be predicted to such a degree. We are already seeing a lot of sections prior to onset of labor for 'big baby', with the fear obviously being difficulty getting baby out without damage, shoulder distocia, etc. Problem there is u/s is used to determine baby's size, and it's notoriously inaccurate late in pg.

We see virtually all women with breech babies being sectioned, again because it is known that breech babies experience more complications during delivery compared to their vertex counterparts.

The trade off to more sections is pretty much always going to be more dead moms and less dead babies, but the overall numbers would likely mimic the VBAC/ERCS numbers. As we can see in this thread alone, there are mothers who would choose the risk of a dead baby rather than the risk of dying themselves in the absence of a true emergency, so I don't see ALL women electing to have sections based on the very valid feelings expressed in this thread alone.
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#30 of 59 Old 09-03-2006, 06:12 PM
 
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I have not read every post on this thread. I had a hard time reading about "dead babies" and "dead mommies." But thought I'd answer the question in the thread title.

After living through the death of our first son, I was willing to take on the "extra" risk that was quoted in your study. For me a repeat c-section was worth it emotionally and physically.

I know that many on here would disagree.

Proud mom to superhero.gifds2 (7/05), angel2.gif ds 1 (born into heaven at 38 weeks 11/03), and 5 more angels angel.gif (4/02) angel.gif (7/10) angel.gifangel.gif (11/10) angel.gif (11/12)

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