Does anyone out there have experience with 'frozen pelvis' & vbac? Essentially, lots of my internal organs are stuck together with adhesions due to an appendix leak when I was a child. The doctor who did my c-section last time (I had a breech twin) said (at the time) that I have "the worst abdomen he's ever seen" and it "looks like a grenade went off in there."
At my 17-week appointment today, he said not only would he recommend a repeat (& scheduled) c-section, he'd recommend having 2 doctors present in the OR.
Any of you wise women out there have experience in this area? I will have a repeat c without complaint if it's truly the best option but I'd love to hear your stories.
It may not be the same situation as you, but my SIL had a ruptured appendix...and had it for about a week before it was caught and finally treated. many of her internal organs were (and may still be) fused together...lost one tube and ovary too I believe...could be wrong. She was told she should never get pregnant and if she did she'd lose the baby. Well, she's been pregnant twice, delivered the first vaginally, the 2nd was a C-section due to the baby having severe spina bifida.
Very similar story, except that my appendix ruptured/leaked when I was 6 and the adhesions etc. were not discovered until I was an adult and had been ttc for 4 years without success. We eventually did IVF, after which I had a c-section and the state of my insides, and source of the fertility problem, was discovered. I was told that I would not be able to get pregnant (I was actually told 1:1,000,000 chance) and that if I did it would almost certainly be ectopic.
Long story short, I'm 17 weeks pg today with the biggest surprise of my life. All appears well.
So your SIL was able to do a vaginal birth. Interesting. I will definitely get more information from my OB next time -- I was just sort of in shock this afternoon (esp. after hearing the bit about needing 2 OBs on hand for the surgery) and didn't ask the right questions.
I don't know anything about a "frozen pelvis", but I hope you don't mind me asking some questions. . .
What do the adhesions, exactly, have to do with labor? I'd imagine by the time babe's full-term, your uterus has already expanded as much as it's going to. Any adhesions to the uterus or nearby organs would have already been problem, if they were going to be. So what happens during labor that changes it? Are they afraid your uterus won't contract properly, or your cervix won't dilate, or your pelvis won't accomodate the baby? I guess I fail to understand exactly what the problem is.
I am a little clueless here, but it seems to me if you have so many adhesions which is a surgical nightmare shouldn't they be more encouraging of VBAC to avoid another surgery?
We all have the same questions! Now I have to go back and ask. I was just so surprised & shocked that I didn't ask the OB anything. I did find a birth story thread here about someone with a similar situation who had a planned section and felt that it was really the best choice for her. (http://www.mothering.com/discussions...d.php?t=259631)
I am not finding much information out there about severe adhesions and labor one way or the other.
My sister had a ruptured appendix for two weeks (while in middle school) before doctors figured it out (by doing complete open abdominal surgery). She scars easily, and they think that the reason she wasn't ever able to get pregnant was because of scar tissue/adhesions.
She and her dh are expecting their first biological baby, a real surprise, this spring. Her doctor has not told her any concerns about her scar tissue; but he also hands out free formula samples at the first OB appointment, too.
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I will be curious to learn more about this. Based on what I've read in Pushed and Goer's book, it seems to me that a c/s would be the LAST thing they'd want to do to a mother with excessive internal adhesions; a vaginal birth would be best, no?
At the same time, I can understand them being very concerned about how a c/s would go, if it were necessary. I'd think the focus ought to be on avoiding the c/s entirely, though, right??
Originally Posted by elanorh
My sister had a ruptured appendix for two weeks (while in middle school) before doctors figured it out (by doing complete open abdominal surgery). She scars easily, and they think that the reason she wasn't ever able to get pregnant was because of scar tissue/adhesions.
That sounds a lot like my SIL...she was 11. Holy cow I can't imagine living with that for 2 weeks!
Originally Posted by goldfinch
Does anyone out there have experience with 'frozen pelvis' & vbac? Essentially, lots of my internal organs are stuck together with adhesions due to an appendix leak when I was a child. The doctor who did my c-section last time (I had a breech twin) said (at the time) that I have "the worst abdomen he's ever seen" and it "looks like a grenade went off in there."
That wasn't a very nice thing for him to say! Just because the intestines and other organs are fused, they still move, I would think.(I think of peristalsis, the movement of the intestines that gets poop thru our systems.)
Quote:
At my 17-week appointment today, he said not only would he recommend a repeat (& scheduled) c-section, he'd recommend having 2 doctors present in the OR.
I wonder if it was to have visual backup, so someone else could learn what really adhered innards looked like.
I would read Henci Goer's books and maybe email Nancy Wainer Cohen in Massachusetts. She is now a midwife and does LOTS of VBACs. If you get a copy of your records and she wants to see them, maybe she might take you as a client?
In any case, I would research that more thoroughly, and if the uterus grows all the way to full term, like it did last time(I am assuming, here) I shouldn't think there would be a problem with the labor/dilation, or giving birth vaginally, per se. After all, your last birth would probably have been completely vaginal if they hadn't known the one baby was breech, and you would have never known anything was amiss. So your body seems to be working OK. I would find a mw experienced with VBAC, and have the baby at home. I am more sure each day, that that is the only way most women will ever be able to VBAC well, if at all. It is the best chance for a vaginal(and healthy) birth.
My appendix ruptured when I was 10, and I also had tons of adhesions. I don't know much details about mine, just that there was a ton glueing my bladder to my uterus. It was a very anti-vbac ob who tried to scare me out of vbac. When I talked to him at the 2 week pp visit when he was explaining everything, I grilled him about the significance of the adhesions, and he said that it would not add any extra risk to pregnancy/labor, would not increase risk of rupture. I confirmed this with a pro-vbac ob. She said that it was mostly just a nuisance to cut through in surgery.
Her baby was born vaginally a couple days ago. She had no complications in the pregnancy, baby was born one day past her "due date," after spontaneous rupture of membranes. There was meconium in it, so they went to the hospital (she was not in labor). She didn't go into labor (or wasn't progressing fast enough) after several more hours; they gave her pit and after two hours of that, she was having strong regular contractions (1pm); baby was born at 4pm, so she labored pit-free for three hours (and didn't use pain meds).
So -- in her case, she was able to have a vaginal delivery despite all her abdominal adhesions, and carried to term with no issues, as well. Her baby was a little over 7 pounds.
TRY !! At least try, if it fails, at least you tried and wont wonder what you could do differently.
I am planning a vba2c at home. My appendix was taken out in March due to severe appendicitis. I have no CLUE how anyone could go 2 weeks with that, my pain in the matter of hours was nothing to so severe I couldnt walk.
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