do I really need another c-section? - Mothering Forums
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#1 of 23 Old 03-07-2008, 04:42 PM - Thread Starter
 
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I had uterine surgery prior to getting pregnant with my ds (19mo) to repair a bi-cornute uterus and remove several fibroids. I got pregnant with him 10 months after the surgery with a stern warning from the surgeon that I should not even attempt a vaginal delivery. I went to an OB that I knew as a friend and he agreed, with the type of surgery I had undergone, a c-section would be needed and I would have it early, so I wouldn't go into labor. We scheduled the c-section at 37.5 weeks and my ds came out just fine with no problems.

I am pregnant again and I am seeing the same OB so I know it will be the same drill.

I just wonder what the statistics really are for uterine rupture. Of course I dont want to take any chances, a healthy baby and an alive me are the most important things. Just wondering your opinion. Most of me doesnt care, but this time I really dont want to stay in the hospital for 4 days because I will have my toddler to consider.
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#2 of 23 Old 03-07-2008, 05:44 PM
 
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I would need much more information about your first surgery before commenting further.
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#3 of 23 Old 03-07-2008, 11:56 PM
 
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You should look for a VBAC friendly OBGYN or midwife to discuss your situation with... they will be able to ask for many more specifics about your uterine surgery than you might think to provide in a written forum. Where in the bible belt do you live?

Warm wishes

Allyson - wife, mama, midwife
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#4 of 23 Old 03-08-2008, 12:14 AM - Thread Starter
 
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smack dab in the middle. kansas

Thanks for the advice. I am not even sure if I know all the details to provide although I am sure its written in a file somewhere.
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#5 of 23 Old 03-08-2008, 12:39 AM
 
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Repair of a bicornuate uterus and removal of several fibroids?

You did not have a low transverse incision with that surgery. That much I can tell you without any more information. What you had was at least one full-thickness uterine incision in the fundus, which is the most active part of the uterus in labor and carries the greatest risk of rupture.

The standard VBAC risks are for a LTCS incision. You do not have just that incision. IMO, your OB is right on. I would not consider personally VBACing with that surgical history.

mama to Max (2/02) and Sophie (10/06); wife to my fabulous girl
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#6 of 23 Old 03-08-2008, 12:41 AM
 
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Yes - I would start by gathering your records asap. Even if you speak with a VBAC friendly obgyn or midwife and decide not to go that route (or find that you cannot go that route)- you really should have copies of your records (including for your C-sec). You should check out the Finding Your Tribe (FYT) section of these message boards for recommendations of VBAC care providers in your area. Good luck!

Allyson - wife, mama, midwife
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#7 of 23 Old 03-09-2008, 09:50 AM
 
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I would definitely consult a VBAC-friendly OB. Vaginal birth is safer in most cases and definitely easier to recover from. I would expect most OBs to recommend surgery because they prefer it. You'd need to get your records and consult a truly VBAC-supportive doc to get a true idea of what you need, IMO.

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#8 of 23 Old 03-10-2008, 10:38 AM
 
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Originally Posted by maxmama View Post
Repair of a bicornuate uterus and removal of several fibroids?

You did not have a low transverse incision with that surgery. That much I can tell you without any more information. What you had was at least one full-thickness uterine incision in the fundus, which is the most active part of the uterus in labor and carries the greatest risk of rupture.

The standard VBAC risks are for a LTCS incision. You do not have just that incision. IMO, your OB is right on. I would not consider personally VBACing with that surgical history.
I agree with this. I wouldn't feel comfortable VBACing.

edited to add: I'm on the crunchier side of folks I know IRL, but probably a bit more medical than folks on MDC, so that clouds my judgement. You have to do what feels right for you.
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#9 of 23 Old 03-11-2008, 09:52 AM
 
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I think you could at least get a second opinion from a doc who is known to support VBACs. If s/he says it is needed, okay. If s/he supports a VBAC in your circumstances, go for it! Ask local childbirth educators, doulas, midwives for a recommendation of an openminded OB in your area. Also, contact ICAN for support and information. www.ican_online.org

Good Luck!
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#10 of 23 Old 03-12-2008, 02:34 AM
 
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Originally Posted by maxmama View Post
Repair of a bicornuate uterus and removal of several fibroids?

You did not have a low transverse incision with that surgery. That much I can tell you without any more information. What you had was at least one full-thickness uterine incision in the fundus, which is the most active part of the uterus in labor and carries the greatest risk of rupture.

The standard VBAC risks are for a LTCS incision. You do not have just that incision. IMO, your OB is right on. I would not consider personally VBACing with that surgical history.

:

The repair of the bicornuate uterus alone is enough to make VBAC an unacceptably risky venture.
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#11 of 23 Old 03-12-2008, 02:42 AM
 
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Have you signed up for ICAN's email list? They may be able to help you with finding studies and getting more information so you can make an informed choice. You can find a link to the email group on their site at www.ican-online.org

mom to all boys B: 08/01ribboncesarean.gif,  C: 07/05 uc.jpg, N: 03/09 uc.jpg, M: 01/12 uc.jpg and far too many lost onesintactlact.gifsaynovax.gif

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#12 of 23 Old 03-12-2008, 03:06 AM
 
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Not a birth pro but I found the place for me was at the Topeka Birth and Women's Center. It is a wonderful fsbc and there is an OB on staff, and an awesome MW. I wouldn't take advice on whether to vbac from anyone else. I just don't really trust the average OB, but Dr. Norris really believes in vbac and so if she didn't think it was safe, I would be able to accept her judgement.

I had to travel over an hour and a half to get there, and it was worth every minute and every gallon of gas. If I had gone there for my first birth, instead of Emporia, which is closer, I might well have avoided the c/s altogether.

hth
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#13 of 23 Old 03-12-2008, 01:33 PM
 
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I suggest you get a copy of your surgical report and a second opinion. It sounds from your description like they would have had to lay open your uterus to repair a bicoronate - too risky for a VBAC IMHO (but I'm just a researcher - not a medical professional). Your doc is probably right on, but it never hurts to get another opinion from a pro-VBAC doc.

Mom to James (ribboncesarean.gif 5/2006), Claire (vbac.gif 6/2008), furry kitties Calvin and Bob, and wife to Dennis. 

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#14 of 23 Old 03-12-2008, 05:09 PM
 
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Quote:
Originally Posted by NotTheOnlyOne View Post
I had uterine surgery prior to getting pregnant with my ds (19mo) to repair a bi-cornute uterus and remove several fibroids. I got pregnant with him 10 months after the surgery with a stern warning from the surgeon that I should not even attempt a vaginal delivery. I went to an OB that I knew as a friend and he agreed, with the type of surgery I had undergone, a c-section would be needed and I would have it early, so I wouldn't go into labor. We scheduled the c-section at 37.5 weeks and my ds came out just fine with no problems.

I am pregnant again and I am seeing the same OB so I know it will be the same drill.

I just wonder what the statistics really are for uterine rupture. Of course I dont want to take any chances, a healthy baby and an alive me are the most important things. Just wondering your opinion. Most of me doesnt care, but this time I really dont want to stay in the hospital for 4 days because I will have my toddler to consider.
Also, why would you stay in the hospital 4 days for a section? I went home at 36 hours, and most of our sections stay less than 72 -- usually go home around 48 hours.

mama to Max (2/02) and Sophie (10/06); wife to my fabulous girl
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#15 of 23 Old 03-12-2008, 07:10 PM - Thread Starter
 
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Originally Posted by maxmama View Post
Also, why would you stay in the hospital 4 days for a section? I went home at 36 hours, and most of our sections stay less than 72 -- usually go home around 48 hours.
really?? I never talked to anyone else who has had one... they just told me that was standard. 36 hours, huh? I could handle that, just one night away from my toddler.

From most of the responses I have gotten I think I'll just stick with my doc and let him do what he wants. It sounds like I have a legitimate need for a c-section. I still miss the idea of a natural birth a little though......
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#16 of 23 Old 03-13-2008, 06:19 PM
 
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Also, why would you stay in the hospital 4 days for a section? I went home at 36 hours, and most of our sections stay less than 72 -- usually go home around 48 hours.
My c-section was a Sunday night. I didn't get to go home until Thursday & my gp tried to convince me to stay until Friday, but I'd had enough.


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From most of the responses I have gotten I think I'll just stick with my doc and let him do what he wants. It sounds like I have a legitimate need for a c-section. I still miss the idea of a natural birth a little though......
Totally understandable. If it were me, I'd do a bunch more research to make sure that VBAC was too dangerous in your situation, but my cesarean was the worst experience of my life and I don't think I'll ever completely recover from it, emotionally or physically. I'm sure you'll make the best decision for you, though.

mom to all boys B: 08/01ribboncesarean.gif,  C: 07/05 uc.jpg, N: 03/09 uc.jpg, M: 01/12 uc.jpg and far too many lost onesintactlact.gifsaynovax.gif

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#17 of 23 Old 03-13-2008, 07:32 PM
 
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Where in KS, mama? I am familiar with the wichita area.

Midwifery Student and Mama to 2 daughters and 3 sons.     
ribboncesarean.gif vbac.gifhomebirth.jpg I have given birth a variety of ways and I am thankful for what each one has taught me.

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#18 of 23 Old 03-13-2008, 08:44 PM
 
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My c-section was a Sunday night. I didn't get to go home until Thursday & my gp tried to convince me to stay until Friday, but I'd had enough.
But WHY? The longer you're in, the more likely you are to get infected. An uncomplicated section staying for five days makes no sense at all.

mama to Max (2/02) and Sophie (10/06); wife to my fabulous girl
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#19 of 23 Old 03-13-2008, 10:56 PM
 
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I went home at 36 hours, too. It was the right amount of time for me.
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#20 of 23 Old 03-13-2008, 11:28 PM - Thread Starter
 
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Where in KS, mama? I am familiar with the wichita area.
I am in Olathe. A suburb of Kansas City
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#21 of 23 Old 03-14-2008, 08:10 AM
 
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I left at 48hrs. I told every single medical professional who walked in that room over those 2 days that I was planning on leaving early. So by the 2nd day, they were like...yeah, yeah,we know you want to leave! lol But I didnt want there to be any issues like the Ped was onboard but the OB wasnt, etc.

So assuming there are no complications, yes you can definitely leave early after a c/s. I would have gone insane if I had to stay there 2 more days.

Jenn, perpetually tired mom to DS(9): DD(4.5): DD(2) :
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#22 of 23 Old 03-15-2008, 06:09 PM
 
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But WHY? The longer you're in, the more likely you are to get infected. An uncomplicated section staying for five days makes no sense at all.
3-4 days is standard here, or was, they keep you in until they take out the staples. I actually left the hospital where ds was delivered on Tuesday, but they wouldn't let me go unless I agreed that I would go into the hospital in my own town (no deliveries in my town due to lack of anesthesiologists) until they released me. So I was 2 days in one hospital & 2 in another. I don't know why the gp wanted me in for another day, it might have been because the ob screwed up. My scar is about halfway between my belly button and the usual spot for a transverse incision & angles slightly.

mom to all boys B: 08/01ribboncesarean.gif,  C: 07/05 uc.jpg, N: 03/09 uc.jpg, M: 01/12 uc.jpg and far too many lost onesintactlact.gifsaynovax.gif

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#23 of 23 Old 03-15-2008, 08:02 PM
 
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3-4 days is standard here, or was, they keep you in until they take out the staples. I actually left the hospital where ds was delivered on Tuesday, but they wouldn't let me go unless I agreed that I would go into the hospital in my own town (no deliveries in my town due to lack of anesthesiologists) until they released me. So I was 2 days in one hospital & 2 in another. I don't know why the gp wanted me in for another day, it might have been because the ob screwed up. My scar is about halfway between my belly button and the usual spot for a transverse incision & angles slightly.
Staples here come out at 36-48 hours. Longer than that and they tend to pull when you're removing them. Yowza.

My scar is high too. It's not a screw up though; my son was breech and not at all engaged.

mama to Max (2/02) and Sophie (10/06); wife to my fabulous girl
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