Vaginal Birth after C-section (VBAC)? - Mothering Forums

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#1 of 14 Old 12-16-2006, 10:34 PM - Thread Starter
 
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Hi ladies~

I'm hoping to become preggers this spring, and have been researching VBAC. My former OB (Dr. Jan Stafl, Eugene) said that he didn't think VBAC was a good idea for me because my C-section was done when I was only 25 weeks pregnant. I'll be discussing VBAC with my new OB, though, and if you know of any good websites about VBAC after an early C-section, or you have opinions to share, I'm interested.

I tend to think I won't go VBAC (Why add another risk to what would already be a high-risk pregnancy?), but I'd still like to know more about it.

Thanks!

Kristina
www.kristinaseleshanko.com/baby.htm
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#2 of 14 Old 12-16-2006, 10:44 PM
 
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Quote:
Originally Posted by kriswrite View Post
Hi ladies~

I'm hoping to become preggers this spring, and have been researching VBAC. My former OB (Dr. Jan Stafl, Eugene) said that he didn't think VBAC was a good idea for me because my C-section was done when I was only 25 weeks pregnant. I'll be discussing VBAC with my new OB, though, and if you know of any good websites about VBAC after an early C-section, or you have opinions to share, I'm interested.

I tend to think I won't go VBAC (Why add another risk to what would already be a high-risk pregnancy?), but I'd still like to know more about it.

Thanks!

Kristina
www.kristinaseleshanko.com/baby.htm
If your section was done at 25 weeks, it's almost certainly a classical incision, which is much more likely to rupture than is a transverse incision. The first step would be to get a copy of your records; the relative risk of VBAC varies dramatically according to several variables, a few of which relate to the prior section.

mama to Max (2/02) and Sophie (10/06); wife to my fabulous girl
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#3 of 14 Old 12-16-2006, 10:53 PM
 
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Kristina, I didn't have much to add, but I wanted to tell you that I was touched by your daughter's story. My cousin gave birth to a 24 weeker on July 20, 2005. It's a true miracle watching these little babies fight for their lives. He is now a fiesty, energetic toddler- so far from the 1 lb 5 oz micro-preemie.

Best of luck as you journey towards adding another blessing.

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Violet Lane Birth Services Doula care and placenta encapsulation serving Seattle to Mount Vernon
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#4 of 14 Old 12-17-2006, 12:42 AM
 
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is your scar up and down or side to side?
also check out ICAN its a GREAT resource.
we even have our very own local ICAN leader here in portland (i think in PDX?)
also, swing my the local PDX thread here, there are a few Salem mamas that join in the discussions.

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#5 of 14 Old 12-17-2006, 01:04 AM
 
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Definately check out the link for ICAN posted in the link above. Also in my signature. There is also a great VBAC forum here on Mothering.

Allison

Allison wife and mom to four. 

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#6 of 14 Old 12-17-2006, 03:08 AM
 
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I heard a doctor say once that they didn't recommend VBACs before 30 weeks (I think, but I can't totally remember) because the lower uterine segment hasn't developed enough by then....have not a clue if this is true but for some reason I've always remembered that statement.
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#7 of 14 Old 12-17-2006, 05:30 AM
 
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Originally Posted by PapayaVagina View Post
I heard a doctor say once that they didn't recommend VBACs before 30 weeks (I think, but I can't totally remember) because the lower uterine segment hasn't developed enough by then....have not a clue if this is true but for some reason I've always remembered that statement.
It's why classical incisions are used preterm.

Also, your skin incision has nothing to do with the uterine incision.

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#8 of 14 Old 12-17-2006, 03:38 PM
 
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Definetely check out the ICAN link. A book I've found particularily helpful for people is Silent Knife - it also has statistics on the success rates of classical/transverse VBAC and their likelihood of rupturing.

Eternal Companion to DH , Homeschooling mama to DS 05/04 , DS 11/05 , DD 12/07 , DS 07/10 and one on the way: June 2015!
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#9 of 14 Old 12-17-2006, 05:41 PM
 
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It's why classical incisions are used preterm.

Also, your skin incision has nothing to do with the uterine incision.
very very true. she could have a smilie cut on the outside and an up n down inside.

OP maybe you could get a copy of your medical records to see what type of uterine incision you have.

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#10 of 14 Old 12-17-2006, 07:16 PM - Thread Starter
 
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Memiles: Thank you

Addys and others: My scar is horizontal. I recall Dr. Stafl saying he was pleasantly surprised he was able to do it this way. (He'd been afraid he'd have to cut vertically.)

I guess I must have missed the VBAC forum...I'll look again. And I'll check out that link, too.

Kristina
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#11 of 14 Old 12-18-2006, 04:29 AM
 
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I also think it would be a good idea to look over your records with a VBAC supportive doctor or midwife.

I'd lean towards planning a VBAC as its the normal way to give birth and change my plan if there was a need to do so.

I hope it does work out for the best and that you can have a VBAC. I had one, at home with a midwife, and it was a fabulous experience.

Mom of a 7 yr old, 4 yr old, and 1 yr old. Wow. How did that happen?
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#12 of 14 Old 12-18-2006, 10:34 PM
 
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Originally Posted by mamao'two View Post
I also think it would be a good idea to look over your records with a VBAC supportive doctor or midwife.
great idea.

I have had 3 wonderful home VBACS after an emergency c-section with a premature baby 15 years ago...

Why is your pregnancy high-risk this time? Remember, it's always high-risk to have major surgery instead of birthing, but I don't fully know your circumstances.

VBAC- vaginal birth after cesarean- can be the single most empowering
event in a woman's life. VBAC shows women how strong and amazing they
are; it is giving birth, as opposed to experiencing surgical
extraction. It is climbing the mountain of one's own pain, fear and
self-doubt and emerging victorious at the top. VBAC can even heal up
past abuse (medical, sexual, you name it) with the ushering in of
gentleness and love.

VBAC is possible even if "caregivers" say it isn't- women who were told
they could never give birth vaginally for whatever reason find that
with true prenatal care (as with low interventionist lay midwives or
educated self-care), they can indeed give birth as their bodies were
designed to. It is my passionate belief that if left alone, our bodies
know how to give birth!


Here are a few good links and books on the subject;

http://www.childbirth.org/section/VBACindex.html

http://www.homebirth.org.uk/vbac.htm


The Vbac Companion : The Expectant Mother's Guide to Vaginal Birth
After Cesarean by Diana Korte

Obstetric Myths Versus Research Realities by Henci Goer

Open Season: A Survival Guide for Natural Birth and VBAC in the 90's by
Nancy Wainer Cohen

Birth After Cesarean by Dr. Bruce Flamm

Silent Knife: Cesarean Prevention & VBAC by Nancy Wainer Cohen & Lois
Estner

Rebounding From Childbirth: Towards Emotional Recovery by Lynn Madsen

Recovering from a Cesarean Section by Karyn L. Feiden , Manuel Alvarez

Natural Birth After Cesarean: A Practical Guide by Johanne C. Walters ,
Karis Crawford

Expectant Parent's Guide to Preventing a Cesarean Section by Carl Jones

The Vaginal Birth After Cesarean Experience: Birth Stories by Lynn
Baptisti Richards
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#13 of 14 Old 12-19-2006, 06:53 AM
 
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I just wanted to add my 2 cents here. I plan on do a VBAC with my next baby. (DS was supposed to be a home water birth but he was brow presentation and after 36 hour labor we went to OHSU.) I had Andaluz midwives and plan on doing my VBAC with them. IMO they are great and very supportive of VBACs and are a great resource. They also do a free consultation at the birth center in Tualatin. HTH
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#14 of 14 Old 12-19-2006, 03:43 PM - Thread Starter
 
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Momma, I'm considered high risk because of my previous PROM and resulting early birth. There was no known cause for the PROM, but I believe I had pre-term labor on and off before my water broke. It's true I could have a completely normal pregnancy the second time around, too.

I suppose here is the main concern with a VBAC: "During the past decade, improved neonatal care has increased the survival rate of preterm babies. This in turn has led to a reduction in the stage of gestation at which obstetricians are prepared to perform cesarean sections for fetal indications. It has resulted in cesarean sections being used to deliver babies at, or even before, 26 weeks. At these early gestations, the lower segment is poorly formed and so-called 'lower segment' operations at this period of gestation are, in reality, transverse incisions in the body of the uterus. Whether or not such an incision confers any advantage over a classical incision remains in doubt. Indeed, some obstetricians now recommend performing a classical incision in these circumstances." ( http://www.vbac.com/chapter38.html )

Kristina
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