Still processing...uterine rupture after VBA2C attempt. - Mothering Forums

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#1 of 9 Old 10-01-2011, 12:18 PM - Thread Starter
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I had my daughter, my third baby, on Sept 17th.  I was trying for a VBA2C.  My first birth ended in c-section after too-early AROM and pitocin, and failure to progress, and ever since I have wanted a vaginal birth.  I was convinced with my second that I would be successful, and I got to the pushing stage, and then he moved into a weird position and wouldn't descend any further.  This time, I was surprised that my doctor and OB were both supportive of trying VBA2C, but wouldn't have thought of doing anything else.  The thought of scheduling a repeat c/s just wasn't an option to me.  I think I had a feeling all along that I would have another c/s, and I was so much more worried about rupture this time than I had been the last time, so it wasn't really a surprise for me to have the c/s, but I could never have *not* tried, you know?  I would have regretted it so much.  I always would have wondered.  I have always wanted to have a baby "the real way" and if I hadn't tried, I would have felt like a failure before I even began.


Not many people around me understood the way I felt, especially my family.  They felt the risk was too big (they didn't know how small the risk really was,) and worried the whole pregnancy.  They kept asking me why I would take such a huge risk, and were convinced something would go wrong.  They just couldn't understand why this was so important to me.


Well, I guess someone has to fit into that 1%...and I had a uterine rupture.  I had a wonderful labour, for about 14 hours, and most of it was amazing.  I was managing contractions really well, and felt really good about everything.  I was sure that this time I could do it.  But the last little bit of the labour was suddenly excruciating, and I wasn't progressing despite the strong contractions, and the OB wanted to do a c/s.  I agreed, it just felt like the right thing to do at that point, even though I was very sad to agree to it.  When they opened me up, I had ruptured, and we are so lucky that we did the c/s when we did, before baby showed any signs of distress.  If we had waited any longer, it would have been catastrophic.  The top of her head was out, but the cord was still inside the uterus.  I just feel so blessed that I consented when I did, and that there happened to be a free OR just then, or I might have lost my baby. 


Now I'm at the point where I'm trying to process.  I'm recovering really well, and my baby is an absolute dream.  That helps.  But I do burst into tears pretty regularly when I think about what could have happened.  What if things had played out differently?  What if we'd been too late?  Should I have tried a VBA2C? 


I still believe that a trial of labour is the best option.  I don't have any regrets.  This was my best labour and birth by far, believe it or not.  I am happy that I know for sure that the c/s was necessary--with the others, I always wondered (and still do,) what I could have done differently to avoid it.  This time, I know it saved my baby's life, and possibly mine.  I am also strangely content to know that this is my last baby (the OB could only do a single row of stitches instead of double, because my bladder ended up in a weird spot, and was very traumatized by baby's head pushing on it.  He strongly feels it would be a bad idea for me to get pregnant again, and I tend to agree.)  If I hadn't had the UR, I might have had another baby, and then it could have gone really wrong.  For so many reasons, I just don't have any regrets for trying, even though when I think about it, I am just so lucky that I have a live baby.  This is a hard dichotomy for me to process.  I am glad I tried, but am scared that I did, and am just glad that it turned out the way it did.


And explaining those feelings to my family and others...they don't understand.  They think I'm selfish for trying, or stupid.  They keep telling me how lucky I am (believe me, I KNOW!) and tell me I should have just had a repeat c/s to begin with.  In a way they're right, but how was I to know?  I just wish they could understand, instead of trying to make me feel guilty.


And in a way, I guess I do feel guilty.  If she hadn't made it...I can't even think about that.  I would have blamed no one but myself. 


I don't know who to talk to about it.  I don't want to scare ANYONE out of trying for a VBAC, because I still truly believe it is the safest and best option.  But my feelings about my birth experience are so mixed up right now, I don't know what to think.  I'm so incredibly grateful for my healthy baby, but I get so upset when I think about what could have happened if things had been just a little different.  I am at peace with the c/s, but I'm not at peace yet with the whole experience, if that makes any sense.


Robyn - In stillheart.gif with Tyson, Gothy Mama to fairy.gif Jasmyn (March 12 2003), jammin.gifGrayson (August 2 2005), my angel3.gif Aurora Hope (m/c Nov 10 2010), and baby.gif Sydney Rayne (September 17 2011)     ribboncesarean.gifx3

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#2 of 9 Old 10-06-2011, 10:44 PM
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So happy everything turned out okay and for what it's worth from a stranger on the internet, I can understand why you are feeling everything that you are feeling. At the end of the day, you followed your heart in consultation with medical professionals you trusted. there is always some risk involved in birth, but you put your hands in the best care and in the best environment if something went wrong and your doctors acted quickly and appropriately. Even though I understand your feelings of guilt for doing a TOL, I think you did the best you could based on the advice of your doctor and I hope that eventually you can let go of the voices who would blame you for doing a TOL. And I'm glad it was your best labor and birth - 14 hours and feeling great and confident is a huge accomplishment and the kind of pain you felt at the end is the very first sign of uterine rupture and it's great that you communicated what you were feeling to your HCPs and they reacted appropriately - you were part of the solution that helped your daughter arrive safely. I had a c-section too - for failure to progress and a swelling cervix - turned out her head was inappropriately positioned making her descent and dilation difficult. Although we were in no danger at any time, I am still grateful for the medical team that got her here safely - because really, when we are holding our beautiful babies in our arms, who wouldn't cry at even the thought of them being in any danger! You are totally normal! I hope you can find a supportive friend or family member to help you process your experience, but I think you are headed in the right direction.

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#3 of 9 Old 10-08-2011, 04:40 AM
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It is understandable to have mixed feelings - you came through more or less okay and your baby is fine, but things didn't turn out exactly as you'd hoped, and your family is giving you a hard time when they ought to just be supportive during your recovery. No one should be anything but supportive of you right now!


It's too late to think about the "could have beens".  Don't torment yourself.  Because anyway it sounds like you knew the right thing to do, when you felt things going awry, to agree to the c/s and it turned out to be what you needed.  You gave it your best shot but you did what you had to do when it needed to be done.

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#4 of 9 Old 10-08-2011, 05:35 AM
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Please don't blame yourself for trying.  You know from your research that in most cases, and with extremely high probability, that a trial of labor IS the best thing for the baby & yourself.  You chose to birth that way because it is normally safer and better (for baby's lungs, health, etc.).  It went wrong, but a million other statistical improbabilities could have gone just as wrong...  you could have had complications from a scheduled c-birth just as easily, mama, but if that had happened you wouldn't be feeling judged for your choice quite as much. 

i am so glad your birth ended well.  just remember that there is no way, NO WAY, mama, to predict the outcome, and that you made a very informed, educated decision. 


Is it getting lonely in the echo chamber yet?

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#5 of 9 Old 10-08-2011, 06:11 AM
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I know how scary it is to think about how close you came to a disaster.  My second baby had a true knot in his cord and it was wrapped around his neck in such a way that the knot was lying over the back of his neck.  So when he descended through the birth canal, the cord was compressed either decreasing or cutting off his blood supply and slowing his heart rate to such a degree that doctors and nurses swarmed into my room as I was pushing him out.  Luckily he was born quickly and started screaming immediately, but no one knew about the possible cord accident until his neck was out and the midwife saw the knot. 


This baby was breech for most of the pregnancy and my midwife and I were both planning to deliver him vaginally breech, in spite of hospital policy that all breech babies must be C-sectioned.  It just terrifies me to think what might have happened if the baby hadn't turned vertex at 36 weeks.  He more than likely would have died during birth.  My God, that would have been such a stupid decision. 

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#6 of 9 Old 10-08-2011, 10:20 AM
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DO not feel guilty. I think you struck a perfect balance, actually.   You wanted to have a VBAC but you did it in the safest setting possibale. You did it in the hospital next to OR with a qulified medical staff such as OBs and RNs. Kudos to you and your maternal wisdom!


In any other setting, things would have not ended well because one can't be teleported from home or free standing center to the hospital..


You are a wise women for striking a middle path in your desire for vaginal birth and safety of your child.


Things worked out exactely the way they should if you have a an emergency.  You have nothing to feel bad about. Nothing!  Congrats on your baby!

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#7 of 9 Old 10-08-2011, 10:58 PM
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I completely understand how you are feeling because I felt that way too, albeit on a smaller scale. My midwife wanted to induce me when I was 41.5 weeks because my blood pressure was elevated.  We did a bio-physical profile and baby was perfect, my fluid levels were perfect, and there were only trace amounts of protein in my urine (which had been there since very early on in the pregnancy). I trusted my practice, so I agreed to the induction. I had cervadil overnight and then spent hours walking the halls waiting for something to happen - nothing did.  Eventually it was time for pitocin. I was still hopeful that I could have a natural birth even with pitocin because I had access to a telemetry monitor (mandatory continuous fetal monitoring with pitocin use).  Problem was, the only way the monitor picked up my baby's heartbeat was when I was flat on my back.  I was totally devastated. I knew that if I was forced to labor with pitocin on my back without any ability to get out of bed and move around or walk or change positions or anything, I would have a c-section. So DH and I decided to leave the hospital and wait until I went into labor naturally. We informed my midwife of what we were doing and asked for her blessing because in the 17 hours I spent at the hospital, my blood pressure had come down and I had absolutely no symptoms of pre-eclampsia. The midwife agreed and allowed us to go home. I went into labor naturally about 18 hours later and DD was born after 36 hours of labor and 2 hours of pushing.


After DD was born, I questioned myself about the risk we had taken.  At the time, it seemed like the very best thing that we could do for me and for the baby.  Once I had that baby in my arms, I was less sure.  It all worked out for us, but I couldn't help wondering what could have happened.  What if something went wrong after we left the hospital because I was so gung ho to have a natural birth. That I could have taken a risk that meant I would not have that perfect little human child in my arms was unthinkable. I started to understand the sentiment that "all that matters is that you have a healthy baby."


Here's the thing though - we both made the right decisions in light of all the information we had. If you knew that you would have had a UR, you obviously would not have labored at all. The statistics supported you though, so while it is absolutely normal and natural to have the trauma of a near miss, the decision you made was not stupid or dangerous. Please try to go easy on yourself.

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#8 of 9 Old 02-16-2012, 02:49 PM
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My second had a true knot. My labour was soooooo slow to start, so random, contractions were only regular for 55mins, i pushed for 6. I spent a good few days after crying about the what ifs. I still shudder about it. Every time someone i know tells me they were given pit for a slow or irregular labour, or induced "just because" i think about how that action, in all likelihood, would have killed MY baby, and marvel that doctors do it so regularly.

So even though i had a different complication, and due to circumstance it didn't complicate anything, i do know that feeling of being torn apart by what ifs and feeling grateful and naive at the same time. Life is unpredictable and alarming at times, never is it thrown into sharper relief than by the dramatic backdrop of birth.
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#9 of 9 Old 03-02-2012, 07:18 AM
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i had a uterine rupture with my vbac attempt. my first was a kneeling footling breech 33wker surprise preemie and i made it to transition with a pain-free labour. it was fast and his positioning coupled with being a preemie meant a transfer of care from my midwife to people i had never met before. i had booked acupuncture to try and turn him at 34.5wks but obviously didn't make it. i had a lot of sadness, didn't get to hold him - first time i saw him he was hooked up to machines and in an isolette


ffwd to my vbac. i made it to 36wks, was trying for an hbac (always wanted a home birth), but not making it to 37wks is automatic transfer to the hospital. this time, my midwife had rights at that hospital so she was with me and saw things go wrong after a normal labour for 3hrs. any preemie, even late term, requires a consult and the most excruciating local pain had started in my abdomen. i didn't want to agree to surgical birth. it took me some time in agony before i agreed. and i was wheeled out so fast, cut broadly and i didn't even get to see him. rupture. i could have written your post. a mix of gratitude and trauma. i do often regret trying for a vbac because it was a close call for ds2. his nicu stay i couldn't even face going in there after doing nicu time with ds1. he had hydroencephaly pretty badly,likely from him being thrust in and out of the birth canal. i had uti after uti and a bad bladder infection that went into my kidneys as they had to operate so quickly. i am grateful that he is ok, but my big thing is i wish i had been more aware of symptoms of uterine rupture, and perhaps some of what happened could have been avoided. i do still sometimes feel guilty that my desire to have a vaginal birth put me and my child's lives in real danger.


i have mostly forgiven myself. i am a registered massage therapist and broke down the scar tissue from the first surgical birth. i had an angry keloid scar on the outside, but the obstetrician who cut me open said that they saved time because i had no scarring on the inside, and that the location of the rupture was not from the first birth. i told him how i had broken down the scarring, and he said that may have very well saved my son's life or at the least prevented major complications. so am grateful for that (and this time, the keloid is gone and my outside scar is almost invisible). but having said all of that, there is the sadness with knowing that a scheduled c-section could have prevented it all. it's a really hard one. and i really get what you are feeling...a cauldron of mixed emotions.


self forgiveness is really important. ultimately the statistics didn't favour you (or me) and you couldn't have predicted that.

mama to callum (april 8,07) and everett (sept 24,09) - blessed to be married to my life's love since '98. novaxnocirc.gif

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