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<div>Originally Posted by <strong>rmzbm</strong> <a href="/community/forum/post/10823504"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">The logical side of my brain agrees with you...but when you're literally in a corner with more than one OB basically hysterically yelling about losing your entire blood volume in under 5 min...you really don't know what to think. A section sure beats THAT. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/greensad.gif" style="border:0px solid;" title="greensad"></div>
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Ohhh, I am so sorry they are treating you like this. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/hug.gif" style="border:0px solid;" title="hug"><br>
They just know that if they can scare and confuse parents enough, then they can get them to agree to just about anything.<br><br>
I agree with one of the posters who said they can totally reschedule the section if that is what YOU decide to do. You don't have to be pressured into their schedules. That's what they do with so many medical decisions, they schedule things so we feel trapped and have no time to fully educate ourselves. It keeps them in a position of authority. Here I go with my conspiracy theories...<img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/winky.gif" style="border:0px solid;" title="Wink"><br><br>
I'll send you good vibes instead. <img alt="" class="inlineimg" src="/img/vbsmilies/smilies/goodvibes.gif" style="border:0px solid;" title="Goodvibes">:
 

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<div>Originally Posted by <strong>vaughnmama</strong> <a href="/community/forum/post/10824333"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">That's what they do with so many medical decisions, they schedule things so we feel trapped and have no time to fully educate ourselves. It keeps them in a position of authority.</div>
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I totally agree! <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/irked.gif" style="border:0px solid;" title="irked">:
 

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<div>Originally Posted by <strong>rmzbm</strong> <a href="/community/forum/post/10823418"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">I think she's covering her ass, and getting mad at me for doing the same.</div>
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Truer words were never spoken. You are a brave soul. If the placenta is high and posterior, the chances of an accreta are low. Very low. You still have time. Will you kick yourself for surgery when your daughter is healthy and you could have had a vaginal birth? I know she will be fine either way.What about just waiting a few more days. I am sure you are tired of the pressure you have been put under. Ethel KennedY (Bobby's wife) had 11 c/s...so it is possible. But I have been away from the puter, and thought you were still UC'ing....Hugs to you...cAthi
 

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<div>Originally Posted by <strong>alegna</strong> <a href="/community/forum/post/10823752"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">Okay- to summarize:<br><br>
There is nothing magic about Monday.<br>
Nothing magic about Monday. Don't let that "scheduled" thing even factor into your decision.<br><br>
I would venture a guess that in women that have had 4+ sections in general the accreta numbers aren't as high as 25%. Much LESS if the placenta is well away from the scar.<br><br>
-Angela</div>
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<img alt="" class="inlineimg" src="/img/vbsmilies/smilies/yeahthat.gif" style="border:0px solid;" title="yeah that">: x2 Your chances of problems are much greater with surgery than without, all other things being considered. PS, the section rate is highest Mon-Thurs, between the hours of 8am-4 pm....
 

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<div>Originally Posted by <strong>cathicog</strong> <a href="/community/forum/post/10825795"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">Truer words were never spoken. You are a brave soul. If the placenta is high and posterior, the chances of an accreta are low. Very low. You still have time. Will you kick yourself for surgery when your daughter is healthy and you could have had a vaginal birth? I know she will be fine either way.What about just waiting a few more days. I am sure you are tired of the pressure you have been put under. Ethel KennedY (Bobby's wife) had 11 c/s...so it is possible. But I have been away from the puter, and thought you were still UC'ing....Hugs to you...cAthi</div>
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Thank you & you are so right. And that's hystrical you brought her up, as I did at my apppt...they keep saying NOONE has more than 3, I said "Mrs. Kennedy had 10 & noone stopped her!" (So it's ELEVEN she had?)
 

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<div>Originally Posted by <strong>rmzbm</strong> <a href="/community/forum/post/10823504"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">The logical side of my brain agrees with you...but when you're literally in a corner with more than one OB basically hysterically yelling about losing your entire blood volume in under 5 min...you really don't know what to think. A section sure beats THAT. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/greensad.gif" style="border:0px solid;" title="greensad"></div>
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Please don't let them bully you like this, Marie. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/hug.gif" style="border:0px solid;" title="hug"> You found your peace with your decision before. Clear out your mind and find it again. You won't be led astray.
 

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I'm sorry I did not read this thread closer, there is nothing diagnosed or "wrong" how did this thread get so speculative. Doctors have a terrible habit of covering all their bases with the worst case scenarios when they practice defensive medicine.<br>
Lets look at what your doctor said in a different way<br>
She said You have a 75% chance of absolutely nothing "wrong"<img alt="" class="inlineimg" src="/img/vbsmilies/smilies/dizzy.gif" style="border:0px solid;" title="Dizzy">:<img alt="" class="inlineimg" src="/img/vbsmilies/smilies/hug2.gif" style="border:0px solid;" title="Hug2">.<br><br>
Good luck with whatever decision you make !<br><br>
Best to you,<br>
Dew
 

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<div>Originally Posted by <strong>yvonnemlv</strong> <a href="/community/forum/post/10826501"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">Please don't let them bully you like this, Marie. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/hug.gif" style="border:0px solid;" title="hug"> You found your peace with your decision before. Clear out your mind and find it again. You won't be led astray.</div>
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<img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/nod.gif" style="border:0px solid;" title="nod"><br><br><br><div style="margin:20px;margin-top:5px;">
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<div>Originally Posted by <strong>dewi</strong> <a href="/community/forum/post/10826914"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">I'm sorry I did not read this thread closer, there is nothing diagnosed or "wrong" how did this thread get so speculative. Doctors have a terrible habit of covering all their bases with the worst case scenarios when they practice defensive medicine.<br>
Lets look at what your doctor said in a different way<br>
She said You have a 75% chance of absolutely nothing "wrong"<img alt="" class="inlineimg" src="/img/vbsmilies/smilies/dizzy.gif" style="border:0px solid;" title="Dizzy">:<img alt="" class="inlineimg" src="/img/vbsmilies/smilies/hug2.gif" style="border:0px solid;" title="Hug2">.<br><br>
Good luck with whatever decision you make !<br><br>
Best to you,<br>
Dew</div>
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Thanks, I had a talk with an OB I really like. He assured me I have at LEAST a 93% chance of being fine, with no (not even minor) issues, and that THAT is his "conservative" estimate with the liklihood of good outcome being probably even higher. And he is the last one to see my insides. (No, going back there for care is not an option, unfortunately...)<br><br>
I have to learn to block out the doomsayers...
 

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<div>Originally Posted by <strong>rmzbm</strong> <a href="/community/forum/post/10827077"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">I have to learn to block out the doomsayers...</div>
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Yes... you really must... (I need a smilie with her hands on her hips and waggling her finger) <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/winky.gif" style="border:0px solid;" title="Wink"><br><br>
-Angela
 

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<div>Originally Posted by <strong>alegna</strong> <a href="/community/forum/post/10827279"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">Yes... you really must... (I need a smilie with her hands on her hips and waggling her finger) <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/winky.gif" style="border:0px solid;" title="Wink"><br><br>
-Angela</div>
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I'm sure it's on their to do list, right after the "Developmentally Appropriate" with a line through it similie! <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/winky.gif" style="border:0px solid;" title="Wink">
 

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In general, the risk of placenta accreta after 4 sections is 2.33%. If a woman is diagnosed with placenta previa, the chance of also having placenta accreta rises dramatically to 67%. In other words, most placenta accreta cases also have placenta previa. The OP has the opposite of previa--placenta is high and posterior. Her risk in general of having accreta (if no one did an U/S or knew the position of the placenta) is 2.33%. But with her placenta being at the top of the fundus and posterior, the likelihood of accreta is VERY low. Very, very low.<br><br>
Here's a recent study on placenta accreta and multiple cesareans:<br><br><div style="margin:20px;margin-top:5px;">
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<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">Obstetrics & Gynecology (2006;107:1226-1232) found that there is maternal morbidity associated with multiple repeat cesareans.<br><br>
OBJECTIVE: To estimate the magnitude of increased maternal morbidity associated with increasing number of cesarean deliveries.<br><br>
METHODS: Prospective observational cohort of 30,132 women who had cesarean delivery without labor in 19 academic centers over 4 years (1999–2002).<br><br>
RESULTS: There were 6,201 first (primary), 15,808 second, 6,324 third, 1,452 fourth, 258 fifth, and 89 sixth or more cesarean deliveries. The risks of placenta accreta, cystotomy, bowel injury, ureteral injury, and ileus, the need for postoperative ventilation, intensive care unit admission, hysterectomy, and blood transfusion requiring 4 or more units, and the duration of operative time and hospital stay significantly increased with increasing number of cesarean deliveries. Placenta accreta was present in 15 (0.24%), 49 (0.31%), 36 (0.57%), 31 (2.13%), 6 (2.33%), and 6 (6.74%) women undergoing their first, second, third, fourth, fifth, and sixth or more cesarean deliveries, respectively. Hysterectomy was required in 40 (0.65%) first, 67 (0.42%) second, 57 (0.90%) third, 35 (2.41%) fourth, 9 (3.49%) fifth, and 8 (8.99%) sixth or more cesarean deliveries. In the 723 women with previa, the risk for placenta accreta was 3%, 11%, 40%, 61%, and 67% for first, second, third, fourth, and fifth or more repeat cesarean deliveries, respectively.<br><br>
CONCLUSION: Because serious maternal morbidity increases progressively with increasing number of cesarean deliveries, the number of intended pregnancies should be considered during counseling regarding elective repeat cesarean operation versus a trial of labor and when debating the merits of elective primary cesarean delivery.</td>
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<div>Originally Posted by <strong>rixafreeze</strong> <a href="/community/forum/post/10827944"><img alt="View Post" class="inlineimg" src="/community/img/forum/go_quote.gif" style="border:0px solid;"></a></div>
<div style="font-style:italic;">In general, the risk of placenta accreta after 4 sections is 2.33%. If a woman is diagnosed with placenta previa, the chance of also having placenta accreta rises dramatically to 67%. In other words, most placenta accreta cases also have placenta previa. The OP has the opposite of previa--placenta is high and posterior. Her risk in general of having accreta (if no one did an U/S or knew the position of the placenta) is 2.33%. But with her placenta being at the top of the fundus and posterior, the likelihood of accreta is VERY low. Very, very low.<br><br>
Here's a recent study on placenta accreta and multiple cesareans:</div>
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Thanks for the numbers. How dare an OB throw 25% at her... <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/angry.gif" style="border:0px solid;" title="angry"><br><br>
-Angela
 

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Some info on accreta. It's really serious when it happens, although it looks very unlikely that the OP actually HAS accreta:<br><br>
An <a href="http://www.smh.com.au/news/national/when-birth-is-a-race-to-stem-the-flow-of-blood/2008/01/13/1200159276811.html" target="_blank">article about operating with an accreta</a><br><br><a href="http://www.smh.com.au/multimedia/2008/national/caesareans/main.html" target="_blank">Video on cesareans</a>, including the increase on placenta accreta
 

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THANK YOU for that!!! Wow. That is actually VERY reassuring. I had all the rupture #'s (which, btw, she said is 25% too...I personally think she has a fetish with the number 25...) but it's good to have this info. too. Printing it out. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile">
 

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"Because serious maternal morbidity increases progressively with increasing number of cesarean deliveries, the number of intended pregnancies should be considered during counseling regarding elective repeat cesarean operation versus a trial of labor and when debating the merits of elective primary cesarean delivery."<br><br>
She asked me, too, if I planned more children after this one. I told her that we would like one more beyond this. Though likely not for 4 or 5 years, I do need a rest. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/wink1.gif" style="border:0px solid;" title="wink1"> But she saw no problem with that. How totally irrisponsible, NO talk of the risks of SIX c-sections. How dangerous would THAT pregnancy be?! <img alt="" class="inlineimg" src="/img/vbsmilies/smilies/eyesroll.gif" style="border:0px solid;" title="roll"> I mean I'm a walking bomb as it stands NOW. There's no way though, if I DID winbd up with a section this time I'd be done, no flipping way will I have 6...
 

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I hope you figure out the best path to take. Just wanted to throw this out there as something you can discuss with your doctor if you do wind up having your section and they do make the decision to leave the placenta in to detach on its own. Why not get a scrip for domperidone so that you can artificially elevate your prolactin levels while you wait? I think that might be a good, low-risk option to take to preserve both your health and your nursing relationship. Couldn't hurt, could it?
 

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IF I had a section and IF there was accreta and IF it caused an issue I would DEMAND a hysterectomy. If they didn't abide by that I'd be too busy initiating lawsuits to think about anything else. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/angry.gif" style="border:0px solid;" title="angry">
 

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I don't get why you don't believe the doctors? I mean, you have seen a whole bunch. Why do you think they are lying to you? Why do you think they are just scaremongering you? I am just curious why you think they are wrong and you are still capable of a UC with all that they have told you? (not criticizing, just asking)
 

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I don't THINK they're lying, it's been WELL ESTABLISHED they're lying. 25%? They aren't above pulling #'s out their rears, and the REAL research indicates the opposite of what they say. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/shrug.gif" style="border:0px solid;" title="shrug"> They don't even look at my entire file, if they can't be bothered...um, yeah. <img alt="" class="inlineimg" src="/img/vbsmilies/smilies/eyesroll.gif" style="border:0px solid;" title="roll">
 

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you know this is not the first time I have read/heard the 25% info I wonder if the docs have read an article or heard a lecture and got the info confused. I think I'll have to go through the lit and see if I can find where the mistake is being made/drawn from, it is a huge misrepresentation -it is true that since C-sections have been on the increase, with 1/4-1/3 of births are sections , that the numbers of accreta, previa and abruption tubal pregnancies and infertility have gone up directly related to previous sections but it is still a single digit % .<br>
It is of course your choice to refuse conservative management, it is good though that some docs in the US are now offering in the past the only option was aggressive magement and it has a high rate of maternal morbidity and mortality. In the French study nearly all the women in the aggressively managed group ended up with a hysterectomy-- I recommend you read up on consiquence of one , there are hormonal considerations and blood loss considerations and....
 
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