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I'm at 39 weeks... with VBAC planned using midwives in a local community hospital with 24 hour ob/anesth availability.<br><br>
They have a routine vbac policy which requires monitoring for 15 minutes approx every hour. I've been trying to do everything positive to prepare my body for this vbac after my unplanned cesarean with baby #1 - including acupuncture, chiropractic care, evening primerose oil, raspberry leaf tea, pelvic tilts, prenatal yoga, walking, etc. My first labor was a long one (30+ hours at 41 weeks, posterior position, did not drop, pushed for 3 hours, convined that c/s was best option, did single layer suture...ugghghh!)<br><br>
So now the little thing in the back of my mind, especially after we went to a lawyer to discuss a will since this is our 2nd child, is a bit of fear around uterine rupture. I don't know if it's so minimal, but seems a little worse by the cavalier approach that the OB on shift took with my first labor, that he did a single layer suture. I've read that it can increase risks around the placenta during pregnancy, but i don't have previa so not sure if that's the main concern and/or rupture?
 

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I know one of the research gurus will post more information, and I don't have it at my fingertips. My understanding is that the jury is still out on single vs double layer suture. And whichever one your doctor used depends entirely on who taught them and which one they prefer.<br><br>
Mama, what do you need to do to let go and gestate in peace? I'm not asking for a response, but for you to ask yourself. You are so close to meeting your baby. You have done all the physical preparation, but what about mental preparation? What do you need to do to quiet the nagging fear of UR? You are not fearing cord prolapse. You are not fearing shoulder dystocia. You are not fearing hemorrhage. You are not fearing any of the potentially life-threatening things that are part of birth. Focus on your baby, healthy and strong. Connect with your baby, talk to him/her. Find a way to not fear the unknown. You will be holding your baby soon!
 

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I had a single layer suture...<br>
Well, as far as we know I do. My OB neglected to even make an operative note for my surgery. But, my m/w has seen many other VBACers whose sections were done by her and she always does single layer. Btw, the OB is a VBAC mom herself, so I doubt she would be doing single layer sutures if she felt they were more risky.<br><br>
Anyhow, my m/w and I discussed this and she basically said what Tanya just said. No one knows for sure if there is an increased risk. She said that she hadn't seen any research proving that a single layer was more risky, therefore she was going to treat it as if it were not. She's done plenty of single layer VBACs and never had an issue.
 

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I have read on various websites that single layer sutures have more of a UR risk. However, when I say more of a risk, it is very minimal. Honestly, don't a lot, or most doctors do single layer stitches anymore? They do in my city.
 

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i've had 2 c-sections both w/ sinle layer suture and when my midwife spoke w/ him he wasn't concerned in the least bit and neither was she. i went on to have my vba2c just 15 months after my 2nd section.
 

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Some studies show a slightly increased risk of UR with a single layer...but the real "problem" with single layer sutures is just that many care providers (including midwives) wont take on a VBAC mama with a single layer suture. So although it's not necessarily more risky for the mama having the VBAC in terms of "actual risk to her and her babe", a single layer closure can limit VBAC options/choices...<br><br>
The only other slightly increased risk with the single layer closure is the placenta can sometimes stick more tightly to the scar (or grow into the scar, leading to an accreta)...meaning that your care provider needs to be aware that you could have a slightly increased risk of bleeding after delivery, and a slightly increased risk of the placenta not detaching as quickly (and they shouldn't use traction or active management of the placenta...they should monitor you and give you extra time). However, if you haven't had any placental problems with this pregnancy it's probably not going to be an issue at this point! <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile"><br><br>
I agree with Tanya though...perhaps try to spend these remaining weeks working on the mental and emotional side of VBAC prep? If you're using a program like hypnobabies then perhpas do a few "fear release" sessions. Or meditate or pray (if either of those fit into your personal belief system)? Perhaps just get outside and connect with the strength of nature and the healing offered by the natural world? Whatever it takes to help you move past this concern?
 
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