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stitch method and VBAC

654 Views 9 Replies 6 Participants Last post by  crazy_eights
Hey mamas!
I don't know much about VBACs so I figured Id ask you knowledgeable moms who have been there. My SIL has had 2 C/S in which they did the unpreferable method of stitching. Would she still be able to do a VBAC or is that the key as to wether you can or not, the stitch method I mean?
Thanks for any info! I know the docs told her she has to have a C/S every time now, but I dont really believe that.....They tell that to everyone don't they?
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Try searching for 'single layer uterine incision" or "single layer uterine closure". It's controversial either way, but there is a lot of info and discussion out there.
The type of stitch they like is the "bikini cut" lower horizontal stitch. Outside of that, its very difficult to find any OBs that are willing to consider a VBAC. However, its definitely doable, and IMO still safer. I don't have the information with me anymore, but I had to do a lot of research for mine 2 years ago (my incision documentation was lost so they just assumed the worst even though the outer scar looked 'right'). There is definitely research available on VBACs and the risks related, based on the various incisions. (I think its T cut, upper horizontal, lower horizontal). I had heard of the single layer uterine closure, but I don't recall how that plays into the statistics. ICAN is a great (great great great) place to start, if you want to research it further.
I think what she is refering to is a single layer vs. a double layer of uterine stitching (or "closing"). Some won't do a VBAC with someone who has a single layer closure.
I am assuming we are talking about the SUTURE type not the cut Right?? ICAN has a white paper about the difference between the two types of closures. Here is a link: http://www.ican-online.org/resources.../wp_suture.pdf
Some OB's will use it as an excuse (as they will use everything) to not do VBAC, but overseas they ONLY do single layer sutering and their rupture rate is NOT higher, so she may have a harder time finding an OB if that is what she is looking for, but her risk is not shown to be higher.
And yes, most OB's say that everyone has to have repeat C/S.
I VBACd with a single-layer suture. My m/w said she doesn't really see any real reasons why not to. But, most OBs will try and tell you that you shouldn't.
Funny thing is, my c-section was done by an OB who was a VBACer herself. So... I would wonder if, as a VBAC mother, she would do something that would essentially put someone at more risk to do the same thing she did. Then again, I wonder a lot of things about her...
Quote:

Originally Posted by jrojala View Post
I am assuming we are talking about the SUTURE type not the cut Right?? ICAN has a white paper about the difference between the two types of closures. Here is a link: http://www.ican-online.org/resources.../wp_suture.pdf
Some OB's will use it as an excuse (as they will use everything) to not do VBAC, but overseas they ONLY do single layer sutering and their rupture rate is NOT higher, so she may have a harder time finding an OB if that is what she is looking for, but her risk is not shown to be higher.
And yes, most OB's say that everyone has to have repeat C/S.
I think there is some evidence that single layer can lead to more problems such as placenta percreta, but I don't think there is any good evidence out there showing higher rates of rupture. Some actually say single layer is better b/c there is less scar tissue and less infection risk. It's not so clear cut that it's a bad thing, which is why I said to look into it further and didn't give a straight 'oh, this is bad, this is good' answer.
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I have no idea what stitch my c-section was closed with and not one single doc or midwife has ever mentioned this to me.
I have VBACed for babies, each one progressively bigger then my c-section baby.
the type of stitch is very controversial and if you were in Europe, it would be the opposite of what is "recommended" here in the US
Here you go - an article from ICAN on the research done on both types of closures.
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