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i posted on the VBAC board but was wondering if any midwives over here had any insight on my situation. here is the post:<br><br>
bear with me as i am thinking through this.<br><br>
might it make more sense to do a TOL, even with a classical incision, if the c-section you would need to have is inherently riskier than the "normal" section?<br><br>
what happened to me was that the OB had to go in to my uterus high up to get my baby out because scar tissue/adhesions and bowel were blocking him from doing a low transverse incision. (this was due to a prior abdominal surgery, nothing to do with birth.) he told me that in any future sections, the dr. (probably NOT him, since he seems to want nothing to do with me again! he wants me to go high risk) would probably need to go in even higher because there will be additional scar tissue from my c-section.<br><br>
my OB (a very good OB by all accounts, and i liked him) was not even sure after performing my c/s whether he might have perforated some bowel--and told me so hours after my surgery. according to him bowel was "everywhere." apparently my insides are like a minefield for surgeons<br><br>
anyway, he was visibly shaken after my surgery (i did heal fine, BTW).<br><br>
anyway, my thought on this is that, if a c-section is so very very scary to do on me, and carries with it extra risks like this, might that not mean a TOL could be more appropriate for me, since if it went well i could avoid another surgery? i worry especially about getting perforated or otherwise injured. i also worry that i could really only have one more c-section, with it getting so much worse each time in terms of scar tissue. (we only plan on one more child, but i wouldn't want an "oops" after that to be catastrophic.)<br><br>
the flipside, i guess, would be that since a c-section is technically difficult with me, you would not want to have to do it as an emergency--which it might end up being if a labored first and then needed a C.<br><br>
of course, this is exactly what happened with DD. i labored first, then needed a C because of mec staining and the fact that i'd pushed for 4 hours with no results, and at that point they discovered how damn difficult it was to get her out. they did get her out in time, but it was a little dicey for awhile there.<br><br>
sorry this is so long, but i'm just trying on this reasoning to see what i think of it. it is all hypothetical at this point because i am not pg or even TTC. i don't want to be until i have some idea of how i might approach this.
bear with me as i am thinking through this.<br><br>
might it make more sense to do a TOL, even with a classical incision, if the c-section you would need to have is inherently riskier than the "normal" section?<br><br>
what happened to me was that the OB had to go in to my uterus high up to get my baby out because scar tissue/adhesions and bowel were blocking him from doing a low transverse incision. (this was due to a prior abdominal surgery, nothing to do with birth.) he told me that in any future sections, the dr. (probably NOT him, since he seems to want nothing to do with me again! he wants me to go high risk) would probably need to go in even higher because there will be additional scar tissue from my c-section.<br><br>
my OB (a very good OB by all accounts, and i liked him) was not even sure after performing my c/s whether he might have perforated some bowel--and told me so hours after my surgery. according to him bowel was "everywhere." apparently my insides are like a minefield for surgeons<br><br>
anyway, he was visibly shaken after my surgery (i did heal fine, BTW).<br><br>
anyway, my thought on this is that, if a c-section is so very very scary to do on me, and carries with it extra risks like this, might that not mean a TOL could be more appropriate for me, since if it went well i could avoid another surgery? i worry especially about getting perforated or otherwise injured. i also worry that i could really only have one more c-section, with it getting so much worse each time in terms of scar tissue. (we only plan on one more child, but i wouldn't want an "oops" after that to be catastrophic.)<br><br>
the flipside, i guess, would be that since a c-section is technically difficult with me, you would not want to have to do it as an emergency--which it might end up being if a labored first and then needed a C.<br><br>
of course, this is exactly what happened with DD. i labored first, then needed a C because of mec staining and the fact that i'd pushed for 4 hours with no results, and at that point they discovered how damn difficult it was to get her out. they did get her out in time, but it was a little dicey for awhile there.<br><br>
sorry this is so long, but i'm just trying on this reasoning to see what i think of it. it is all hypothetical at this point because i am not pg or even TTC. i don't want to be until i have some idea of how i might approach this.