VBAC

VBAC with both a horizontal and a vertical cut?

Hello, I am a longtime member but not a frequent poster. In fact, I haven't posted anything regarding my pregnancy this time around, but I'm hoping to get some advice. I am on my fourth pregnancy. The first two were natural deliveries so I was very surprised when I needed an emergency c-section for my third. During the procedure, my uterus clamped down around my sons head and wouldn't let him go. They tried a muscle relaxant but that failed so they had to do an internal vertical cut to get him out. I was unaware of this, so when my OB said I would need to have a c-section for any future children I didn't think much of it. 18 months later I am pregnant with my fourth baby. My new OB wants to try for a VBAC since it's been 2 years for my scars to heal, and since it seems like my labors progress fairly quickly. I am nervous about this. On one hand, I would much rather recover from a VBAC than another C-Section, but I'm scared of uterine rupture considering I have both the horizontal AND a vertical cut to worry about. I've had little to no luck researching similar cases so I don't know if I'm higher risk or not. I have tried to contact the OB who did my c-section for her advice but she has moved out of state and I'm having no luck with her new office. I'm wondering if I should just suck it up and go for the c-section.
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Re: VBAC with both a horizontal and a vertical cut?

  • OBs tend to be more cautious than not, so if yours is recommending it then I'd say go for it. I'm not familiar with your incision type - try searching on https://vbacfacts.com, they have the latest recommendations from ACOG on who is a good candidate for VBACs. I *think* they said an unknown or horizontal incision is not a deal breaker, but can't say for sure.
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  • From what I've learned about my own inverted t / anchor incision it only raises your risk by 0.9% that means 98% of women successfully have a vbac with an inverted t
  • I don't think that means 98% have a successful vbac as the number is not even that high for a normal horizontal cut. I think it would mean you have a 98% chance of not rupturing...
  • edan3579 said:

    I don't think that means 98% have a successful vbac as the number is not even that high for a normal horizontal cut. I think it would mean you have a 98% chance of not rupturing...

    Yes you're totally right. My folly. That's what I was thinking but it came out wrong. 98% chance of TOLAC - which is good enough for me! At least then I know I tried everything!
  • https://www.specialscars.org

    This website and corresponding Facebook group has a lot of information for women who have had c-sections that are NOT the traditional low transverse incision. The is group is supportive of women who VBAC and women who have repeat c-sections.
  • I know it's been some time since you posted however I still wanted to respond.
    I personally don't have experience with having both scars how we I'm part of a very knowledgeable VBAC FB group that I'm sure could help answer.
    Although I'm sure from the date you published and the time that passed there's a good possibility you may have already had your baby

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  • Having only horizontal incisions is most ideal for not rupturing when attempting a VBAC, from what I've been told. My GYN practice will not do VBACs if there is a vertical incision involved bc of increased chance of the uterus rupturing. Many different docs and practices may have different opinions.
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