Starting to have second thought on my VBAC

gdgrl711

Hello Community!

My Dr is gung-ho about my VBAC, but upon reading the numbers from data bases, I'm not so sure. Both VBAC's and RCS pose risks, but risks to baby seem high to me, 2.8-6% of babies die due to uterine rupture during a VBAC. These numbers are from 2010, but they are making me very nervous. It seems like RCS is safer for baby, thoughts? I am not a great candidate since my daughter had to be suctioned out of my pelvis during my C-section, (too narrow.)

Wering

I'm a number's person - a risk mitigator. But I'm attempting a VBAC in August. First - trust you doctor. Ask him/her about the narrow pelvis and if that is a deal breaker. 

Secondly - Let's break that 2.8-6% of babies down to make you feel a little better. Don't forget that the number of babies dying in uterine rupture require a ruptured uterus to begin with. It's NOT 2-6% of VBAC babies. Also, as a note, when delivering at full term, the statistic is actually between 0 and 2.8% (see reference link below). Let's ignore that fact for a minute.

In 2010, 4 million babies were born. We'll ignore that VBAC moms apparently have a higher risk of Uterine Rupture and assume ALL moms had the same risk of .64%. (In fact, a uterine rupture in an unscarred uterus is .007%, a scarred uterus is .64% - so while a scarred mom is more likely - it's still extremely unlikely). 

4 Million Babies Born

High End (.64%) 25,600 moms experienced uterine rupture

Low End (.007%) 280 moms experienced uterine rupture

OF THOSE RUPTURES:

High End Uterine Rupture:

High End Infant Death: 1,536 babies (~1 in 3,000)

Low End Infant Death: 716 babies (~ 1 in 6,000)

Low End Uterine Rupture

High End Infant Death: 16.8 babies (~1 in 245,000)

Low End Infant Death: 7.84 babies (~1 in 500,000)

Long story short - look at the numbers. See if you feel comfortable with the numbers you see. I DO. My midwife did. My doctor does (I transferred because of a hospital issue - and interviewed 4 doctors all of whom agreed VBAC was the best route.) If you are NOT comfortable with those numbers - maybe a repeat section is best for you. It's all about how much risk you are most comfortable taking. BUT - know that the risk of future pregnancies increases with each csection. Ask your doctor to discuss that risk with you, as well.

I'll leave you with this thought:

Your risk of dying in a car accident? 1 in 84

Your risk of dying in a bicycle accident? 1 in 5000

Your risk of dying from an accidental firearm discharge? 1 in 5,000

Your risk of dying from a fireworks discharge? 1 in 340,000

Yet we never think twice about viewing a fireworks show, our neighbors who (legally) have (and use) guns, or riding our bike to the park. OR LETTING OUR KIDS RIDE THEIR BIKES TO THE PARK. Risk is everywhere. It's all a matter of what you're comfortable with.

Reference: https://vbacfacts.com/2012/04/03/confusing-fact-only-6-of-uterine-ruptures-are-catastrophic/

Reference: https://vbacfacts.com/13-myths-about-vbac/

Reference: https://www.blog.joelx.com/odds-chances-of-dying/877/

gdgrl711

Wow, thanks so much for the response. I like numbers too, especially when they are in ones favor. There is a lot here for me to think about. I didn't know about the risks assosiated with c-sections for future babies, so thanks for that as well. This is something I need to talk more to my midwife about and really dig deep inside me to decide the best way to get him out safely. 

Wering

You're welcome - hopefully this helped put it into perspective for you. I did a LOT of research in the two years between my CSection and my next pregnancy, and then I had to use numbers like those above to help get my hubby on board with a VBAC. There's a lot of stigma out there as to whether or not it is safe. Ultimately it's not "safe" vs "not-safe" - it's about how much risk we are willing to take and what steps we can take to mitigate those risks.

Ask you doctor about things you can do to help you with a successful VBAC, as well. I'm in the process of researching that, and it looks like gaining ONLY the recommended amount of weight, staying active during pregnancy, sitting in positions conducive to baby's movements (AKA don't recline), and using an exercise ball to keep your hips open is important. If I can dig up anything else, I'll let you know. 

gdgrl711

That would be great, thanks!