question about VBAC's...

kurlieq

When I had DD, I had to have an emergency c-section after 23 hours of labor b/c she was transverse. Now that I'm pregnant again, I would love to be able to have a natural birth, and my doctor told me that was fine, since the c-section I had before was due to baby's position.

However, a friend of mine had a baby last year and also had to have a c-section. She was told by her doctor that if she has any other children, she will always have to have a c-section because of the strain that would be placed on the uterus during a vaginal birth.

Has anyone had any experience with this? I trust my doctor, but at the same time was a little nervous after my friend told me the advice of her doctor. Should I get a second opinion? I would really love to try a natural birth this time around, but not at the risk of my health or my baby's health. TIA!

bensbabe

First of all, do your own research, but I want to tell you that your OB is absolutely correct....and I'm very excited that your OB is open to VBAC. Baby positioning is the #1 reason for a failed vaginal delivery.

I am having a slightly lazy morning, but if you read through other posts about VBAC & uterine rupture (what your friend's OB is referring to--the strain on the uterus around the scar tissue can cause it to rupture, but those risks are VERY low...less than 1%, which is the same as a virgin uterus), there are links to various research people have posted. Please stick to the actual medical websites to get the best info.

FWIW, and I had to go through two other OBs to get one TOTALLY on-board w/a VBAC. One flat out refused (like your friend's OB), and the other had too many rules/restrictions. I followed the advice of a perinatologist to wait at least two years btwn pregnancies for the "best" outcome & least risk for uterine rupture, and I found a very positive OB to deliver this baby. I am hopeful for my VBAC come summer. I have great faith in my OB & trust her completely. I have delivered many babies VBAC with her. HTH

papagena

There is a slight (less than 1%, I believe it's .7 - .9% statistically) chance of a uterine rupture in a VBAC, but, frankly, there are adverse risks for repeat c/s as well.  Your OB is right, VBACs for mal-positioned babies have a great chance for success.  There are even things you can do to encourage baby to be in the best position possible. 

The long and short of it is that the entire 'once a c/s always a c/s' rule is out.  The ACOG is getting more supportive of VBACS as well, with fewer restrictions placed on them.  I don't know your friend's case, obviously, but if she had wanted a VBAC, I'd encourage her to get a second opinion from your OB or another doctor who is known not to be anti-VBAC.