Question from a lurker (kind of long)
Hi ladies, I mostly lurk, but have learned a lot from all of your posts. I finally have a question of my own to post and would appreciate any input.
Let me preface this by saying I had an emergency c/s at 36 weeks with my last pregnancy due to pre-e. My recovery was awful.
I had my 28 week appointment today and everything is looking great. I've been so nervous lately about getting pre-eclampsia again, but everything looks normal. The OB talked to me about VBACs and a repeat c/s. I am hoping for a VBAC, but she told me a lot of the pros and cons today, and now I'm second guessing myself.
She said that because I was 4 weeks early last time, my uterus wasn't as low as it should have been when they did my u/s. Therefore, this time, if I have a VBAC, there is a 13% chance that my uterus/scar will rupture due to how high my scar is. She said that they absolutely will NOT let me go past 39 weeks if I need to have another c/s, so if I go in for my weekly check ups and have no signs of dilation or progress, I don't have a choice at that point. I'm fine with that.
So, she has tentatively set up a c/s date of 1/4/12 for me. She said this doesn't mean I will have a c/s by any means, but just that the date is secured for me in case I do develop the pre-e again, that way we aren't wasting any time. I'm not super heartbroken if I can't have a VBAC, but it's something that I have always wanted to experience, and it would be ideal.
13% seems really high to me. All of the websites I've looked on says it's more like 1% (or less) of a chance of the uterus/scar rupturing. What has everyone else's OB's said about this percentage? What would you do if you were in my situation.. go for the VBAC, or just schedule the repeat c/s?
Re: Question from a lurker (kind of long)
I can't speak specifically to your situation, but I do know that it is true that the earlier you have your c/s the more of an impact the scar has on your uterus because of the size and location of it at the time. I know that my cousin had an emergency c/s at 27 weeks. She was told not to get pregnant again because the scar was much larger on her uterus because of the size it was at that time. She accidentally got pregnant again and they did a cs at 36 weeks because they were concerned about her scar which did rupture immediately before the c/s. She and baby were fine. But she was scared enough by it that they took measures to ensure another pregnancy did not happen.
I am not sure if a scar from 36 weeks would have the same issues, I would think not. I think it is more than reasonable to get a second opinion if you'd like.
Is it 13% regardless of when you go into labor, or is it 13% once you hit 39 weeks?
I agree that you should get a second opinion. I would also casually ask your OB if she could provide you with more information on where she got that statistic regarding early c/s and rupture risk. I would never VBAC if I heard that I had a 13% chance of rupture. But to be honest, that statistic sounds suspect and I do not think that any competent care provider would give you the choice of a VBAC, if the rupture rate were that high. Many care providers won't even VBAC given a 1% rupture rate!
If I were you I would do some more digging before making a decision. Good luck!
ETA: I do not believe that the ACOG bulletin on VBACs has anything to say regarding previous pre-term c/s and rate of uterine rupture. If pre-term c/s were a major contradiction for VBAC, I think that the bulletin would have included it.
Thank you so much for the input, I really appreciate it!
ILoveRunning: I'm not exactly sure on the specifics of the statistic of 13%. I thought it was incredibly high myself, and couldn't believe that they would offer VBACs with a percentage that high. The office I go to has four different OB's. I usually see two of them regularly. Today I saw one that I had never seen before, and she threw all of these statistics and scary scenarios at me. My normal OB seems totally on board witha VBAC and never mentioned such a high statistic. I go back on November 1st, so I will definitely speak with my regular OB about this.
I think what I might do is just play it by ear. If I get the pre-e again, I will obviously do whatever is the safest for my baby and me. However, if I don't have pre-e, and all is going smoothly, I think I will try for the VBAC no matter what.
I will tell you that it is completely possible to have a VBAC in your situation. Here is "My Birth Story"- Yes the day I was born. My mom was 5 hours away from home. My dad was out hunting with my uncle and my mom and aunt were hanging out at home. Early in the afternoon my mom started having bad back pains. She chalked it up to me sitting wrong on her nerve. She took Tylenol and again later took Tylenol. Next thing you know she went to the bathroom and she was bleeding. She got a hold of my dad and told him that she thought she was in labor, she was 32 weeks pregnant at the time.
My dad and mom drove 5 hours to the hospital where it was confirmed that my mom was in labor and at that point full dilated, however I was footling breech. She had an emergency c-section and I was born at 32 weeks. She had a transverse scar.
My mother went on to have 5 children after me all VBAC deliveries. Her next pregnancy my brother was a 10 pound baby with extremely broad shoulders and she did it med-free after her due date with no problems.
My point is get a second opinion because it clearly can be done.
I'm WAY late to this but I just happened to pop over here and read this. I do not know how the statistic came to be but I had my first c-section at 30 weeks and my Dr. never say anything about my chances of rupture being higher. The statistics and info she gave me were all 1%.
I did have a successful VBAC and am planning for another one!