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Feeling Discouraged

liltatgirl0280liltatgirl0280
in VBAC

I went to the doctors recently for our 20 week AS. They found out my placenta is low. It only allows a 1cm opening at this point but they said it may move up as the baby grows and things stretch. I read some when I got home and I have a 90% chance of still being able to VBAC. If it doesn't move then I'm SOL and will end up with another c-section.

At the same visit they went over the VBAC consent form. It's just plain scary! I knew I had a 1 % chance of rupture. But if the rupture occures I have a 50% chance of one of us dying. My c-section was 8 years ago. You'd think I'd have a better chance than 1% but the doctor says no. If the baby's heart rate drops then it will be an immediate c-section because it can be a sign of rupture. Then they went into the risks of having an emergency c-section which is what I had the first time.

All the statistics and what ifs have my head spinning. How do you ladies deal with all the negatives and still consider VBAC? I need to hear some positives here.

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Re: Feeling Discouraged

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    lostaspenlostaspen

    I've never heard of the 50% chance of one of you dying in the event of a UR.  Especially since you're planning a monitored hospital birth, with emergency services seconds-minutes away.  And usually the dealth-risks involved with UR are for the baby more than the mom.  Also, there are various types of UR--some are very minor and don't affect you or the baby (usually discovered after the baby is born), while others are sudden and severe.

    I would be slightly concerned about their "if the baby's heartrate drops then it will be an immediate c/s"--babies heartrates drop throughout labor normally, and it is in only in certain conditions does the drop actually indicate a UR.  I would ask more questions about that and find out their exact criteria.

    But to answer your question, I focus on the fact that I hated my c/s and hated that I was lied to, and hated that it really wasn't necessary at all, and hated the 8 week recovery, emotional turmoil, etc.  I've also done a lot of reading (online, books, etc) and have come to the conclusion that a VBAC is the only way to go for me (barring an actual emergency), and when I weigh the pros/cons/risks of both, VBAC comes out leagues ahead of a c/s every time.  

    The best thing I can recommend is be as educated about both options as possible.  And get DH on board too, and get a VBAC doula.   

     

     

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    angelina477angelina477 member
    You have a 99% chance of not rupturing. That sounds better than stating the negative aspect. 
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    iris427iris427 member

    Those statistics are wrong and they have been taken out of context.  

    First of all, your chance of a rupture is not 1%.  It is around 0.7%.  

    Now let's put that number into the proper context.  Your chance of having a UR is around 7 per 1000 births.  What about other obstetrical emergencies?

    Table 1.
    Uterine Rupture1Placental Abruption2Umbilical Cord Prolapse3Shoulder Dystocia4
    7-8 out of every 1000 VBAC attempts11-13 out of every 1000 labors14-62 out of every 1000 labors6-14 out of every 1000 labors

     So you see, VBAC is not really that much riskier than any other vaginal delivery.  The risk of UR has been inflated because people are afraid of being sued.

    Now, the statistic that if a UR happens, there is a 50% chance someone will die.  This is just not true.  Only 6 out of every 100 uterine ruptures will result in a fetal death and far fewer will result in a maternal death.  

    Again, this information is not very helpful unless you put it into context.  How do VBAC mortality rates compare to RCS mortality rates?

    For the mother, the risk of dying in a RCS is around 13 per 100,000 vs. 4 per 100,000 in a VBAC.

    For the baby, the risk of dying in a RCS is around 50 per 100,000 vs. 130 per 100,000 in a VBAC.  

    So you can see that RCS carries an increased risk of death for the mother and VBAC carries an increased risk of death for the baby.  You can also see that the risk in either case is very small.  Your doctor is basically telling you that 1 out of every 200 VBAC attempts will end with somebody dying.  This is simply not true at all. 

    https://givingbirthwithconfidence.org/2-2/a-womans-guide-to-vbac/putting-uterine-rupture-into-perspective/ 

    https://consensus.nih.gov/2010/vbacstatement.htm 

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    Brownie_222Brownie_222 member
    imageiris427:

    Those statistics are wrong and they have been taken out of context.  

    First of all, your chance of a rupture is not 1%.  It is around 0.7%.  

    Now let's put that number into the proper context.  Your chance of having a UR is around 7 per 1000 births.  What about other obstetrical emergencies?

    Table 1.
    Uterine Rupture1Placental Abruption2Umbilical Cord Prolapse3Shoulder Dystocia4
    7-8 out of every 1000 VBAC attempts11-13 out of every 1000 labors14-62 out of every 1000 labors6-14 out of every 1000 labors

     So you see, VBAC is not really that much riskier than any other vaginal delivery.  The risk of UR has been inflated because people are afraid of being sued.

    Now, the statistic that if a UR happens, there is a 50% chance someone will die.  This is just not true.  Only 6 out of every 100 uterine ruptures will result in a fetal death and far fewer will result in a maternal death.  

    Again, this information is not very helpful unless you put it into context.  How do VBAC mortality rates compare to RCS mortality rates?

    For the mother, the risk of dying in a RCS is around 13 per 100,000 vs. 4 per 100,000 in a VBAC.

    For the baby, the risk of dying in a RCS is around 50 per 100,000 vs. 130 per 100,000 in a VBAC.  

    So you can see that RCS carries an increased risk of death for the mother and VBAC carries an increased risk of death for the baby.  You can also see that the risk in either case is very small.  Your doctor is basically telling you that 1 out of every 200 VBAC attempts will end with somebody dying.  This is simply not true at all. 

    https://givingbirthwithconfidence.org/2-2/a-womans-guide-to-vbac/putting-uterine-rupture-into-perspective/ 

    https://consensus.nih.gov/2010/vbacstatement.htm 

    This is why we love you, Iris.
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    cchill01cchill01 member

    As Iris said, those stats are wrong.  I just signed my paper work too and it was 1% of 1% for catastrophic rupture and it's almost always the baby who gets the bad end of that deal.  And at least I could still care for my DD.  What also convinced me to pursue a VBAC is knowing that there are also serious risks - with similar rates of incidence - for a 2nd c-section.  And even more for a 3rd. 

    RCS is not risk free - it's more LIABILITY free - for the hospital that is.  That form you signed has nothing to do with you or your baby or your health.  It has to do with some lawyer trying to protect the doctor and the hospital.  If you remember, you signed a MUCH MORE awful release before your c-section. 

    I know my perspective is depressing and I have lots and lots of positive reasons...but you were talking risks.

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    nosoup4unosoup4u member

    My advice: Find a new provider.

    I was never given a hard time or presented with shady stats when I was pg with my VBAC baby. Remind yourself that RCS or VBAC are  both reasonable options. Both have their own set of risks and benefits.

     

    DS1 - Feb 2008

    DS2 - Oct 2010 (my VBAC baby!)

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    MAprincessMAprincess member
    Not only are the stats on your consent form wrong, but there was never a time in recent history that 50% of ruptures are fatal.  As pp stated, it's .7% chance for rupture and less than 1% of the .7% is fatal.  I'd question the hospital and my provider for giving me such terrible information.
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    surprise3rdsurprise3rd
    imageBrownie_222:
    imageiris427:

    Those statistics are wrong and they have been taken out of context.  

    First of all, your chance of a rupture is not 1%.  It is around 0.7%.  

    Now let's put that number into the proper context.  Your chance of having a UR is around 7 per 1000 births.  What about other obstetrical emergencies?

    Table 1.
    Uterine Rupture1 Placental Abruption2 Umbilical Cord Prolapse3 Shoulder Dystocia4
    7-8 out of every 1000 VBAC attempts 11-13 out of every 1000 labors 14-62 out of every 1000 labors 6-14 out of every 1000 labors

     So you see, VBAC is not really that much riskier than any other vaginal delivery.  The risk of UR has been inflated because people are afraid of being sued.

    Now, the statistic that if a UR happens, there is a 50% chance someone will die.  This is just not true.  Only 6 out of every 100 uterine ruptures will result in a fetal death and far fewer will result in a maternal death.  

    Again, this information is not very helpful unless you put it into context.  How do VBAC mortality rates compare to RCS mortality rates?

    For the mother, the risk of dying in a RCS is around 13 per 100,000 vs. 4 per 100,000 in a VBAC.

    For the baby, the risk of dying in a RCS is around 50 per 100,000 vs. 130 per 100,000 in a VBAC.  

    So you can see that RCS carries an increased risk of death for the mother and VBAC carries an increased risk of death for the baby.  You can also see that the risk in either case is very small.  Your doctor is basically telling you that 1 out of every 200 VBAC attempts will end with somebody dying.  This is simply not true at all. 

    https://givingbirthwithconfidence.org/2-2/a-womans-guide-to-vbac/putting-uterine-rupture-into-perspective/ 

    https://consensus.nih.gov/2010/vbacstatement.htm 

    This is why we love you, Iris.

    I am new on the VBAC board and I love you too:)

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    iris427iris427 member
    imagesurprise3rd:
    imageBrownie_222:
    imageiris427:

    Those statistics are wrong and they have been taken out of context.  

    First of all, your chance of a rupture is not 1%.  It is around 0.7%.  

    Now let's put that number into the proper context.  Your chance of having a UR is around 7 per 1000 births.  What about other obstetrical emergencies?

    Table 1.
    Uterine Rupture1 Placental Abruption2 Umbilical Cord Prolapse3 Shoulder Dystocia4
    7-8 out of every 1000 VBAC attempts 11-13 out of every 1000 labors 14-62 out of every 1000 labors 6-14 out of every 1000 labors

     So you see, VBAC is not really that much riskier than any other vaginal delivery.  The risk of UR has been inflated because people are afraid of being sued.

    Now, the statistic that if a UR happens, there is a 50% chance someone will die.  This is just not true.  Only 6 out of every 100 uterine ruptures will result in a fetal death and far fewer will result in a maternal death.  

    Again, this information is not very helpful unless you put it into context.  How do VBAC mortality rates compare to RCS mortality rates?

    For the mother, the risk of dying in a RCS is around 13 per 100,000 vs. 4 per 100,000 in a VBAC.

    For the baby, the risk of dying in a RCS is around 50 per 100,000 vs. 130 per 100,000 in a VBAC.  

    So you can see that RCS carries an increased risk of death for the mother and VBAC carries an increased risk of death for the baby.  You can also see that the risk in either case is very small.  Your doctor is basically telling you that 1 out of every 200 VBAC attempts will end with somebody dying.  This is simply not true at all. 

    https://givingbirthwithconfidence.org/2-2/a-womans-guide-to-vbac/putting-uterine-rupture-into-perspective/ 

    https://consensus.nih.gov/2010/vbacstatement.htm 

    This is why we love you, Iris.

    I am new on the VBAC board and I love you too:)

    Aww thanks you guys <3 

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    Jena503Jena503
    Definitely time for a new OB. Did he try to scare the crap out of you about RCS risks too? No? Hmmm...
    The former jen5/03.

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    YaraCYaraC
    As you can see by the excellent responses ans stats provided by PPs, your doctor is either ignorant or a liar. Either way, I would start looking at other options. And do lots of research on your own. Don't trust doctor's to give you the complete picture, they are looking to convince you to do things their way.
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    liltatgirl0280liltatgirl0280

    Thanks everyone! Seeing the stats on both sides definitely makes me feel better. I have my reasons for wanting a vbac over another c-section but the concent form was just discouraging.

     As for my provider.. she basically read the concent form. She didn't argue for one or the other. And I only have a 1 in 5 chance of this doctor delivering my baby. The other 4 doctors haven't seen it as a big deal. I suppose now I just have to sit and see if the placenta decides to get out of the way.

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