thoughts on this article? stolen from 3rd tri board

itsstillme

someone posted this article this morning. I had finally in the last month came to a good place in my head about trying for a vbac, so of course reading this now has me all a twitter again. Who can make me feel better about the vbac again? tell me why this article is wrong? lol. but seriously.....

https://community.thebump.com/cs/ks/forums/thread/64271673.aspx

iris427

They only had a 43% VBAC success rate?  That makes me question their findings--were their VBACs being poorly managed?  Or was it a statistical anomaly?  There is pretty solid evidence that VBAC is safer for mothers, so I think this study may be an outlier.  And we already know that VBAC carries an increased risk for the baby, so that is nothing new.  But that risk is very small, and it is comparable to the risk of losing your baby to a prolapsed cord or placental abruption in a non-VBAC labor.

The other thing that studies like this don't account for is the risk of RCS to future pregnancies.  The more c/s you have, the higher your chances of serious placental complications like placenta accreta and placenta previa are, and mothers and babies can die from those. 

The bottom line in this article is still that VBAC and RCS are both safe options. 

cchill01

I posted over on 3rd tri too.  But I want to know, at what point is a VBAC attempt truly an attempt, and when is it a failure.  They list "elective c-sections" in their VBAC group.  If it's elective, I don't consider that a VBAC attempt.  If I don't go into labor before 41 weeks and they force me into a RCS, I don't consider that a VBAC attempt.  And if my baby is breech and we go to RCS, again that's not a VBAC attempt in my book.  They don't mention what they are doing with those people in their study.  They should actually be excluded from the findings, or there should be two success calculations.

I would only consider something a VBAC failure if I actually go into labor and I either can't get the baby out OR there is a true medical emergency.

 

MAprincess

cchill01:

I posted over on 3rd tri too.  But I want to know, at what point is a VBAC attempt truly an attempt, and when is it a failure.  They list "elective c-sections" in their VBAC group.  If it's elective, I don't consider that a VBAC attempt.  If I don't go into labor before 41 weeks and they force me into a RCS, I don't consider that a VBAC attempt.  And if my baby is breech and we go to RCS, again that's not a VBAC attempt in my book.  They don't mention what they are doing with those people in their study.  They should actually be excluded from the findings, or there should be two success calculations.

I would only consider something a VBAC failure if I actually go into labor and I either can't get the baby out OR there is a true medical emergency.

 

I agree.  An attempt means you went into labor and there was an attempt to get the aby out that way.  If you walk into the hospital and go straight to surgery, there's no attempt there.

babyike

MAprincess:

cchill01:

I posted over on 3rd tri too.  But I want to know, at what point is a VBAC attempt truly an attempt, and when is it a failure.  They list "elective c-sections" in their VBAC group.  If it's elective, I don't consider that a VBAC attempt.  If I don't go into labor before 41 weeks and they force me into a RCS, I don't consider that a VBAC attempt.  And if my baby is breech and we go to RCS, again that's not a VBAC attempt in my book.  They don't mention what they are doing with those people in their study.  They should actually be excluded from the findings, or there should be two success calculations.

I would only consider something a VBAC failure if I actually go into labor and I either can't get the baby out OR there is a true medical emergency.

I agree.  An attempt means you went into labor and there was an attempt to get the aby out that way.  If you walk into the hospital and go straight to surgery, there's no attempt there.

Agreed.  If labor did not start (whether naturally or medically induced), then the birth should not be classified as a VBAC attempt.  

I also agree with Iris that this study appears to be somewhat skewed, as their methodology and results are not clearly defined.   

I would not put much stock into any of it, as there are much more credible research studies that have been completed with clear methodologies and non-skewed results supporting VBAC over RCS.  I highly doubt ACOG or other similar groups will be changing their views on VBAC based on this one "study." 

Geekchick921

MAprincess:

cchill01:

I posted over on 3rd tri too.  But I want to know, at what point is a VBAC attempt truly an attempt, and when is it a failure.  They list "elective c-sections" in their VBAC group.  If it's elective, I don't consider that a VBAC attempt.  If I don't go into labor before 41 weeks and they force me into a RCS, I don't consider that a VBAC attempt.  And if my baby is breech and we go to RCS, again that's not a VBAC attempt in my book.  They don't mention what they are doing with those people in their study.  They should actually be excluded from the findings, or there should be two success calculations.

I would only consider something a VBAC failure if I actually go into labor and I either can't get the baby out OR there is a true medical emergency.

 

I agree.  An attempt means you went into labor and there was an attempt to get the aby out that way.  If you walk into the hospital and go straight to surgery, there's no attempt there.

I'm with both of you.  And the stats in that study are very different from what most studies have shown. 

Saltina11