Vertical Incision?

s0ulchicken

Today at my growth scan, my mfm mentioned that I may have to have a vertical incision for my csection. Baby A is breech oblique, and tucked into the rightish "corner" of my uterus, and Baby B is transverse across the very top of my uterus...think spaced between my ribs. I have had two previous sections, but they were low, transverse incisions. I was still absorbing everything my mfm was saying, and didn't have time to consider how "different" this was. What would cause them to do this? Has anyone here had a vertical incision? Is the recovery any different from the low transverse incision? I will ask tomorrow at my NST, but was hoping you ladies might know more than I do in the mean time!! Tia!

HisGirlCridey

I would definitely ask tomorrow at your NST. In my case, Baby A was butt down breech and Baby B was oblique and I still had a transverse section. I have only heard of vertical sections done in case of major emergency type of procedures.

s0ulchicken

HisGirlCridey:

I would definitely ask tomorrow at your NST. In my case, Baby A was butt down breech and Baby B was oblique and I still had a transverse section. I have only heard of vertical sections done in case of major emergency type of procedures.

That is what I was thinking!! Add to it, both of my placentas are anterior...wouldn't that "interfere?" It just doesn't make sense to me!!

HisGirlCridey

Please keep us updated. I also just read your story in your siggy. Holy cow. What a miracle. (or two miracles, I should say!)

E&RMommy

If there is nothing to grab but a back, a transverse incision would need to the "T'ed" up.  Transverse and oblique depepnding on how they lie (back up or back down) can be very scary at c-section if you have a low transverse incision.  There may not be anything to grab to pull out.  I know it's hard to understand but we're working in a very small incisional area.

In certain cases (very preterm, transverse back down) you would make a classical incision on the uterus.  This means you have an incision in the upper, contracting portion and could never labor in the future.

 

rinascita

I am not sure if you plan to have any other children but a vertical uterine incision would prevent you from being able to have a VBAC in the future... if that is something you would even consider.

My conversations with my CNM and MFM have been that a vertical incision would really only be even a possible necessity in the event of an emergency and if I do end up with a C-section they'll take every measure possible to only make a horizontal uterine incision.

I would discuss this further with your doctor...

s0ulchicken

rinascita:

I am not sure if you plan to have any other children but a vertical uterine incision would prevent you from being able to have a VBAC in the future... if that is something you would even consider.My conversations with my CNM and MFM have been that a vertical incision would really only be even a possible necessity in the event of an emergency and if I do end up with a Csection they'll take every measure possible to only make a horizontal uterine incision.I would discuss this further with your doctor...

We do not plan on having any more children, these ladies will be our 3rd and 4th, and I will actually be having a tubal with this csection. I have had two previous sections, and they were both low transverse incisions. VBAC is out for me period, unfortunately, simply due to the number of csections I have had. There are no doctors in my area who will even let me try for a vbac this go round, even if the babies were positioned well.

I am very concerned about my mfm's suggestion, and will definitely be bringing it up with my OB tomorrow after my nst. Thanks for the input ladies!!

s0ulchicken

ERMommy:

If there is nothing to grab but a back, a transverse incision would need to the "T'ed" up.nbsp; Transverse and oblique depepnding on how they lie back up or back down can be very scary at csection if you have a low transverse incision.nbsp; There may not be anything to grab to pull out.nbsp; I know it's hard to understand but we're working in a very small incisional area.
In certain cases very preterm, transverse back down you would make a classical incision on the uterus.nbsp; This means you have an incision in the upper, contracting portion and could never labor in the future.
nbsp;

I hadn't really considered that. Baby A is butt first, with her spine facing outward, Baby B is transverse, with her spine facing outward as well. I am really looking forward to discussing all of this with my OB tomorrow morning. This is all so overwhelming to me right now!

Rynleigh

Wish I had an answer for you. I'm still wondering the differences, too. I haven't had a CS yet - but my abdominal surgery to remove my ovary a couple months ago was a 7" vertical incision, and even though it didn't involve cutting into my uterus, it was a very uncomfortable recovery. I felt like I had a complete lack of abdominal support/control for many weeks. Everything hurt and I could hardly move for the first week...coughing, laughing, sneezing, all of it was horrid. I'm trying to decide whether to let them go through the scar tissue so that I just have the one scar, or if I'd get more support and better healing from going bikini cut instead. I luckily have the choice to do either one so far, but I wish I could find more people who'd been through both cuts who could tell me which is easier to recover from...

Mrs. Alice

You may want to ask this on the c-section board as well.  I know some preemie mamas who had vertical incisions on their uterus and a bikini incision externally.  Some say recovery is a little rougher and more painful with the vertical and of course you can never have a vbac after one.  As far as I know, I don't have a vertical uterine incision even thought my twins were very premature and both transverse.  I do remember it taking quite a while for them to get baby B out.  I wonder if it was because of his positioning.

dmhstarr

I had a vertical with my first, a single. I requested it because my ob said it was the easiest and least stressful for the baby. I knew I would not be wearing a bikini as I'm plus sized and I was just nervous after watching a c section on television. I had 18 staples. Got them removed in 10 days and was playing softball the next day. Recovery wasn't a problem but I only had 1 baby to look after

Brummy14

Mrs. Alice:

You may want to ask this on the csection board as well.nbsp; I know some preemie mamas who had vertical incisions on their uterus and a bikini incision externally.nbsp; Some say recovery is a little rougher and more painful with the vertical and of course you can never have a vbac after one.nbsp; As far as I know, I don't have a vertical uterine incision even thought my twins were very premature and both transverse.nbsp; I do remember it taking quite a while for them to get baby B out.nbsp; I wonder if it was because of his positioning.

I had this. horizontal outside, vertical inside. I didn't really get a chance to ask why given I was told this is what would happen seconds before they put me under, but breech Baby A's feet were visible when they checked to see if I was dilated, so the vertical incision may have been necessary to reach down there and get her back out.

Recovery was a breeze ... I was completely off of all pain meds by day 7 and was pretty dang mobile by day 4. Those first few days were a bit rough, but from what I hear, that's par for the course for a csection.

KarlsSweetie05

I had an emergency C-Section at 33w4d.

It ended up being a T incision internally, but a horizontal "bikini" incision on the outside.

The dr. initially cut both horizontal incisions (outside skin and ute) and got Baby A out fine.  He was down low on my cervix

 But Baby B was stuck up high, under ribs, transverse, and backwards.  If I remember correctly, she had an anterior placenta.  Dr. couldn't get her out and she was crashing and needed to be delivered ASAP.  He quickly cut a vertical up from the horizontal to get her out. 

Being honest, my recovery was beyond horrible.  But I also was super weak from months of bed rest and had poor abdominal tone before I ever got pg.  It took me about 6 months to finally feel normal. 

and I was told I would always have to have a c-section if I ever got pg again.

ougrad1

My mom had a tubal pregnancy and was cut vertically in attempt to literally save her life.  The incision ran from her belly button down to where you're section scare probably is.  It was a big incision.   I was ten years old at the time so, I remember it well.

I would think with an incision like that, the recovery would be a lot harder.  GL- 

ougrad1

Rynleigh:

Wish I had an answer for you. I'm still wondering the differences, too. I haven't had a CS yet - but my abdominal surgery to remove my ovary a couple months ago was a 7" vertical incision, and even though it didn't involve cutting into my uterus, it was a very uncomfortable recovery. I felt like I had a complete lack of abdominal support/control for many weeks. Everything hurt and I could hardly move for the first week...coughing, laughing, sneezing, all of it was horrid. I'm trying to decide whether to let them go through the scar tissue so that I just have the one scar, or if I'd get more support and better healing from going bikini cut instead. I luckily have the choice to do either one so far, but I wish I could find more people who'd been through both cuts who could tell me which is easier to recover from...

I had my appendix taken out in college and it was god awful...exactly what you are describing.  Just the slightest move and everything hurt.  That surgery they made a 3" incision higher up on my side and cut through muscle.

I had both sections way down low and it was completely different.  No where near the pain that I had when I had my appendix removed.  I may be wrong but, the incision down low during both of my sections were done low so, they could lift the muscle rather than, cut through it.  That made all the difference in the world.  Again, I could be wrong but, there isn't any comparison between my abdominal surgery and my sections....the abdominal surgery was absolute agony however, the sections were honestly, not an issue.  

I really think you'll be dumbfounded at how different the surgeries are.  I was...

LottaLattes

I have zero experience here, but am SO freaking excited for you, mama! And you got past 34 weeks, so it's all cruising from here. Woo hoo!! Take a nap every single day if you can, can't wait to see your perfect little gorgeous girls!

Reilly626

I just had one with mine. You are welcome to message me. Recovery was harder- it's harder to heal and yes the scar sucks- belly button down but I have the most gorgeous healthy twins- that's what matters most!