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C-sections
cottonlily84
member
Why so against VBAC?
cottonlily84
member
in C-sections
I never ever expected a c/s so I'm new to all this stuff. I don't understand why some doctors only want women to have rcs, regardless of each individual case and circumstances. What are the risks? I've heard of rupturing but I don't see how you can carry a baby and stretch for 9 months fine but then rupture during delivery. Is it the contractions or the pushing? I haven't talked to my doctor about this yet because my yearly is not until April. I just hope he doesn't have this attitude about it - and doubt he does - because he's a great doctor and I do want to get pregnant again.
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Re: Why so against VBAC?
It's usually the additional pressure of contractions and pushing, although rupture is possible anytime during pregnancy. It's important to remember though, that the overall risk of ANY rupture is low, and the risk of catastrophic rupture (harm to mom or baby) is even lower.
Why so against it? Who knows. Personal biases, lack of updated information, convenience, etc. Many OBs are older, and practiced through an era of classical incisions, then using labor augmenting drugs on VBACs, both of which do lead to an increase in rupture rate. That's not an excuse for not updating knowledge, but it's a possible reason.
Anti-VBAC for all situations is just not a position that is supported by research. VBAC is a reasonable, reasonably safe option for many (most?) moms. RCS are also a reasonable, reasonably safe option, BUT they are not risk free, or even lower risk than VBAC.
Not sure why that is. There are many catastrophic risks of c/s's but they don't seem to be bothered by that or bother to tell some patients about it.
I read somewhere that it is the legal risk. More people sue if they or their baby are harmed during a vaginal delivery than if the mother or baby die during a c/s. Apparently people see a c/s as a life saving event (even if it was an unecessary c/s that killed the mom/baby) while if the baby or mother dies during a vaginal delivery, it is a sign the doctor should have dne surgery.
That all may be true, but I always hope that it is just lack of educating themselves that causes them to make that choice. It is bad enough that there is a recent study that showed that 2/3 of OBs make decisions based on anecdotal information rather than scientific facts. I think the entire system needs an overhaul.
You should post this on the VBAC board.
. We just had a good post about the risks of VBAC vs RCS.
Rupture risk increases during labor because of contractions. But there is always a risk of rupture if you have had a prior cesarean. Choosing RCS lowers that risk but does not erase it.
Back in the 80s or so, there was a big push to do VBAC in order to lower cesarean rates. But VBAC was still "new" and doctors didn't know as much about it. They didn't know that induction could increase the rupture risk, or a classical incision. They didn't know how to screen for it as well. People started having ruptures happen, lawsuits were filed, babies died, and there was a big anti-VBAC backlash rooted partly in litigation concerns and partly in fear. C-section was touted as the safer alternative because people were not fully appraising the risks. Hospitals and malpractice insurance providers began banning VBAC, further reinforcing the idea that it was dangerous and that RCS was the better option. So a lot of doctors are either misinformed or they have been told they cannot do VBAC by their hospital or insurance provider.