VBAC

Is there a point during TOLAC where risks are higher?

Obviously the main concern (though rare in ideal candidates) with a VBAC is uterine rupture.  My question is, does anyone know if there is a point (or points) at which the risk of uterine rupture is higher than others during a TOLAC?  For example, if a uterine rupture is going to occur are chances greater that it will be during the pushing stage than in earlier labor?  I know it can happen at any time, but was just wondering if the risk is same throughout or if it's more likely to happen at a certain point. 
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Re: Is there a point during TOLAC where risks are higher?

  • According to my dr its highest if labor stalls then blood pools in the bottom of the uterus and makes it swell when the top of the uterus contracts.  


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  • I have no science to back this up, but it seems like transition or second stage would be highest risk for rupture, since that is when your uterine muscles are doing the most work.
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  • I asked my doc this question, and she said "no", no stage of labor presents a higher risk. I had assumed like a PP that the highest risk was during pushing, but she told me, statistically, this does not pan out. Partially, simply because that stage of labor is so much shorter than the others.

     

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  • Thanks for your responses.  I had read various things that gave me the impression that risks were higher towards the end as well.

    I asked my MW about this today and she said that the risk is the same throughout unless Pitocin would be used to augment labor.  In that case risks would go up (for obvious reasons).  

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