VBAC
Options
Failure to descend
I just obtained my medical records from my doctor and my pre-op/post-op diagnosis for the csection was "failure to descend and OT presentation" (occiput transverse). I am meeting with a new practice on Friday (the only option at the hospital where I would like to deliver). Has anybody had this reason for c-section and been successful? I am reading that failure to descend lowers my chances for VBAC . Looking for some feedback as I am still not 100% sure if I will switch practices.
Also, any tips for questions to ask the new doctor during the consult visit? I know they take VBAC patients on a "case by case" basis. Thank you!!
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Re: Failure to descend
My dx was Failure to Descend and my doctors have been very clear that that lessens my chances. But I think 50% is better than nothing, so I plan to try. I have tried to find a new doctor but I am resigned to staying with this practice at this point because I can't find anyone who is willing to take me on as VBAC this late in my pregnancy (I am 32 wks)
Little Sister on the Way 04/23/2013
I am hoping that occiput transverse presentation is the reason for the failure. I wonder if they can they do an ultrasound before a VBAC or during a TOL to make sure the positioning is favorable?
I think it would depend on why the baby didn't descend. Was s/he too big? Malpositioned? Wrapped in the cord and couldn't engage?
If baby was too big, there are some things you can control during pregnancy to make that less likely this time, so control what you can (sugar intake, diet, exercise, weight gain) and pray for the rest. Malpositioned, change what you can - sitting up right, avoid lounging, pelvic rocks, etc. For a tangled up baby, not much you can do.
If the reason was that your pelvis was narrow - well it was widened by your last labor, so you chances are probably better now. Personally, I think it's worth a shot.
It's worth noting that in women who had a primary c/s for cephalopelvic disproportion--that is, the baby's head did not fit through the pelvis--the VBAC success rate is over 60%. So even if you were told your first baby was too big, there is a good chance you can have a VBAC.
I also wouldn't worry too much about sitting up straight all the time. There isn't really evidence that this prevents fetal malpositioning. The fact that your baby was OT probably had a lot to do with the failure to descend. It is deep called transverse arrest. Think of it as trying to fit an oval-shaped peg into an oval-shaped hole, but you have the oval peg turned 90 degrees. It doesn't mean the peg wouldn't fit if it were oriented correctly.
And I had my c/s for CPD/failure to descend. Baby was OP. I had a VBAC with a slightly larger baby in OA position. So you can definitely VBAC after failure to descend. In fact, there is evidence that you have an advantage if you dilated a lot before your c/s and your c/s was due to fetal positioning.