How to get past the 1% — The Bump
VBAC

How to get past the 1%

History on me. First baby was vaginal birth with no problems, Second were twins we had a C due to them being breach. I am 19 weeks pregnant and by the time I have this baby the twins will be over 4 years old. So based on my history I am a great candidate for a vbac. My OB said he would not recommend it but he will support me fully if I choose a vbac. 
So here is my question. How do I get rid of this nagging in my brain that says "what if I am the 1% that has a uterine rupture?" "What if my choice causes the death of my child?" 
Does this ever go away? or is it just me that feels this way? I really don't want another C for many reasons including the recovery. I will have no help and 4 kids. DH wants me to do the C but he has no idea how painful and long the recovery is and the risks it poses for me. How do I convince him and myself Vbac is the better way to go. 

Thanks 
DD#1 6 DD#2-3  4 Baby #4 EDD 01/08/2014 Team Green  BabyFetus Ticker

Re: How to get past the 1%

  • What helped it not get to me, is I know someone IRL who had a UR. She was not in labor, she was only 8 months pregnant. I realize that isn't the norm, but the risk is there. Plus, you can get int labor before your scheduled RCS. As would have been the case for me, since DS was born at 38 weeks. So to me, the rupture risk is more about being pregnant again, that being in labor.
  • Every story I have read of a VBAC mom rupturing the rupture did not occur during labor.  It happened before so it didn't really matter that she was a VABAC. The c-section is not risk free, maternal death is always a possibility.  I recently came across some information watching "More Business of Being Born" that stated that babies born via c-section were more likely to go to the NICU and more likely to die in the first month of life than vaginally born children.  This information was regarding c-sections that were not medically necessary.   Also, I believe the rupture statistics include all women trying to VBAC so if you are low risk pregnancy the risk is actually lower.  Do some more research and if you haven't watch "The Business of Being Born" and "Morn Business of Being Born", they are on Netflix.  
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  • What helped me is the fact that the statistic is LESS than 1% and as pp stated, this is including all VBAC patients- including those that are higher risk.  If you are low risk, your risk is even lower for rupture.  And yes, most ruptures are prior to labor.  The risk is in getting pregnant again after a c/s. 

    Also, a vast majority of ruptures still result in a healthy baby and mom.  My fear was in the fact that you are almost 4 times more likely to die during a RCS. 

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  • Also, why would your OB not recommend it?  I would be switching providers.  Especially in your case where you have already had an uneventful vaginal birth, your risks are much greater with a RCS.  Why wouldn't your doctor want you to go the safer route?
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  • Also, why would your OB not recommend it?  I would be switching providers.  Especially in your case where you have already had an uneventful vaginal birth, your risks are much greater with a RCS.  Why wouldn't your doctor want you to go the safer route?
    I was coming back to suggest finding a new OB too if you are interested in a VBAC.  If your doctor doesn't recommend it then I doubt he will actually be fully supportive of it and may find all sorts of "reasons" as to why you shouldn't have a VBAC.
  • Focus on the 99% that everything is fine.  I have had 5 VBACs, no problem.  I don't worry about it anymore.
    holly321honkytonk_kid
  • Nothing is risk-free - repeat CS come with their own set of risks as well. And like MAprincess and mystcl said, UR is actually lower than 1%.

    For me, I knew I didn't want to have a CS again if I could help it, so even though I worried about the risks of VBAC, a CS was more stressful for me. And I also wanted a VBAC in case we have a third baby - I would personally not have a third CS, because of the increased risks that come with that.
    DS1 - Feb 2008

    DS2 - Oct 2010 (my VBAC baby!)

  • I know how you feel. I felt the exact same way. But like others said, there is way more good that will most likely come out of this than the bad. And you will be monitored more closely since you are attempting a VBAC. It's a difficult choice, I know if I didn't have the support from DH and the doctors I probably would have chosen another c-section. You need to surround yourself with those who will support you. You know what's best for your body. I hope you have a successful VBAC and I wish you nothing but happy thoughts from here on out!
  • If you're delivering in a hospital, then even if you do rupture, it's very likely they will get your baby out in time. I would continue to read up on the risks and better understand the whole thing but I think it's really important for you to have support - both from your OB and your husband. Can you attend an ICAN meeting with your DH and find a new provider? It seems strange that he would recommend a RCS when you have a "proven pelvis" as it's called. 
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  • mysticl said:
    Every story I have read of a VBAC mom rupturing the rupture did not occur during labor.  It happened before so it didn't really matter that she was a VABAC. The c-section is not risk free, maternal death is always a possibility. 
    This. I started to rupture with DD2 when I was just in prodromal labor. I had planned a VBAC but didn't even get to that point. I was still 0cm 0% effaced when the rupture started. Even though it happened to me and I am planning one more pregnancy which will definitely be a RCS, I still encourage VBACs in general. What helped me was looking up not just the statistics of UR, but looking at the outcomes. The risk of UR is I think around 0.5% for a non-induced VBAC, but the rates of hysterectomy or (God forbid) death of either mom or baby are low even in cases of UR, putting the rate of something really bad happening to you or your LO extremely low.

    BFP1: DD1 born April 2011 at 34w1d via unplanned c/s due to HELLP, DVT 1 week PP
    BFP2: 3/18/12, blighted ovum, natural m/c @ 7w4d
    BFP3: DD2 born Feb 2013 at 38w4d via unplanned RCS due to uterine dehiscence

  • Thanks so much. This has really calmed my nerves. I talked to my ob who I have been with for 7 years about why he doesn't recommend it. He said he was always encouraging it until a few years back when his partner at work got sued because the lady said he told her to do it. He still believes its the better way but wanted me to make the choice to do it for myself. I told him I want to go Vbac and he said that sounds good we even changed hospitals because he said one is very supportive of Vbac and natural moms.  Thanks again for all the advice.
    DD#1 6 DD#2-3  4 Baby #4 EDD 01/08/2014 Team Green  BabyFetus Ticker
    holly321nosoup4u
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