VBAC after 2 sections?

morebabies · 31-01-2012 2:14pm #1

Hi all, I am about to pop with baby no. 3, literally I'm scheduled for a section in Feb, because I've had 2 previous sections for different reasons (1 x emergency, 1 x breech presentation). This time I really wanted to try going au naturel, like REALLY wanted to. I want to be open to the possibility of more babies, but know that there is a limit to what is safe - my consultant advised no more than 4. I've gone public as we don't have enough for private, but anyway, my consultant just wouldn't enter into discussion on the possibility of a trial labour. "Your uterus will rupture" was the answer I got, even though it's 4 years since my last section and there were no healing issues or anything. It's like standard hospital policy I think - 2 sections, then there's no choice. Castlebar hospital by the way.

Now I hate to look up health stuff on the net, but according to the stats available, there's only a 1% chance of rupture, and a 71% chance a VBAC would be successful.

Does anyone have experience of this in ireland? I guess as my due date approaches, I'm getting very flustered about how I'm being told to go down a certain route without any alternative option. Hormones kicking in too.

liliq · 31-01-2012 7:31pm

As far as I know Doula Ireland have information meeting on VBAC, I'm sure there's another assocaition specifically for VBAC who might be great for informatio / support but I can't remember who they are or where I heard of them. I'll have a root and post when I find it

Can empathise with your frustration, nothing worse than being told what to do :mad:

Ok... http://www.ican-online.org/
ICAN of Dublin
Dublin

Contact: Tracy Donegan
eMail Address: tracy_niall@yahoo.com
Telephone: 087.057.2500

Dublin contact, not sure if this is where you are but I'm sure she could be helpful

January · 31-01-2012 11:36pm

I've read of people have a successful vaginal birth after two c sections. Stand your ground, go to the master of the hospital if you really really want a trial of labour.

morebabies · 01-02-2012 1:26pm

Thanks both for your advice, much appreciated and will follow up on it. Also praying for a miracle.

I'm being realistic, I know there's a chance my attempt at a natural birth could fail, but you know, even to be given the chance to try it, I'd be happy with that. I even said to the consultant, "what would happen if my labour begins before the scheduled C-section date?", as in, would there be any chance they would let me progress a little to see had I any scar pain, etc, etc. "Section. Day or night, you come in, section" - was the answer. As in no room for manoeuvre.

01-02-2012 7:48pm

Greetings OP. According to this study, the rate of uterine rupture after 2 c sections is 3.7%.

From the article: "Women with a history of 2 prior cesarean deliveries have an almost 5-fold greater risk of uterine rupture than those with only 1 prior cesarean delivery"

That is why your consultant is so reluctant to go for a VBAC. 3.7% is a small but significant risk. The reason they are so careful to avoid uterine rupture is that when it occurs, it occurs suddenly and without warning, and can be catastrophic.

The risks to you and your baby if this were to happen would be serious.

Discuss this with other obstetricians and get a second opinion if you like, but I would imagine they would all say much the same thing. They may allow you to try a VBAC if you really push for it, but you should fully consider the reasons why they are so reluctant to do it.

morebabies · 01-02-2012 11:14pm

Thanks James, ok that does make for frightening reading, and no, the last thing I would want is to endanger the life of my unborn baby. This was the study I had found, a more recent one with those stats I quoted above. That's what I was going on.

http://www.ncbi.nlm.nih.gov/pubmed/19781046

Still, I would be dishonest if I said I didn't want to go natural this time. It's the thought of being given a limit on the number of children I can have which bothers me. I know it may sound soppy and sentimental and maybe my hormones are at me, but my children are my life, and I would love to have as many as God will give me. Silly and perhaps irrational - I don't mean to be, but that's just how I feel.

Also, maybe I feel more cheated because the consultant wouldn't enter into a discussion on the subject with me at all - it was like a closed topic with him. I've seen him twice very briefly this pregnancy, next time will be on the operating table, but both times I saw him, there was a waiting room packed with other patients so that I was very conscious they also needed his time and maybe had a much more serious need to see him than me. In an ideal world, had he the time to sit me down and give me a full explanation, maybe I wouldn't be feeling this way.

qwertytlk · 02-02-2012 4:21am

Hi, my friend was in a similar situation to you just last month. Her doc wouldnt hear of her having a natural labour, or at least trying to, so as january suggested, she went above his head and plead her case to the hospital master and lo and behold she delivered a healthy baby girl vaginally at the end of last month. So it can be done. If you feel that strongly, as my friend did, then go above your consultants head. As i said she had 2 sections, no problems on either and it had been 5.5 years since her last baby was born so all very similar situation apart from the fact it was a dublin hospital. Best of luck, i hopw you get what you want;)

02-02-2012 3:22pm

morebabies wrote: »

Thanks James, ok that does make for frightening reading, and no, the last thing I would want is to endanger the life of my unborn baby. This was the study I had found, a more recent one with those stats I quoted above. That's what I was going on.

http://www.ncbi.nlm.nih.gov/pubmed/19781046

Still, I would be dishonest if I said I didn't want to go natural this time. It's the thought of being given a limit on the number of children I can have which bothers me. I know it may sound soppy and sentimental and maybe my hormones are at me, but my children are my life, and I would love to have as many as God will give me. Silly and perhaps irrational - I don't mean to be, but that's just how I feel.

Also, maybe I feel more cheated because the consultant wouldn't enter into a discussion on the subject with me at all - it was like a closed topic with him. I've seen him twice very briefly this pregnancy, next time will be on the operating table, but both times I saw him, there was a waiting room packed with other patients so that I was very conscious they also needed his time and maybe had a much more serious need to see him than me. In an ideal world, had he the time to sit me down and give me a full explanation, maybe I wouldn't be feeling this way.

That's a very interesting article you've linked to there. Perhaps the risks of VBAC after 2 sections have been overstated in the past, or perhaps that study is a bit on the optimistic side, I'd have to read the full article to see what their methodology etc. was but it certainly seems legit.

However, the consensus view amongst obstetricians is still very much staunchly oppossed to VBAC after 2 sections. If you can get another appointment with the obstetrician (or a different one), you should bring a copy of that article with you (seriously!). Even if they are not convinced, it at least shows that you have researched and informed yourself about the risks. Obstetrics is a very litigous area of medicine, as such obstetricians are very reluctant to go against established practice in case something goes wrong and they are accussed of not explaining the risks to the patient adequetely.

If you have your heart set on a VBAC, and understand all the risks, I see no reason why you should not be allowed to do so, however, you will likely face an uphill battle to get the hospital to see it your way!

Whatever option you go for I hope everything goes well and wish you and your baby the best.

Hannibal Smith · 02-02-2012 5:26pm

Question...if the op doesnt mind...when i had the second section the surgeon said they usually go through the first scar but because baby was so far down they had to create a second scar....so if I was to go for another child, does having 2 scars instead of one thats been opened twice, make any difference? If you have a section will the hospital comfirm to the insurance company that its for medical reasons?

SanFran07 · 07-02-2012 8:25pm

There are no current Irish studies on VBAC2. Dr Turner in the Coombe has led the majority of Irish VBAC research. In Ireland the risk of scar separation after 1 caesarean is 1 in 1000 - in other words 999 women will have absolutely no issues with their scar.

As others have said it's definitely an option for you but it sounds like the consultant isn't providing you with the information to make an informed decision. Your Doctor has a duty of care to also provide you with the information on the risks of another caesarean also.

James you've referred to the OP being 'allowed' to go for VBAC - can you clarify what you mean here?

Best of luck with your decision and I hope you'll get the support you need no matter what your decision.

morebabies · 09-02-2012 1:33pm

Thank you all for your advice everyone, it was much appreciated - just to give you the update on what happened: the decision was in fact taken out of my hands as last week my blood pressure suddenly skyrocketed, I swelled up like a balloon, protein in the urine - all the symptoms of that dreaded pre-eclampsia. After racing in to hospital, luckily it wasn't pre-eclampsia but my blood pressure wouldn't stabilise so I had a section, and thanks be to God have a beautiful healthy baby girl. That's the main thing anyway, that all is well in the end.

Still thinking about adding to my clan though...

09-02-2012 10:39pm

morebabies wrote: »

Thank you all for your advice everyone, it was much appreciated - just to give you the update on what happened: the decision was in fact taken out of my hands as last week my blood pressure suddenly skyrocketed, I swelled up like a balloon, protein in the urine - all the symptoms of that dreaded pre-eclampsia. After racing in to hospital, luckily it wasn't pre-eclampsia but my blood pressure wouldn't stabilise so I had a section, and thanks be to God have a beautiful healthy baby girl. That's the main thing anyway, that all is well in the end.

Still thinking about adding to my clan though...

Congratulations! Just one pedantic question though: did you mean to say "luckily it wasn't eclampsia". Because by any current definition, hypertension, proteinurea and oedema is definitely pre eclampsia.

January · 09-02-2012 10:52pm

Congratulations on the birth of your baby girl

liliq · 10-02-2012 12:10am

Congrats!

KittyeeTrix · 10-02-2012 8:47am

Congratulations morebabies!

VBAC after 2 sections?

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