no VBAC for me!!

[jembelina]

I had my first hospital visit today and was givena handout about VBAC written by The Royal Australian and New Zealand College of Obstetricians and Gynaecologists. I had in my mind prior to this that I would need to do a great deal of research before I decided which way I would go. However this pamphlet states quite clearly the statisics relating to the risks of VBAC. Once I read this I knew immediately what I wanted/needed to do.
I'm interested to hear from other women who have opted against VBAC and why. For me, the one and only reason is the risk factor (of uterine rupture and the complications that can arise from it) that I am simply not willing to take. I was under the impression the risk was extremely small, hence my initial need for more info. From the numbers I have, imo the risk is too high for me to take.

[Briannabear]

What was the pamphlet - just out of curiosity. Im planning for a VBAC this time around. What did it say?

[jembelina]

It is fairly basic, runs through - reasons for VBAC, preparing for vaginal delivery, unsuitable conditions for VBAC and risks of VBAC. The risk being uterine rupture.The pamphlet says the risk is small, but these are the stats it gives......

"Rupture of the uterine scar occurs about once in every 200 VBAC attempts. Of those women who do have a uterine rupture during VBAC:
-about 1 woman in 10 of these women will need a hyterectomy
-about one birth in 10 births will result in a stillbirth.
Of every 10 women who attempt VBAC, from 2-5 will need to have a ceasarean section"

To me those numbers do not equate to a small risk - but that is just the way I see it.
Edited to add - the pamphlet doesn't appear to be advocating either option. Just giving some basic info.

[samuelboy]

Hi jembelina

I'm with you on this one. When I first fell pregnant again I thought I would consider VBAC but after reading a few things and asking a few questions of my OB, sorry but any risk is too big a risk for me. Personally I don't feel like I'm missing out on anything by having caesars and I think I would be so stressed out during labour worrying about what could go wrong that it's just not worth it for me.

[Sarie]

Hi jembelina
I haven't had a c/s but I think you should stick to your guns.
You need to do what is best for you and your baby and if the risks are there... don't let anyone talk you out of where you feel comfortable.
Best wishes
Sarie

[Briannabear]

"Rupture of the uterine scar occurs about once in every 200 VBAC attempts. Of those women who do have a uterine rupture during VBAC:
-about 1 woman in 10 of these women will need a hyterectomy
-about one birth in 10 births will result in a stillbirth.
Of every 10 women who attempt VBAC, from 2-5 will need to have a ceasarean section"

Crikey! :eek:
The whole 1 in 10 resulting in hysterectomy, and 1 in 10 resulting in still birth is terrifying! :eek:
I guess there's a risk with any type of birth you choose, I didnt realise it was that big. Ive never seen those stats before.
I guess my ob will explain all of that when I see her.

[Mamaduke]

I also studied the statistics regarding VBAC...I'm with you jembelina...I'm just not prepared to risk it.
This is something that I found...
C:\Documents and Settings\user.USER-FB4E99DF4F\My Documents\csectionvvbac\JS Online Study Labor Risky After Caesarean.htm
The last paragraph clinched it for me.

[pumpkin]

i have had had three c sections and would not do a vbac even though my previous scars have healed perfectly and they do not look as though they will cause any dramas. But i don't want to risk my uterine scars rupturing, my baby being stillborn, major bleeding etc and also in some instances maternal death. just because your scar looks really good does not indicate whether it will rupture etc, i wouldnt risk it i value my life and my childs life more. iykwim

[jarrahsmumma]

I am really shocked to read those stats, as they seem totally different to what I am familiar with.
A passage from VBAC.com:


Of the women who attempted a vaginal birth after cesarean delivery, only 0.7 percent, or 124 women in all, experienced a rupture of the uterus. The study also found that using drugs to induce or speed up labor may also increase the chances for uterine rupture. Such drugs increase the force and duration of uterine contractions. Of the 1864 women given the drug oxytocin alone, without any other drugs to induce labor, 1.1 percent (20 women) had a uterine rupture. None of the 227 women receiving the drugs known as prostaglandins alone experienced uterine rupture. Dr. Spong explained, however, that it's possible that the study sample did not include a sufficient number of women to determine a small increase in uterine rupture from prostaglandins alone.

Among the infants born to the women who attempted vaginal birth after a Cesarean, .08 percent (12) were diagnosed with hypoxic ischemic encephalopathy, a condition that may result from lack of oxygen to the baby's brain. The lack of oxygen may be caused by heavy maternal bleeding, detachment of the placenta, or other complications. Of these 12, seven were associated with a uterine rupture, and two of the babies died. In contrast, none of the infants whose mothers had an elective cesarean delivery developed hypoxic ischemic encephalopathy.

Among the women who attempted vaginal birth, the overall risk for either brain injury to the baby or death to the baby at term from uterine rupture was roughly 1 in 2000 trials of labor, said Mark B. Landon, M.D., of Ohio State University and the lead investigator for the NICHD Maternal-Fetal Medicine Units Network Cesarean Registry.


There is so much more information available, and it ids funny how Drs seldom tell you the DANGERS of a C sec. You are actually safer to have a VBAC than you are a repeat C sec.
*Off to find more stats...*

[jarrahsmumma]

Better info.. http://www.vbac.com/uterine.html

[Goosie22]

Hi,
was the pamphlet referenced to any particular paper/study or even text book?

What was the print date of the pamphlet?

I am with Nel09 those stats dont sound right to me?

Its your choice though to even attempt a VBAC so go with what you think is right for you.

[Tracie]

Did the pamphlet detail the risks of repeat caesarian section? Because they are certainly nothing to be sneezed at either.

I really hope it did because when making the decision about choosing VBAC or repeat caesarean section, women should be told about the risks involved with both.

I'm not trying to change anyone's mind here, because the way that you give birth is always your own decision and has to be made taking into account your individual situation.

I guess I was just worried that some ladies who are considering VBAC might read this post and these stats and be frightened off!

Here is some further information........

The evidence from research confirms the safety of VBAC in that it is associated with lower risk of complications for both mother and baby than a repeat caesarean.

Although the risk of a mother dying with caesarean section is small, it is still about four times higher than with ANY type of vaginal birth. Other complications such as other operative injury, infection, bleeding, post natal pain and effects on future fertility are higher with caesarean section than vaginal birth.

With VBAC the most important consideration of risk is scar rupture. Most scar ruptures are 'silent' or 'incomplete' - the scar stretches and thins but this does not harm mother or baby at all. Research has shown that the generally accepted risk of all scar ruptures is 0.5% or 1 in 200 births.

It is very rare for a life- threatening complete rupture of the uterus to occur - between 0.09% to 0.8%. To put this into perspective, ANY labouring woman is about 30 times more likely to need an emergency caesarean section for another serious complication like a haemorrhage for example, than a woman needing one because of a complete scar rupture (Enkin 2000).

References

Enkin, M et al (2000) 'A Guide to Effective Care in Pregnancy and Childbirth' Third Edition, Oxford University Press.

[cosmic]

Crikey! :eek:
The whole 1 in 10 resulting in hysterectomy, and 1 in 10 resulting in still birth is terrifying! :eek:
I guess there's a risk with any type of birth you choose, I didnt realise it was that big.
Briannabear, remember that the 1 in 10 (if these stats are right) is the risk if you are one of the 1 in 200...

So if you are in the .5% of women who have a uterine rupture (1 in 200) you then have a 10% chance of either of those things (stillborn or hysterectomy) which makes your overall risk .05%. Not that scary..

[SassyMummy]

I am so focussed on getting having a VBAC next time round, that I always wonder "WHY?!" when mothers say they want to just have an elective c-section next time. Not because I think they're horrible people or bad mothers or anything like that - just because I am so intent on having a vaginal birth because I didn't get to experience any of what I expected to (not even labour pains).

From what I have been told (admittedly, most of it is from on here - especially JanetF who seems to be a living medical journal - love it! :thumbsup: ), VBAC is generally safer for mothers and babies than repeat c-sections. I trust that it is - considering it is the natural way to have a baby.

Good luck on your elective c-section...hope it goes well. I know though, that I will do all in my power to make sure I don't have to have one.

[cosmic]

Just wanted to add... (after I fixed up my dodgy figures above :rolleyes: )

This is something that I really don't know much about at all and obviously has to be a personal decision but I agree it's important to be very well acquainted with the risks of caesarian before deciding because it obviously has risks too. After all it's major surgery. Whatever you decide, I hope it goes well.

[Briannabear]

Checked out that link and here are some more stats:

Risk of Uterine Rupture with Low Transverse Uterine Scars* Revised 10/14/2002
Number of Previous Cesareans Successful VBACs Rupture Rate Perinatal Mortality

10,880 Planned VBACs with one prior scar 83% 0.6% 0.018%
1,586 Planned VBACs with two prior scars 76% 1.8% 0.063%
241 Planned VBACs with three prior scars 79% 1.2% 0
Source: Miller, D. A., F. G. Diaz, and R. H. Paul.1994. Obstet Gynecol 84 (2): 255-258


*This study included women with breech babies and twins and use of oxytocin.

[*butterflykisses*]

with my second bub i wanted a VBAC so bad but at 40 weeks my bub hadnt come yet and the doctor talked to me about the higher risks of being induced rather then going for another c/s
I finally made a decision to have another c/s (since ive never even been in labour I weighed the pros and cons and rupturing my scar was just a risk i decided i didnt want to take )
now im preggies with number 3 and know there only 1 way this bub will be coming out (through c/s) & im happy with that

good luck with your c/s and wish you a safe and fast recovery

love kylie-anne xoxo