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    My cs was booked in for 40+6 I went into labor at 40+5. I had 1 S&S and also accupuncture

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    Theophania, the risk of rupture in an induced vbac is actually less than the risk of rupture in a vba2c, but I'm sure I've seen you encouraging women towards that route?

  3. #23
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    Theophania is offline 'see what had happened was..there were these three ninjas and a blue monkey and well it really wasn't my fault..'
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    Quote Originally Posted by Chew the Mintie View Post
    Theophania, the risk of rupture in an induced vbac is actually less than the risk of rupture in a vba2c, but I'm sure I've seen you encouraging women towards that route?
    I would always encourage a woman to give birth naturally because the risks of a VBA2C are smaller than the risks involved with yet another cesarean. It is a known fact that inducing a VBAC increases the risk of rupture, so as I said it was not an option for me.

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    The risk of rupture in an induced c-sec is still under .6%. I think it's very important women have accurate information.

    Unfortunately, statements such as that you made above cause women to think a repeat c-section is their only option when post-dates. Most aren't comfortable going past a certain amount post edd. So making a lot of completely false statements about the high rate of rupture in induced vbacs does not mean people don't get induced, it just means they have another c-section, which really does have health implications.

  5. #25
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    Theophania is offline 'see what had happened was..there were these three ninjas and a blue monkey and well it really wasn't my fault..'
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    Quote Originally Posted by Chew the Mintie View Post
    The risk of rupture in an induced c-sec is still under .6%. I think it's very important women have accurate information.

    Unfortunately, statements such as that you made above cause women to think a repeat c-section is their only option when post-dates. Most aren't comfortable going past a certain amount post edd. So making a lot of completely false statements about the high rate of rupture in induced vbacs does not mean people don't get induced, it just means they have another c-section, which really does have health implications.
    I think that what is important is that women know the truth about going past dates and that it is not as dangerous as people say. If women were given the truth about that they would not feel as if their only option was a repeat cesarean. I don't think 0.6% is actually acurate, from what I have found it appears that rupture rate is 2.3 times more likely with the use of oxytocin whilst the use of prostaglandin E(2) gel made rupture 3.2 times more likely. That seems like a rather large increase in risk and not a mere .6%. the use of these drugs on a first time mother without any previous scars on her uterus carry a risk of about .4% for a uterus rupture. What women need to be informed of is that it is safe to go past 40 weeks and regular monitoring after 42 weeks can help ensure baby is fine.

    The risks associated with an induced VBAC actually outweigh the risks in goiong past your 'edd'...
    Last edited by Theophania; 26-05-2012 at 18:58.

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    Theophania, the risk of rupture is about .4%, the risk of rupture in an induced vbac with synto is less than twice that, so say .8% conservatively.

    Gel is not used in vbac.

    The risk of stillbirth doubles after 14 days past edd, and the risks for c/sec, assisted delivery etc also go up.

    So you have a .8% chance of uterine rupture, an emergency hospitals are well equipped to handle, versus a similar increase in risk of stillbirth past at 14 days past edd. At 21 days past edd the risk has quadrupled.

    Your analysis of the stats is incorrect. Women need to understand that vbacs can be induced safely and they do not have to just have a repeat c- sec.

    I fully encourage women to wait until they go into labour spontaneously, but I will always object to the distortion of stAts to suit an agenda.

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    There is loads of research. As someone who has had 4 ppstdates pregnancies including 2 vbacs I assure you I have researched this relentlessly.

    A recent very rigorous and large scale Australian study reaffirmed that better outcomes are achieved by induction at 42 weeks. In fact, the study recommended that protocols so far as other routine inductions be amended, as it doesn't produce better outcomes ie induction for gd and generally makes c-sec far more likely. However induction for post dates statistically doesn't result in increased c-sec rate. Ie it's basically the only time induction really does produce better outcomes.

    The risk of stillbirth at 43 weeks is quadrupled compared to 40 weeks. This is a result demonstrates in every piece of research I've seen on the topic.

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    I also think the rate of complications and assisted delivery gong up past 42 weeks is very well established and I don't understand how you could have not come across it tbh

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    Please note the increase in risks in real terms is still not very big - a quadrupling in risk of something that has a 1 in 1000 chance of happening still means that the vast vast majority of people will have good outcomes

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    I was 40+12. Ended up being induced and she still didn't want to come out. But I suppose ebing a winter baby, she was smart wanting to stay in the warmth!


 

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