VBAC after three C-SECTIONS???

Kendra - posted on 05/12/2010 ( 14 moms have responded )

11

19

0

Hi ladies! I am 25 yrs old with three children ages 6yrs, 21 mos, and 7 mos. I've delivered all babies by c-section because after the first my dr, whom i trust with my life, cannot do vbacs anymore due to the risks involved. It's a practice thing. He would just refer me to someone he trusts. After my last section, my incision did not heal properly. While getting ready to leave the hospital, the nurse discovered my incision had busted open and there was a gaping wound. So I had to have home health care come into my home twice a day for a little over a month until the incision closed. (did i mention it was NOT my regular dr that performed the c-section this time?) So because of this i'm sooo scared to have another and want to try a natural birth. However, I am aware of the risks involved. So I guess i'm looking for opinions and advice anyone can give me. Especially if you have had a vbac before or in my situation. Thanks:)

MOST HELPFUL POSTS

Cassia - posted on 05/15/2012

3

0

0

It looks like there is quite a bit of misunderstanding here. I know the original poster no longer needs this, but just in case someone else does -

VBA3+C is going to be hard to find support for simply because doctors are scared of being sued and because allowing trickier deliveries increases their malpractice insurance (even if it is not medically more dangerous). But if you can find a doctor who is willing to support you (and there are some!), then it is a very valid option. And, as someone else noted - even with a doctor who isn't terribly supportive, you can still decide not to have the elective c-section. The c-section is the intervention, the deviation from what would normally happen, not labor. :)

Some previous posters said that VBACs were only allowed after one c-section, according to the organization that makes the OB "rules". That is not correct. ACOG used to say that VBAC after 2 c-sections (VBA2C) was only officially recommended if you'd had a previous vaginal birth. More research has come out recently and they revised the guidelines in their 2010 version, saying VBA2C *is* OK in general, not just in special situations. And they didn't discourage VBAC after 3 or more c-sections either - they said they simply didn't have enough evidence to take a stance either way. Interestingly enough, the very little research that has been done on VBA3+C actually found the risk of uterine rupture to be surprisingly similar to a regular VBAC. The sample sizes have been small though (the largest was about 250 women who wanted a VBA3+C). But basically - there is no solid evidence that VBAC after multiple c-sections is more dangerous and should be avoided, or that it is riskier than the alternative of another c-section, and there is evidence that it may actually be less risky.

VBACs don't require 2 years healing time, nor really even 18 months. Studies have found a higher risk when the timing between deliveries (deliveries - not pregnancies - that's a common misunderstanding) is less than 18 months, but the amount of additional risk isn't enough to justify throwing out the idea of VBAC. It's still a very low risk. And the 18 month mark is only there because that what was used to split the groups, not because there is a big difference between say 17 and 19 months. As in all cases, the mom should be able to weigh the risks herself (remember, there are risks to everything - an elective repeat c-section has its own risks too, including some drastic ones). Honestly, these studies are more useful as planning - if you want to have a VBAC, you may want to aim for at least 18 months between births. But, again, that 18 months isn't a magical number for VBAC safety. Actually, I couldn't find any specific spacing recommendations in ACOG's 2010 VBAC guidelines.

On incision not healing properly - that is actually not listed as a reason not to do VBAC anywhere that I am aware of. The thing is, you have two different incisions - your uterus, and your skin/outer tissues. An infection or problems healing in the outer tissue does not mean that there was a problem with uterine healing, and therefore it has no bearing on VBAC safety. Actually, it may do the opposite as surrounding scar tissue can make a c-section harder (making it harder for the doctor to identify and move away the other organs and make sure only the uterus is cut).

All this to say - if you are interested in VBAC after any number of c-sections, you owe it to yourself to research it. It is not completely safe, but it is not particularly dangerous either. *There are risks to either choice,* whether choosing to plan a c-section or choosing to give labor a chance. Some risks are higher if you choose to labor, some are higher if you choose an elective c-section. Thankfully, the risks on both sides are fairly low and most situations will be fine, whichever choice is made. But the risks need to be taken in context, weighed against each other not against the belief that the other choice is completely safe.

If anyone would like links to the research I've referenced, I'm happy to give them. Just send me a message. And for the record - I'm referencing research that is among those used by ACOG to make their formal recommendations, not just random internet sites saying what I'm wanting them to. :)

Nicole - posted on 04/30/2012

3

0

0

Hi I had 3 prior csections with my first three children and had a vbac with my fourth baby this past sept. it was an amazing experience and I am so grateful that I had the opportunity to experience a vaginal birth. My little guy was almost 2 weeks late and weighed in at 9lb 5oz..I had a supportive doctor and two of the best nurses I could have asked for..I did have an epidural but was still able to move and feel everything. I had my baby in New Jersey at a hospital. They were not thrilled that I was trying to have a vbac but ultimately it was my choice to make..a csection elective surgery. If there is no true medical need they cant force you to have surgery..you do have to sign alot of release forms. I had to be very persistent but thankfully it worked.

Ashley - posted on 05/15/2012

7

0

0

I just had my dr appointment yesterday, everything is gonna be great she said, and she told me to stay the hell off of the internet, only your doctor will . she said im gonna have 4 c sections this time around, and get my tubes tied and thats that, how else is the lil one supposed to come out! so im pretty confident in my Dr :)

Iridescent - posted on 05/12/2010

4,519

272

1080

Nobody anywhere is going to allow you a VBAC, for several reasons.
1 - you have had 3 C-Sections. Usually when VBAC's are allowed, it is after ONE.
2 - you have had two children within the past 2 years. Most VBAC's require a healing time of 2 years since your C-Section. Some doctors are willing to do it sooner, but most don't.
3 - Your most recent C-Section did not heal properly, meaning there is more scar tissue present throughout than a typical C-Section. This increases risk for rupture by a TON.

It's not safe for you. Your risk of maternal and fetal death due to uterine rupture attempting a VBAC is huge. If you attempt it at home on your own, you are asking for trouble, and I do not know of any hospital in the world that would willingly allow you to attempt it.

Lindsey - posted on 05/15/2012

10

0

0

i want one too soo much.as i have had 3 c sections,2 of those were emergency c sections so i have scares inside my belly also....ll be able to advise in a few dayz..hopeflly.this wee one dosent wanna come out..lol

This conversation has been closed to further comments

14 Comments

View replies by

Cassia - posted on 05/15/2012

3

0

0

Unfortunately, not all doctors are up to date on the research. :( I've known a few that were unaware that the 2010 guidelines even existed. That's why it is good to do your own research. (But again, your own research - not just what some random person on the internet says - including me, I realize.) :) But honestly there is a lot to say about going with your gut. If you feel uneasy, then maybe it's a sign to search out other options. If you feel peace about the advice you are given, then maybe that's a sign that it's right for you. :)



Lindsey - most emergency c-sections are done the same way as an elective c-section. Only classical incisions (straight up and down with the cut into the upper part of the uterus) are considered bad for VBAC. Those are usually only done in a very early c-section now (like around 30 weeks) because the uterus isn't big enough to do a low incision. The others (low vertical, low T, low horizontal - that's the most common) are all OKed. Here is a link to the ACOG 2010 guidelines (ACOG is the OB group that sets the OB guidelines for the United States): http://www.ourbodiesourblog.org/wp-conte... Also, Pubmed.gov is a good source for searching public medical research.

Ashley - posted on 05/13/2012

7

0

0

i've had 3 c sections, im 25 last one was 4 years ago, and im pregnant again, im so worried about all the crap i read on here, I cant wait till tomorrow i go to my first dr app. So i can put my mind at ease, it's not good looking at all the negative things that people put on here, you're your own person, plus with God's help everything is possible

Connie - posted on 05/13/2010

3

0

0

i don't remember the name of the organization that makes the "medical rules" but they just changed it to where Vbacs are not allowed after 2 c/s. for people that are really wanting to have a Vbac, you'd have to go to Canada. GL

Danielle - posted on 05/13/2010

915

38

42

I am going for my second c-section in September...I just feel it is less risky than going for a VBAC. As much as I would love to have a vaginal delivery, I doubt it will happen because my pelvis is small and I also am scared that labour would cause my uterus to rupture. If I was in your position, I really wouldn't go for a VBAC because after each surgery your uterus becomes weaker and weaker. It's ultimately up to you but I strongly suggest you research risks associated with both types of delivery and also bare in mind, the more c-sections you have, the less chance you have of a vaginal delivery. If you choose to do the c-section, ask your doctor (the one you said you trust with your life, obviously) to schedule a c-section for you so you can come in and make sure he is the one to do it..

Linda - posted on 05/13/2010

59

21

4

I agree with the first poster. No dr would/should even consider you for a VBAC after having 3 c-seciions. My Dr wouldn't even do it after 2 c-sections, and I healed well and had no complications. Don't risk your health or the health of your baby!

Kathy - posted on 05/13/2010

462

15

68

I had a sucessful vbac seven years after the birth of my first child. I would be very very careful in your situation. You have had 2 pregnacies close together that resulted in c-sections. It takes a good year for your body to heal from the surgery itself. If you are considering another child and one by vbac, I would suggesting waiting a few years to give your body ample opporunity to heal and scar adequatly. With the problems after your last surgery, you probably run a very very high risk of your uterus tearing just from the pregnacy itself. Remember that it doesn't matter how you give birth to your children, just that they are healthy and so are you!

Blackwood - posted on 05/12/2010

0

0

36

Hey, sorry to hear your last C-section wasn't that great, but 1 of 3 isn't bad, if your body can heal from that, you will be fine. I don't blame you for being scared, but just think about all the c-sections (including your previous ones) that do go smoothly or with very little complications. The odds are on your side. Best of luck

Kendra - posted on 05/12/2010

11

19

0

Okay. scratch that. I just looked it up and saw that it probably wouldn't be possible. Thanks for your help.

Join Circle of Moms

Sign up for Circle of Moms and be a part of this community! Membership is just one click away.

Join Circle of Moms