Edsite WA: APH in Labour

my profile | register | search | faq | .

»	Edsite WA » Ask a Midwife » APH in Labour

UBBFriend: Email this page to someone!

Author

Topic: APH in Labour

<Krystyn>
unregistered

posted 20 October 2004 01:02 PM

Hi there,

I am wondering whether or not to attempt a VBAC.

My first child was born 3 1/2 years ago by emergency caesarean under a GA due to Ante-Partum Haemorrhage in labour. She had to be resuscitated twice after birth, but is now a healthy preschooler with no lasting effects of the labour (thankfully).

I am now pregnant again and find myself wanting to research the chances of another APH happening again this time round. I have recieved conflicting information about this and wonder what your thoughts are.
I would love to attempt a VBAC but know that I do NOT want to experience like the last one again. I also do not want to put my baby in any danger and wonder if I am being selfish for wanting to try a VBAC.

Thanks for your reply on this.

Krystyn

Mary
Moderator
Member # 461

posted 08 December 2004 01:32 PM

Hi Krystyn

You certainly had an ordeal with the birth of your first baby! Glad to hear that you and your daughter are well.

Every pregnancy, baby and birth are different and there is no guarantee that an APH will happen again. Your fear of it happening again is very real because that has been your experience of birth so far. I’d suggest talking to other women about your experience (women who have had a similar thing happen) or a councellor, or writing down your birth story, identifying those things that you feel most afraid of. Then, work through each issue slowly, either with the guidance of a councellor, or with your partner. The book ‘Birthing from Within’ is a great guide on journeying through fears.

As mentioned previously, the main risk with vbac is uterine rupture – which occurs less than 1%. In a systematic review of 568 articles on uterine rupture after previous caesarean section, (Guise JM, McDonagh MS, Osterweil P, Nygren P, Chan BK, Helfand M. Systematic review of the incidence and consequences of uterine rupture in women with previous caesarean section. BMJ 2004;329:19-25.) Guise et al, state that to prevent one rupture, you’d need to perform 370 (213 to 1370) elective caesarean deliveries! They also state that repeat caesarean delivery is not guaranteed to prevent uterine rupture.

It’s always a good idea, when planning for a vbac to write a birthplan, including your desires for a vaginal birth as well as a caesarean birth (if it becomes necessary). At the end of the day it is not vaginal vs caesarean, but a birth where both mother and baby are safe and well and the experience has been an enjoyable, empowering one for the mother (and the baby too). See the ‘planning a positive caesarean’ section on this website for ideas.

You’re not being selfish in your desire for a vaginal birth (or to not have a repeat of what happened last time). It just takes a bit more planning and exercising of your rights to have the kind of experience that you desire. So, read, talk, prepare, work through your fears and as someone once said to me, aim for the moon and even if you don’t reach it, you’ll be up there with the stars…

Good Luck
Midwife Mary

Posts: 22 | Registered: Dec 2004

All times are WST (Australia)

Printer-friendly view of this topic