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Author
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Topic: Advantages of VBAC
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<Tasha>
unregistered
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posted 12 February 2006 05:00 PM
I am realy realy confused. My doctor who I have seen since I was 13 firstly encouraged me to try VBAC due to my dream of having 4 kids and he was concerned of rupture. I was all set to try vbac. Then I spoke to my OB and he told me that he has only ever seen a rupture during labour. Now I am wondering why I am still so gunho about a vbac, I mean what are the advantages am I just putting my baby and me in greater risk?. I cannot deny a voice deep inside of me, despite my hate of pain and my request for an epidural last birth (turned out to be an emergency C - LOnnnngggg story) that is pushing for one, I guess an emotional response. However I am so confused now about any physical advantages. I have thought, hoping somebody can confirm, that whilst there is a greater risk of rupture (by 0.2%) during a vbac, it is better to risk it then, rather than a sudden rupture when carrying a fourth child becaue of being cut and recut?????Am I off base, I still can't get my head around any physical advantages for vbac (i understand emotional reasons). I would love someone to help, my husband is a teacher and I am living in the outback of QLD (very remote) feeling so lost. Due 18th July 06
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<Redlyn>
unregistered
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posted 12 February 2006 05:35 PM
Dear Tasha,
God I understand your confusion and fear, there are so many facts and figures but I just finished reading a book called Silent Knife and I'm going VBAC all the way unless of course I am in dire need of a C/s for the safety of my baby and me. Read the book I found it in my local library. Best wishes for your birth. Redlyn
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<Tasha>
unregistered
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posted 12 February 2006 06:01 PM
Thankyou for your reply, I've written down the book. It sucks cause i'm trying to complete three subjects as an external uni student in time to do eight weeks of teaching (prac) beginning April plus have a one year old. My only point being...I don't have time to read books except uni related, or to sift out all of the books out there. I realy want the hardcore advantages and disadvantages & then if I still feel positive to go vbac (which despite logic I still am) then I'll go for it. but somewhere I can fit in one if I know this book is closer to the track i'm wanting it helps me out a lot. It would be so much easier for me to go planned C because we live remote, there is a huge chance my husband will not make it in time for the birth which is devestating for me, not to mention travel arrangements (my nerves will not handle a twelve hour drive with a one year old and newborn), I'm so mixed up. I'll try and get the book. Thanks for the direction.
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<Janet from Joyous Birth>
unregistered
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posted 12 February 2006 07:58 PM
Hi ![[Big Grin]](biggrin.gif) The advantages of vaginal birth are many, regardless of previous surgery. The advantages to both you and are baby are almost endless since a normal physiological process is virtually always safer than surgery, regardless of the kind of surgery you're having. Here are some risks for ERC, check out the risks for your baby at the same link: (Personally I think the death rate is conservative as most studies put it at 4-5 times higher for caesareans than vaginal birth.)
http://www.motherfriendly.org/Downloads/csec-fact-sheet.doc
Hazards of Repeat Cesarean Section
• Elective cesarean section carries twice the risk of maternal death compared with vaginal birth.10
• Old scar tissue increases the likelihood of surgical injury.
• One more woman in every 100 with a history of more than one cesarean will have an ectopic pregnancy (embryo implants outside the womb).15 Hemorrhage associated with ectopic pregnancy is one of the leading causes of maternal death in the US.7
• Compared with women with no uterine scar, women have more than 4 times the risk of placenta previa with one prior cesarean, 7 times the risk with two to three prior cesareans, and 45 times the risk with four or more prior cesareans.3 Placenta previa more than doubles the chance of the baby dying and increases the rate of preterm birth more than 6-fold.8
• Compared with women with prior births and no previous cesareans, women with one prior cesarean or more have as much as 3 times the risk of placental abruption.15 With placental abruption, 6 in every 100 babies will die, and 3 in 10 will be born too early.19
• The odds of placenta accreta (placenta grows into or even through the uterus) jump from 1 in 1,000 with one prior cesarean to 1 in 100 with more than one prior cesarean.5 Nearly all women with this complication will require a hysterectomy, nearly half will have a massive hemorrhage, and as many as 1 in 11 babies and 1 in 14 mothers will die.26 The incidence of placenta accreta has increased 10-fold in the last 50 years and now occurs in 1 in 2,500 births.2
• Women having elective repeat cesareans are more likely to experience hemorrhage requiring transfusion, blood clots, and infection.24,27,28
• Postpartum recovery after repeat cesarean section is even more difficult when there is another child or children to care for.
Try this for more caesarean risks:
http://www.radmid.demon.co.uk/csrisks.htm
A quick summary by Olubusola Amu, Sasha Rajendran and Ibrahim I Bolaji,
BMJ 1998;317:462-465 ( 15 August )
http://www.bmj.com/cgi/content/full/317/7156/462
"Caesarean sections are not without complications and consequences. Maternal risks in the short term include haemorrhage, infection, ileus, pulmonary embolism, and Mendelson's syndrome. The prevalence of hysterectomy due to haemorrhage after caesarean section is 10 times that after vaginal delivery, and the risk of maternal death is increased up to 16-fold.
Long term morbidity including formation of adhesions, intestinal obstruction, bladder injury, and uterine rupture is often underestimated during subsequent pregnancy. There is evidence suggesting decreased fecundity, increased risk of ectopic pregnancy, placenta praevia, and worse infant outcome in subsequent pregnancies, although the effect on non-reproductive health is unclear and contradictory. Feelings of inadequacy, guilt, and failure in not completing a natural process may affect bonding between mother and infant, particularly if the operation was conducted under general anaesthetic"
If you have concerns about your scar, you need ask yourself why. Do you doubt you can heal properly? Do you doubt your surgeon's skill? If you had another part of your body sewn up would you expect it to start shut during normal use? Birth IS normal use, remember, for a uterus : )
Read this and let it inspire you:
http://www.ageofwoman.com/articles/integrityofscars.html
Basically caesareans are for lifethreatening emergencies, when the risk of the surgery is less than the risk of a vaginal birth. A VBAC simply isn't that risky. No study in 20 years has shown ERC to be safer than VBAC.
This is an excellent link to great VBAC info.
http://www.homebirth.org.uk/vbac.htm
There is SO much excellent info online and I can email you the latest studies into VBAC if you like. My email address is sheelnagig @ hotmail.com (take out the gaps of course!)
Just birth your baby, ok?
; )
I hope it's great for you : )
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<Tasha>
unregistered
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posted 13 February 2006 09:41 AM
Thankyou, thankyou, Thankyou Thankyou!!!, I was so excited to such info and the sites. Of course I will look further into it (between studies) but for now I have a place to start, I was getting so wound up. I now understand my instinctive feelings to try for a natural birth. Only thing is I went into debt to pay for private health after the birth of my last baby, with the thoughts of trying naturally for the next. Thinking I would be safer that way. Now I discover that is not the case. One more thing to look into. Thankyou.
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<mumoffour>
unregistered
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posted 13 February 2006 08:34 PM
From mumoffour - who can;t remember her password! ![[Smile]](smile.gif)
Hi Tasha, I've just realised I was replying to your question on the email discussion - but not here where you could see my response - so anyway - here's the two emails I sent in - it's very long info, but probably worth reading.
I also have new research from the Cochrane Library which collects and analyses the best medical research from the world - its view on VBAC is that there has not been enough research (ie randomised trials) into VBAC versus caesarean to make a clear conclusion over which is safest. This is a 2006 report and can be found here:
http://www.cochrane.org/reviews/en/ab004224.html
here's my early emails, all the best, Michelle
Tasha,
I just wanted to assure you that even if you have four children
and four caesars, the chance of rupturing during pregnancy is extremely low.
I have had four babies and four caesars - and they were biggish babies and I
gained lots of weight but never had any probs.
As I see it the advantage of a VBAC is that you avoid all the risks of a
major operation and replace it with a more natural process.
I think the main thing is to decide what YOU feel most comfortable about and
go with that - not everyone is so focused on the method of birth - for me it
was all about the babies and the fact that I could have natural birth was a
bummer and disappointment, but nothing could change the joy of bringing my
children in to the world.
All the best of luck, Michelle
EMAIL TWO
Janet, there was a study published in the New England Journal of Medicine in
2004 which claimed that a repeat caesarean section was safer for mothers and
babies than a vaginal birth.
Vaginal delivery after caesarean section had higher infection rates and
higher transfusion rates and higher risk of newborn complications such as
oxygen insufficiency.
However the risk for a serious newborn complication was gauged to be only
approximately 1 in 2000 trials of labor.
Also the fact sheet
(http://www.motherfriendly.org/Downloads/csec-fact-sheet.doc) you quote is
from a fairly biased source (The Maternity Coaltion, which has a stated aim
of reducing caesareans) and has quite a lot of old figures - I'm not
discounting it, I just think it makes sense to read everything as there are
so many conflicting reports around.
Also in the info you quote last, you left out the sentence which came just
before it - which reads:
"An elective caesarean section does, however, avert the need for
episiotomies, prolonged and painful labours, and difficult instrumental
deliveries. Trauma to the pelvic floor and to the urethral and anal
sphincters, associated with long term predisposition to genital prolapse and
urinary and anal incontinence, would also be avoided."
Also on the same page is this info:
"We encourage "family planning" and prepregnancy counselling, we routinely
perform antenatal screening, and we offer prenatal diagnosisall of which are
"unnatural" and promote a concept of the "designer baby." Can we do all this
and then refuse a woman a safe mode of delivery (caesarean section) that
removes the gambles associated with labour and which she personally finds
unacceptable?
"Recent evidence of maternal morbidity after caesarean section and normal
and instrumental vaginal delivery challenges some deep rooted obstetric and
midwifery teachings: normal vaginal deliveries can cause damage to the
pelvic floor,7 and instrumental vaginal deliveries are associated with
slower recovery8 and greater pelvic floor damage and incontinence9 than
normal delivery and caesarean section."
http://bmj.bmjjournals.com/cgi/content/full/317/7156/462
I'm by no means suggesting we should disregard the importance of VBAC, or be
encouraging electice caesareans, but I don't think we should ignore any
information which draws different conclusions.
Anyway Tasha, good luck!!!
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<Colette>
unregistered
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posted 16 February 2006 10:54 AM
Hi....
Could you please tell me the name of the author for the book mentioned..."Silent knife". Thank you.
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JenBen
Member
Member # 520
Rate Member
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posted 16 February 2006 12:51 PM
Hi Colette,
Silent Knife is listed in the Suggested Reading link on the right but the writers are Nancy Wainer Cohen & Lois J Estner, 1983 (USA).
cheers Jennie
Posts: 49 | From: perth | Registered: Sep 2005
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<Larissa>
unregistered
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posted 23 April 2006 01:34 AM
I had a CS in 97 and a natural birth in 2002, during the 2nd birth my midwife kept asking if I felt localised pain where my scar was, which I didn't. Please correct me if I'm wrong, but I get the impression that you'd know if something bad was happening as labour pains etc, have a character of their own. ???
BTW VBAC was a very rewarding experience after a nasty CS... my hubby and I did lots of research and he was a great advocate for me in labour, fear esp. of the unknown can be your greatest enemy... avoid interventions as much as possible too and good luck.
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<neat>
unregistered
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posted 24 April 2006 04:33 AM
I had 2 normal deliveries and then 3 c/s.Although natural labour may be painful at the time, for me all that pain ended the moment the baby was placed in my arms.After my c/s, the pain didnt disappear for a long time, each c/s got harder for me.Coming home 2 days after major surgery, caring for little ones,husband away at work(for weeks at a time) living in remote area without family support isnt easy!I have much fonder memories of my first 2 births.Looking at my 3 c/s bubs I found myself looking for family similarities, it was like I kept wondering if they were really mine since they were just taken out not birthed out.Our bodies were created for birth.c/s should be for neccessaties.We are planning on more children and planning on vbac.Hope all goes the way you want.Its your body,your choice.Educate yourself,know your rights and dont be bullied into any descision you dont feel is right.Whatever your birth choice is enjoy being parents cos they grow up so fast and they truly are a blessing.Dont spend your time on regrets or fears, its far too time consuming.Congrats on your growing family.
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