Comments on: Rupture rate 10% for VBA2C with prior vaginal birth within one year of last cesarean? http://vbacfacts.com/2008/06/18/rupture-rate-10-for-vba2c-with-prior-vaginal-birth-within-one-year-of-last-cesarean/?utm_source=rss&utm_medium=rss&utm_campaign=rupture-rate-10-for-vba2c-with-prior-vaginal-birth-within-one-year-of-last-cesarean Vaginal birth after cesarean? Don't freak, know the facts. Mon, 21 May 2012 06:08:41 +0000 hourly 1 http://wordpress.org/?v=3.3.1 By: Jen Kamel http://vbacfacts.com/2008/06/18/rupture-rate-10-for-vba2c-with-prior-vaginal-birth-within-one-year-of-last-cesarean/comment-page-1/#comment-76227 Jen Kamel Wed, 18 Apr 2012 02:52:33 +0000 http://vbacfacts.com/2008/06/18/rupture-rate-10-for-vba2c-with-prior-vaginal-birth-within-one-year-of-last-cesarean/#comment-76227 Tammy, what kind of scars do you have? If you don't know, you can review your operative reports from your cesareans. Low transverse, also called "bikini" cut, cesareans carry the lowest risk of rupture. The Landon (2006) study found that there was 0.9% risk of rupture after two cesareans. That includes induced and augmented labors which have higher rates of rupture. <a href="http://www.plus-size-pregnancy.org/CSANDVBAC/vbac_after_2_cs.htm" rel="nofollow">This website</a> is an excellent resource on VBA2C rupture risks. For what it's worth, the American Congress of Obstetricians and Gynecologists <a href="http://vbacfacts.com/2010/07/21/acog-issues-less-restrictive-vbac-guidelines/" title="ACOG issues less restrictive VBAC guidelines" rel="nofollow">supports vaginal birth after two cesareans</a> in "some women." I would love to know who is claiming that a third of women pregnant after two cesareans rupture during their third trimester. I've never seen any data like that. Maybe they mean, of the women who rupture, one third occur before labor. That makes more sense to me. Don't spend your time worrying. Your risk of rupture is low and it's even lower if you have a planned repeat cesarean. If learning about the symptoms of uterine rupture will give you some peace (since you know what to look for), you can read them towards the bottom of <a href="http://www.vbacfacts.com/vbac" rel="nofollow">this page</a>. Enjoy your pregnancy and your baby!! Warmly, Jen Tammy,

what kind of scars do you have? If you don’t know, you can review your operative reports from your cesareans. Low transverse, also called “bikini” cut, cesareans carry the lowest risk of rupture.

The Landon (2006) study found that there was 0.9% risk of rupture after two cesareans. That includes induced and augmented labors which have higher rates of rupture. This website is an excellent resource on VBA2C rupture risks.

For what it’s worth, the American Congress of Obstetricians and Gynecologists supports vaginal birth after two cesareans in “some women.”

I would love to know who is claiming that a third of women pregnant after two cesareans rupture during their third trimester. I’ve never seen any data like that. Maybe they mean, of the women who rupture, one third occur before labor. That makes more sense to me.

Don’t spend your time worrying. Your risk of rupture is low and it’s even lower if you have a planned repeat cesarean. If learning about the symptoms of uterine rupture will give you some peace (since you know what to look for), you can read them towards the bottom of this page.

Enjoy your pregnancy and your baby!!

Warmly,

Jen

]]> By: Tammy http://vbacfacts.com/2008/06/18/rupture-rate-10-for-vba2c-with-prior-vaginal-birth-within-one-year-of-last-cesarean/comment-page-1/#comment-76181 Tammy Tue, 17 Apr 2012 18:10:52 +0000 http://vbacfacts.com/2008/06/18/rupture-rate-10-for-vba2c-with-prior-vaginal-birth-within-one-year-of-last-cesarean/#comment-76181 Hi, I am being scared to death reading things all over the web and being told by my Spanish midwife.. I had one Vaginal delivery then two cesarians. I became pregnant 6 months after my second section and am now 6 weeks gone. I am reading risks all over the place, varying from 1% result in uterine rupture up to a third of women rupture during the third trimester... Not even attempting a vaginal delivery. Where I am in Spain a Vaginal delivery is not an option, I am just petrified of the last three months... Hi, I am being scared to death reading things all over the web and being told by my Spanish midwife.. I had one Vaginal delivery then two cesarians. I became pregnant 6 months after my second section and am now 6 weeks gone. I am reading risks all over the place, varying from 1% result in uterine rupture up to a third of women rupture during the third trimester… Not even attempting a vaginal delivery. Where I am in Spain a Vaginal delivery is not an option, I am just petrified of the last three months…

]]> By: Christina http://vbacfacts.com/2008/06/18/rupture-rate-10-for-vba2c-with-prior-vaginal-birth-within-one-year-of-last-cesarean/comment-page-1/#comment-7200 Christina Mon, 10 May 2010 20:47:21 +0000 http://vbacfacts.com/2008/06/18/rupture-rate-10-for-vba2c-with-prior-vaginal-birth-within-one-year-of-last-cesarean/#comment-7200 @Laura, I have heard that Dr. Annette Palaez is an OB that will do VBA2C, but no personal experience here. @Laura,
I have heard that Dr. Annette Palaez is an OB that will do VBA2C, but no personal experience here.

]]> By: Jocelyn http://vbacfacts.com/2008/06/18/rupture-rate-10-for-vba2c-with-prior-vaginal-birth-within-one-year-of-last-cesarean/comment-page-1/#comment-7172 Jocelyn Wed, 05 May 2010 19:14:50 +0000 http://vbacfacts.com/2008/06/18/rupture-rate-10-for-vba2c-with-prior-vaginal-birth-within-one-year-of-last-cesarean/#comment-7172 @Laura have you had your child? What have you learned? I'm expecting my 4th child after 2 C-s. I'm in the same boat in Iowa. @Laura
have you had your child? What have you learned? I’m expecting my 4th child after 2 C-s. I’m in the same boat in Iowa.

]]> By: Laura http://vbacfacts.com/2008/06/18/rupture-rate-10-for-vba2c-with-prior-vaginal-birth-within-one-year-of-last-cesarean/comment-page-1/#comment-6151 Laura Tue, 03 Nov 2009 18:12:20 +0000 http://vbacfacts.com/2008/06/18/rupture-rate-10-for-vba2c-with-prior-vaginal-birth-within-one-year-of-last-cesarean/#comment-6151 Shannon, I am assuming that based on your comment post date, you had your 5 child. I am pregnant with my third and dead set on a vaginal birth after 2 sections. Can you update me on how you delivered? I am finding it almost impossible to find a birth center or midwife that wil take me in Florida. Anyone out there have suggestions for South Florida? Shannon, I am assuming that based on your comment post date, you had your 5 child. I am pregnant with my third and dead set on a vaginal birth after 2 sections. Can you update me on how you delivered? I am finding it almost impossible to find a birth center or midwife that wil take me in Florida. Anyone out there have suggestions for South Florida?

]]> By: Jen from vbacfacts.com http://vbacfacts.com/2008/06/18/rupture-rate-10-for-vba2c-with-prior-vaginal-birth-within-one-year-of-last-cesarean/comment-page-1/#comment-1540 Jen from vbacfacts.com Tue, 30 Jun 2009 04:59:07 +0000 http://vbacfacts.com/2008/06/18/rupture-rate-10-for-vba2c-with-prior-vaginal-birth-within-one-year-of-last-cesarean/#comment-1540 Hi Edie! Here is the link: <a href="http://pt.wkhealth.com/pt/re/ajog/abstract.00000447-199910000-00019.htm;jsessionid=KJhD2NVFRSHsc88tQMnQvr6H1rhn5lNDgDyzFdPT7sL3kLpprZZ1!-631714950!181195629!8091!-1" rel="nofollow">Rate of uterine rupture during a trial of labor in women with one or two prior cesarean deliveries.</a> American Journal of Obstetrics & Gynecology. 181(4):872-876, October 1999. Caughey, Aaron B. MD, MPP a; Shipp, Thomas D. MD b; Repke, John T. MD c; Zelop, Carolyn M. MD d; Cohen, Amy BA a; Lieberman, Ellice MD, DrPH a Only 137 women had two prior cesareans, so their sample was very small. Best, Jen Hi Edie!
Here is the link: Rate of uterine rupture during a trial of labor in women with one or two prior cesarean deliveries.
American Journal of Obstetrics & Gynecology. 181(4):872-876, October 1999.
Caughey, Aaron B. MD, MPP a; Shipp, Thomas D. MD b; Repke, John T. MD c; Zelop, Carolyn M. MD d; Cohen, Amy BA a; Lieberman, Ellice MD, DrPH a

Only 137 women had two prior cesareans, so their sample was very small.
Best, Jen

]]> By: Edie Wells, CPM, LM http://vbacfacts.com/2008/06/18/rupture-rate-10-for-vba2c-with-prior-vaginal-birth-within-one-year-of-last-cesarean/comment-page-1/#comment-1517 Edie Wells, CPM, LM Wed, 24 Jun 2009 03:05:52 +0000 http://vbacfacts.com/2008/06/18/rupture-rate-10-for-vba2c-with-prior-vaginal-birth-within-one-year-of-last-cesarean/#comment-1517 The link to the Caughey study is broken. Do you have a copy I could have? I want to see where they got these high numbers. The link to the Caughey study is broken. Do you have a copy I could have? I want to see where they got these high numbers.

]]> By: Knitted in the Womb » Lehigh Valley Hospital Makes a Statement http://vbacfacts.com/2008/06/18/rupture-rate-10-for-vba2c-with-prior-vaginal-birth-within-one-year-of-last-cesarean/comment-page-1/#comment-1431 Knitted in the Womb » Lehigh Valley Hospital Makes a Statement Mon, 01 Jun 2009 16:58:08 +0000 http://vbacfacts.com/2008/06/18/rupture-rate-10-for-vba2c-with-prior-vaginal-birth-within-one-year-of-last-cesarean/#comment-1431 [...] number of VBA2C examples, ignoring other, more sound data that supports the safety of VBA2C. Also , http://vbacfacts.com/2008/06/18/rupture-rate-10-for-vba2c-with-prior-vaginal-birth-within-one-year-o... makes good reading, as it gives an example of how obstetricians will use misinformation to [...] [...] number of VBA2C examples, ignoring other, more sound data that supports the safety of VBA2C. Also , http://vbacfacts.com/2008/06/18/rupture-rate-10-for-vba2c-with-prior-vaginal-birth-within-one-year-o... makes good reading, as it gives an example of how obstetricians will use misinformation to [...]

]]> By: Shannon http://vbacfacts.com/2008/06/18/rupture-rate-10-for-vba2c-with-prior-vaginal-birth-within-one-year-of-last-cesarean/comment-page-1/#comment-740 Shannon Sun, 11 Jan 2009 17:18:40 +0000 http://vbacfacts.com/2008/06/18/rupture-rate-10-for-vba2c-with-prior-vaginal-birth-within-one-year-of-last-cesarean/#comment-740 I'm due with our fifth child and have had four previous c-sections. It's been four years since my last birth. I am considering a vaginal birth and wondering where I can find more information and/or encouragement. Thank you! Shannon <em>Shannon, I have to say upfront, I am not a doctor or a midwife, so I can not give you medical advice. What I can do is point you to information. To my knowledge there are not any large studies looking at VBA4C. It is the realm of the unknown. There are a bunch of very small studies where some of the participants were a VBA3C or VBA4C, please <a href="http://www.plus-size-pregnancy.org/CSANDVBAC/vbac_after_2_cs.htm#VBAC%20After%203%20or%20More%20Cesareans" rel="nofollow">click </a>here for an excellent summary. Have you read <a href="http://vbacfacts.com/2008/03/08/finding-a-vbac-supportive-ob-or-midwife/" rel="nofollow">Finding a VBAC Supportive OB or Midwife</a>? An OB might be willing to give you a chance if you agree to external continuous fetal monitoring and to go to the hospital shortly after labor begins. But, you need to find an OB who is <a href="http://vbacfacts.com/2008/04/13/the-three-types-of-care-providers-amongst-obs-and-midwives/" rel="nofollow">truly supportive</a> of VBA<strong>2</strong>C and negotiate. Realize that s/he is really, really going out on a limb for you. Build a rapport and trust with this OB. They are putting their professional career at risk if anything goes wrong. It's also important for you to know that if you do need an emergency cesarean after a trial of labor, the (many?) <a href="http://vbacfacts.com/2008/06/06/cesarean-risks-adhesions/" rel="nofollow">adhensions</a> in your abdominal cavity could make the surgery longer and more complicated which could put your baby at risk. I wish I had more encouraging news for you. I'm sorry. Best, Jen</em> I’m due with our fifth child and have had four previous c-sections. It’s been four years since my last birth. I am considering a vaginal birth and wondering where I can find more information and/or encouragement.

Thank you!

Shannon

Shannon, I have to say upfront, I am not a doctor or a midwife, so I can not give you medical advice. What I can do is point you to information. To my knowledge there are not any large studies looking at VBA4C. It is the realm of the unknown. There are a bunch of very small studies where some of the participants were a VBA3C or VBA4C, please click here for an excellent summary. Have you read Finding a VBAC Supportive OB or Midwife? An OB might be willing to give you a chance if you agree to external continuous fetal monitoring and to go to the hospital shortly after labor begins. But, you need to find an OB who is truly supportive of VBA2C and negotiate. Realize that s/he is really, really going out on a limb for you. Build a rapport and trust with this OB. They are putting their professional career at risk if anything goes wrong. It’s also important for you to know that if you do need an emergency cesarean after a trial of labor, the (many?) adhensions in your abdominal cavity could make the surgery longer and more complicated which could put your baby at risk. I wish I had more encouraging news for you. I’m sorry. Best, Jen

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