Comments on: ACOG issues less restrictive VBAC guidelines http://vbacfacts.com/2010/07/21/acog-issues-less-restrictive-vbac-guidelines/ Vaginal birth after cesarean? Don't freak, know the facts. Tue, 07 Feb 2012 04:51:05 +0000 hourly 1 http://wordpress.org/?v=3.3.1 By: Jen Kamel http://vbacfacts.com/2010/07/21/acog-issues-less-restrictive-vbac-guidelines/comment-page-1/#comment-66203 Jen Kamel Mon, 23 Jan 2012 00:34:39 +0000 http://vbacfacts.com/?p=1309#comment-66203 Sp80, The limited data we have on the rates of rupture in a classical incision vs. a low transverse incision reveal that the differences are significant. I personally wouldn't attempt a VBAC after what could be two prior classical incisions. If I felt very strongly about it, I would find a hospital-based provider. You can always look for the two most VBAC supportive OBs in your area and review your medical records from your second surgery together and get their opinions. I'm sure you will find many people on-line to support you if you decided to peruse a VBA2C. You just have to decide how much risk is acceptable to you. I like to know all the variables at play, but that's me. The data we have on birth intervals is also not very strong because the studies have been rather small (less than 5,000 woman after a cesarean.) You can review an over here: http://vbacfacts.com/2011/11/11/birth-intervals-uterine-rupture/. Warmly, Jen Sp80,

The limited data we have on the rates of rupture in a classical incision vs. a low transverse incision reveal that the differences are significant. I personally wouldn’t attempt a VBAC after what could be two prior classical incisions. If I felt very strongly about it, I would find a hospital-based provider. You can always look for the two most VBAC supportive OBs in your area and review your medical records from your second surgery together and get their opinions.

I’m sure you will find many people on-line to support you if you decided to peruse a VBA2C. You just have to decide how much risk is acceptable to you. I like to know all the variables at play, but that’s me.

The data we have on birth intervals is also not very strong because the studies have been rather small (less than 5,000 woman after a cesarean.) You can review an over here: http://vbacfacts.com/2011/11/11/birth-intervals-uterine-rupture/.

Warmly,

Jen

]]> By: sp80 http://vbacfacts.com/2010/07/21/acog-issues-less-restrictive-vbac-guidelines/comment-page-1/#comment-64565 sp80 Sat, 14 Jan 2012 05:16:32 +0000 http://vbacfacts.com/?p=1309#comment-64565 I know Im reviving an old thread here, but I am working on conceiving another child and want a vbac when I get pregnant. My first pregnancy was almost 14 years ago. I was pregnant with twins and wound up having a c-section due to premature rupture of membranes at 26 weeks. My next pregnancy (over 4 years ago)was a c-section because the doctor insisted that I have one due to unknown type of incision(didnt know I had other options at the time). I tried to get my records recently and found out that the records were held onto for 10 years and are now gone. My obgyn said he couldnt get the records at the time but it was only about 9 years since my first delivery so I'm thinking he lied about my records not being found. He is sort of known as the c-section king where I'm from. What I want to know is if there is less chance of rupture as time goes by, and would I be a good candidate for vba2c. Thanks I know Im reviving an old thread here, but I am working on conceiving another child and want a vbac when I get pregnant. My first pregnancy was almost 14 years ago. I was pregnant with twins and wound up having a c-section due to premature rupture of membranes at 26 weeks. My next pregnancy (over 4 years ago)was a c-section because the doctor insisted that I have one due to unknown type of incision(didnt know I had other options at the time). I tried to get my records recently and found out that the records were held onto for 10 years and are now gone. My obgyn said he couldnt get the records at the time but it was only about 9 years since my first delivery so I’m thinking he lied about my records not being found. He is sort of known as the c-section king where I’m from. What I want to know is if there is less chance of rupture as time goes by, and would I be a good candidate for vba2c. Thanks

]]> By: Quick Facts on VBACs | Olive Tree Midwifery http://vbacfacts.com/2010/07/21/acog-issues-less-restrictive-vbac-guidelines/comment-page-1/#comment-12922 Quick Facts on VBACs | Olive Tree Midwifery Fri, 05 Nov 2010 06:17:26 +0000 http://vbacfacts.com/?p=1309#comment-12922 [...] the American College of Obstetricians and Gynecologists (ACOG, 2010), VBAC is a “safe and appropriate choice for most women” with one prior cesarean and for “some women” with two prior cesareans.  Being pregnant with [...] [...] the American College of Obstetricians and Gynecologists (ACOG, 2010), VBAC is a “safe and appropriate choice for most women” with one prior cesarean and for “some women” with two prior cesareans.  Being pregnant with [...]

]]> By: john http://vbacfacts.com/2010/07/21/acog-issues-less-restrictive-vbac-guidelines/comment-page-1/#comment-8277 john Sun, 01 Aug 2010 11:31:24 +0000 http://vbacfacts.com/?p=1309#comment-8277 Thanks. Thanks.

]]> By: Jen Kamel http://vbacfacts.com/2010/07/21/acog-issues-less-restrictive-vbac-guidelines/comment-page-1/#comment-8124 Jen Kamel Fri, 23 Jul 2010 17:15:01 +0000 http://vbacfacts.com/?p=1309#comment-8124 Thanks Kmom! It's been hard to manage it with my adorable children pulling at my skirt, but this was to big not to mention! Thanks Kmom! It’s been hard to manage it with my adorable children pulling at my skirt, but this was to big not to mention!

]]> By: The WellRounded Mama http://vbacfacts.com/2010/07/21/acog-issues-less-restrictive-vbac-guidelines/comment-page-1/#comment-8123 The WellRounded Mama Fri, 23 Jul 2010 16:49:18 +0000 http://vbacfacts.com/?p=1309#comment-8123 I covered the new ACOG guidelines (and in particular, the changes about VBA2C) on my blog. http://wellroundedmama.blogspot.com/2010/07/about-damn-time-good-news-for-vaginal.html I agree that they have a long way to go to eradicate the harm that came from the "immediately available" change and they have GOT to be more aggressive about preventing more primary cesareans in the first place. Good to see you blogging again, Jen. I covered the new ACOG guidelines (and in particular, the changes about VBA2C) on my blog.

http://wellroundedmama.blogspot.com/2010/07/about-damn-time-good-news-for-vaginal.html

I agree that they have a long way to go to eradicate the harm that came from the “immediately available” change and they have GOT to be more aggressive about preventing more primary cesareans in the first place.

Good to see you blogging again, Jen.

]]> By: Jen Kamel http://vbacfacts.com/2010/07/21/acog-issues-less-restrictive-vbac-guidelines/comment-page-1/#comment-8096 Jen Kamel Fri, 23 Jul 2010 00:53:36 +0000 http://vbacfacts.com/?p=1309#comment-8096 Thanks CM! Thanks CM!

]]> By: Larissa http://vbacfacts.com/2010/07/21/acog-issues-less-restrictive-vbac-guidelines/comment-page-1/#comment-8095 Larissa Thu, 22 Jul 2010 23:49:20 +0000 http://vbacfacts.com/?p=1309#comment-8095 I agree that this bulletin is more sophisticated than the one it replaces (which is 54 by the way, not 45), but it isn't enough for ACOG to just back pedal and issue a new bulletin. The original "immediately available" bulletin had a huge impact on hospital policies, medical practice and women's health. As I said in my own blog entry about this issue, there is going to have to be a more deliberate effort to dial the cesarean rate back from where it is than what can be expected from the issuing of a practice bulletin such as this. Thanks for such a great site! I agree that this bulletin is more sophisticated than the one it replaces (which is 54 by the way, not 45), but it isn’t enough for ACOG to just back pedal and issue a new bulletin. The original “immediately available” bulletin had a huge impact on hospital policies, medical practice and women’s health.

As I said in my own blog entry about this issue, there is going to have to be a more deliberate effort to dial the cesarean rate back from where it is than what can be expected from the issuing of a practice bulletin such as this.

Thanks for such a great site!

]]> By: Courtroom Mama http://vbacfacts.com/2010/07/21/acog-issues-less-restrictive-vbac-guidelines/comment-page-1/#comment-8092 Courtroom Mama Thu, 22 Jul 2010 17:51:11 +0000 http://vbacfacts.com/?p=1309#comment-8092 Hey Jen - I just wanted to drop a line to let you know that I saw your hello comment on my blog, and that I've been reading your stuff for a very long time! I was inspired by Gina's most recent post to come over and say thank you for all your hard work for VBACing moms. Yours, CM Hey Jen –

I just wanted to drop a line to let you know that I saw your hello comment on my blog, and that I’ve been reading your stuff for a very long time! I was inspired by Gina’s most recent post to come over and say thank you for all your hard work for VBACing moms.

Yours,
CM

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