What a miracle this woman survived! This was her fifth baby and fourth cesarean.
She had a complication known as placenta percreta which is when “the placenta attaches itself and grows through the uterus, sometimes extending to nearby organs, such as the bladder” (March of Dimes 2012). The risk of having placenta accreta, increta, or percreta during a fourth cesarean or a VBA3C (vaginal birth after three cesareans) is 2.13% (1 in 47) (Silver 2006).
Most women planning a VBA1C (vaginal birth after one cesarean) are aware of the risks of uterine rupture. However, women planning their first vaginal birth […]
Some new research questions the idea that women who are “too posh to push” are responsible for America’s rising cesarean rate. The work of University of Arizona sociologist Louise Roth has been featured in an University of Arizona UA News article dated April 13, 2012.
Watch for Roth’s research which will be “published in the May issue of the sociology journal Social Problems, published by the Society for the Study of Social Problems.”
I’ve highlighted a few passages for those who like to skim.
By Jeff Harrison, University Communications, April 13, 2012
UA sociologist Louise Roth says the increasing […]
I thought that I would take the data from the Silver (2006) that I’ve previously discussed and share it in a different way that would be helpful to women with multiple prior cesareans. (You might find it worthwhile to read this article specifically, where you can view the data below in graphs, as well as other articles on placental abnormalities first.) Remember that accreta is when the placenta abnormality deeply attaches into the uterus requiring surgical removal. There is a 7% maternal mortality rate with accreta as well as a high rate of hemorrhage and hysterectomy. One of the […]
If primary and secondary cesarean rates continue to rise as they have in recent years, by 2020 the cesarean delivery rate will be 56.2%, and there will be an additional 6236 placenta previas, 4504 placenta accretas, and 130 maternal deaths annually. The rise in these complications will lag behind the rise in cesareans by approximately 6 years. […]
Per Silver (2006), “The risks of placenta accreta, cystotomy [surgical incision of the urinary bladder], bowel injury, ureteral [ureters are muscular ducts that propel urine from the kidneys to the urinary bladder] injury, and ileus [disruption of the normal propulsive gastrointestinal motor activity], the need for postoperative ventilation, intensive care unit admission, hysterectomy, and blood transfusion requiring 4 or more units, and the duration of operative time and hospital stay significantly increased with increasing number of cesarean deliveries.” […]
There is this idea that if you don’t VBAC and you schedule a repeat cesarean, that you will be safe from complications. This is because during a “VBAC counsel,” women are often told of the risks of VBAC, namely uterine rupture, but they are rarely told the risks of repeat cesareans in their current and future pregnancies.
Abnormal placental implantation is one risk of cesareans that only present themselves when you get pregnant again.
Women who expect to only have two children, and thus opt for a repeat cesarean, might think that not VBACing is the safer, and more controlled […]
This information is so important for any woman seeking VBAC. It’s not enough that your hospital “allows” VBAC. In order to see how supportive that hospital is of vaginal birth, you need to know what their VBAC rate is in addition to their primary CS rate. Be sure to read, “Why if your hospital ‘allows’ VBAC isn’t enough” for more information as well as I’m pregnant and want a VBAC, what do I do?.
From 2006 to 2007, the total cesarean rate increased from 27.9% to 28.8% and the primary cesarean rate grew from 16.6% to 17.1 whereas the […]
This is a great piece for deciding between VBAC and repeat cesarean. Those who wish to VBAC, but have husbands, family, and/or friends who don’t understand why, might find this document very useful. I have found that people who are anti-VBAC really seem impressed by what doctors and medical organizations have to say, so I’m thinking they will find this document compelling. Plus, VBAC has this reputation of being “risky” and repeat cesareans are thought of as the “conservative approach,” and this document challenges both lines of thinking. Why not write a sweet little note like, “I know you are […]
This is a comprehensive article on adhesions which is a fancy word for scar tissue. I think the most relevant points of this whole discussion are:
Adhesions “develop in 93% of people who have undergone pelvic surgery” and “they are especially common after cesarean sections.” You get more adhesions with each cesarean. Adhesions can cause: Pelvic or Abdominal Pain Bowel Obstruction Infertility Adhesions impact future cesareans by making the surgery longer which can put your baby at risk in an emergency situation (emphasis mine): “If you have had a cesarean section and are pregnant or planning to have another child, […]
We all know the primary risk of VBAC – uterine rupture. And when your typical VBACing mom meets with an OB, she must sign a “VBAC consent form” acknowledging that she understands this risk. However, I find it ironic that women signing up for a repeat cesarean are not required by their OB to sign a “Repeat Cesarean Section consent form” as a matter of course during prenatal exams since there are risks associated with cesarean section. But since this does not happen, and most OBs breeze over the risks if they even bother to mention them, expectant moms are […]