Comments for VBAC Facts http://vbacfacts.com 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 Comment on A father says, Why invite the risk of VBAC? by Jen Kamel http://vbacfacts.com/2011/11/07/a-father-says-why-invite-the-risk-of-vbac/comment-page-1/#comment-80368 Jen Kamel Mon, 21 May 2012 06:08:41 +0000 http://vbacfacts.com/?p=1546#comment-80368 Carly, To go through surgery, and the increased risks that come with repeat cesareans and VBACs, all because your OB had a flight to catch. It is a real shame. The increased risks that come with post-cesarean pregnancies are real. Just to clarify, the risk of uterine rupture in a non-induced/augmented VBAC after one prior low transverse ("bikini") cut cesarean is 0.4% (1 in 240 trail of labors after a cesarean) per Landon 2004. There are some that believe that you can measure the <a href="http://vbacfacts.com/2009/01/17/predicting-uterine-rupture-via-sonogram-to-measure-uterine-thickness/" rel="nofollow">thickness of your uterine scar</a> and gauge your risk of rupture, but the studies that have been performed are not large enough to accurately measure rupture. The <a href="http://vbacfacts.com/2012/04/11/best-compilation-of-vbac-research-to-date/" rel="nofollow">Guise 2010 Evidence Report</a> does discuss uterine scar thickness, so you might be interested in reading what they had to say. To my knowledge, there is no way to accurately measure the strength of a scar by looking at it or performing any other test. But new information is always being discovered. Just be sure to know and read the source that people cite when they write things that seem to good to be true. If it doesn't pass the smell test, dig deeper!! Warmly, Jen Carly,

To go through surgery, and the increased risks that come with repeat cesareans and VBACs, all because your OB had a flight to catch. It is a real shame. The increased risks that come with post-cesarean pregnancies are real.

Just to clarify, the risk of uterine rupture in a non-induced/augmented VBAC after one prior low transverse (“bikini”) cut cesarean is 0.4% (1 in 240 trail of labors after a cesarean) per Landon 2004.

There are some that believe that you can measure the thickness of your uterine scar and gauge your risk of rupture, but the studies that have been performed are not large enough to accurately measure rupture. The Guise 2010 Evidence Report does discuss uterine scar thickness, so you might be interested in reading what they had to say.

To my knowledge, there is no way to accurately measure the strength of a scar by looking at it or performing any other test. But new information is always being discovered. Just be sure to know and read the source that people cite when they write things that seem to good to be true. If it doesn’t pass the smell test, dig deeper!!

Warmly,

Jen

]]> Comment on A father says, Why invite the risk of VBAC? by Jen Kamel http://vbacfacts.com/2011/11/07/a-father-says-why-invite-the-risk-of-vbac/comment-page-1/#comment-80366 Jen Kamel Mon, 21 May 2012 05:58:44 +0000 http://vbacfacts.com/?p=1546#comment-80366 Carly, Deciding where to birth is a very difficult choice especially if you do not have a hospital based provider who is supportive of VBAC. The risks of hospital birth are very different than the risks of home birth. I don't know if you read these two articles, but I write in more detail about the risks and benefits, including the factors to consider when thinking of your distance to a hospital, <a href="http://vbacfacts.com/hbac/" rel="nofollow">here</a> and <a href="http://vbacfacts.com/2008/09/06/homebirth-vs-hospital-birth-for-the-number-cruncher/" rel="nofollow">here</a>. You might also want to share the many articles I have that may be helpful to <a href="http://vbacfacts.com/category/vbac/resources-for-unsupportive-family-members/" rel="nofollow">unsupportive family members</a>. Best of luck with your decision and birth. Please keep me posted! Warmly, Jen Carly,

Deciding where to birth is a very difficult choice especially if you do not have a hospital based provider who is supportive of VBAC. The risks of hospital birth are very different than the risks of home birth. I don’t know if you read these two articles, but I write in more detail about the risks and benefits, including the factors to consider when thinking of your distance to a hospital, here and here.

You might also want to share the many articles I have that may be helpful to unsupportive family members.

Best of luck with your decision and birth. Please keep me posted!

Warmly,

Jen

]]> Comment on Placenta problems in VBAMC/ after multiple repeat cesareans by Jen Kamel http://vbacfacts.com/2012/03/30/placenta-problems-in-vbamc-after-multiple-repeat-cesareans/comment-page-1/#comment-80365 Jen Kamel Mon, 21 May 2012 05:53:02 +0000 http://vbacfacts.com/?p=1353#comment-80365 Sarah, I am so sorry. That is the secret truth about post-cesarean births. VBAC is a very important option especially for moms planning large families. It is unfortunate that family size is often not considered when moms are faced with their first post cesarean birth. As you know, once a mom has two cesareans, the number of providers willing to attend her VBACs greatly diminish if not totally disappear. It is my goal to share the information I have on this site so that women may understand the ramifications of post-cesarean birth options and how their future birth options are massively impacted by their current mode of delivery. Warmly, Jen Sarah,

I am so sorry. That is the secret truth about post-cesarean births. VBAC is a very important option especially for moms planning large families. It is unfortunate that family size is often not considered when moms are faced with their first post cesarean birth. As you know, once a mom has two cesareans, the number of providers willing to attend her VBACs greatly diminish if not totally disappear. It is my goal to share the information I have on this site so that women may understand the ramifications of post-cesarean birth options and how their future birth options are massively impacted by their current mode of delivery.

Warmly,

Jen

]]> Comment on Celebrity VBAC: Kate Winslet by Jen Kamel http://vbacfacts.com/2008/05/11/celebrity-vbac-kate-winslet/comment-page-1/#comment-80363 Jen Kamel Mon, 21 May 2012 05:47:33 +0000 http://vbacfacts.com/2008/05/11/celebrity-vbac-kate-winslet/#comment-80363 Michelle, Congratulations! That is wonderful that your doctor supported vaginal delivery of twins! Warmly, Jen Michelle,

Congratulations! That is wonderful that your doctor supported vaginal delivery of twins!

Warmly,

Jen

]]> Comment on Finding a VBAC Supportive OB or Midwife by Jen Kamel http://vbacfacts.com/2008/03/08/finding-a-vbac-supportive-ob-or-midwife/comment-page-1/#comment-80362 Jen Kamel Mon, 21 May 2012 05:45:30 +0000 http://vbacfacts.com/2008/03/08/finding-a-vbac-supportive-ob-or-midwife/#comment-80362 Jenn, Sounds like you have a great plan in place! Best of luck and keep me posted! Warmly, Jen Jenn,

Sounds like you have a great plan in place! Best of luck and keep me posted!

Warmly,

Jen

]]> Comment on A father says, Why invite the risk of VBAC? by Carly http://vbacfacts.com/2011/11/07/a-father-says-why-invite-the-risk-of-vbac/comment-page-1/#comment-79625 Carly Mon, 14 May 2012 16:49:07 +0000 http://vbacfacts.com/?p=1546#comment-79625 Sorry, I should have mentioned. My previous c-section was not because of complications, my Dr and I had not been in aggreence almost my entire pregnancy, but because we prepaid we thought it wasn't worth the trouble to switch Dr.s, boy were we wrong. She had a plane to catch and my natural birthing ways were getting on her and the nursing staffs nerves, after being in the hospital thirty minutes she declared that my baby's heart rate was fluctuating too much and I needed an emergency c section. I asked for a second opinion, which I never got and told her that mine and the baby's heart rates might be fluctuating due to her screaming in my delivery room after I for the third time refused induction. So off to surgery I went.... Oh and did I mention she had a plane to catch!? So I have no bad medical history, my baby and I were both healthy all through pregnancy, and I am not overweight. So I guess I'm saying after my research it would seem I am a good candidate for VBAC. Just scared that I might be that .05%!! Is there any way to tell by how your scar healed or if it is still sensitive that you might rupture, seems silly, but I read lots of things before visiting your site? Sorry, I should have mentioned. My previous c-section was not because of complications, my Dr and I had not been in aggreence almost my entire pregnancy, but because we prepaid we thought it wasn’t worth the trouble to switch Dr.s, boy were we wrong. She had a plane to catch and my natural birthing ways were getting on her and the nursing staffs nerves, after being in the hospital thirty minutes she declared that my baby’s heart rate was fluctuating too much and I needed an emergency c section. I asked for a second opinion, which I never got and told her that mine and the baby’s heart rates might be fluctuating due to her screaming in my delivery room after I for the third time refused induction. So off to surgery I went…. Oh and did I mention she had a plane to catch!? So I have no bad medical history, my baby and I were both healthy all through pregnancy, and I am not overweight. So I guess I’m saying after my research it would seem I am a good candidate for VBAC. Just scared that I might be that .05%!! Is there any way to tell by how your scar healed or if it is still sensitive that you might rupture, seems silly, but I read lots of things before visiting your site?

]]> Comment on A father says, Why invite the risk of VBAC? by Carly http://vbacfacts.com/2011/11/07/a-father-says-why-invite-the-risk-of-vbac/comment-page-1/#comment-79623 Carly Mon, 14 May 2012 16:38:12 +0000 http://vbacfacts.com/?p=1546#comment-79623 I have been reading and researching and making phone calls for months, I live in Houston and am 4 months pregnant with our second child. Our first was a c-section. I wanted to have the first at home, but husband and family were not on board. Now I am stuck in this awkward battle, I feel in my heart that I should have this baby at home, but what if I am wrong? What if I am one of the ones who will rupture, we live twenty minutes from the nearest hospital, but the midwife I have been speaking with assures me that is not too far. Because she would be listening very closely to the baby's heart. My husband and family are with the majority who think it is selfish to even try, that we should just go to the hospital try to have our VBAC, (even though we could not find a truly supportive provider,) and if it doesn't work out I'll already be there to have my 2nd c-section. What do I do? Do I trust myself or listen to my family? How can I help them understand? How do I get my husband on my side? Thank you for all of this wonderful information . It's nice to see it all on one site after spending months looking through too many others that didn't seem fact based. Keep us in your prayers any one who reads this please! I have been reading and researching and making phone calls for months, I live in Houston and am 4 months pregnant with our second child. Our first was a c-section. I wanted to have the first at home, but husband and family were not on board. Now I am stuck in this awkward battle, I feel in my heart that I should have this baby at home, but what if I am wrong? What if I am one of the ones who will rupture, we live twenty minutes from the nearest hospital, but the midwife I have been speaking with assures me that is not too far. Because she would be listening very closely to the baby’s heart. My husband and family are with the majority who think it is selfish to even try, that we should just go to the hospital try to have our VBAC, (even though we could not find a truly supportive provider,) and if it doesn’t work out I’ll already be there to have my 2nd c-section. What do I do? Do I trust myself or listen to my family? How can I help them understand? How do I get my husband on my side?

Thank you for all of this wonderful information . It’s nice to see it all on one site after spending months looking through too many others that didn’t seem fact based.

Keep us in your prayers any one who reads this please!

]]> Comment on Placenta problems in VBAMC/ after multiple repeat cesareans by sarah http://vbacfacts.com/2012/03/30/placenta-problems-in-vbamc-after-multiple-repeat-cesareans/comment-page-1/#comment-79490 sarah Sat, 12 May 2012 13:02:33 +0000 http://vbacfacts.com/?p=1353#comment-79490 Dina, I'm so sorry you were lied to! I was as well. My dr told me that VBACs were incredibly dangerous and that it was safe to have 9 cesareans. She told me that the risks do not increase and then downplayed the initial risks. She didn't tell me about placenta problems, either. Since then I've had a hard time finding an OB willing to do repeat cesareans on me (nor do they want to do VBACs) and are shocked I was "allowed" to get pregnant with my fifth, sixth and seventh pregnancies. Like you, if I had known I would have insisted on that first VBAC. She was frank breech but only 5 lbs/34 weeks and I was nearing transition. I'm now a doula and training to be a midwife and hope to help women educate themselves as well! Dina, I’m so sorry you were lied to! I was as well. My dr told me that VBACs were incredibly dangerous and that it was safe to have 9 cesareans. She told me that the risks do not increase and then downplayed the initial risks. She didn’t tell me about placenta problems, either. Since then I’ve had a hard time finding an OB willing to do repeat cesareans on me (nor do they want to do VBACs) and are shocked I was “allowed” to get pregnant with my fifth, sixth and seventh pregnancies. Like you, if I had known I would have insisted on that first VBAC. She was frank breech but only 5 lbs/34 weeks and I was nearing transition. I’m now a doula and training to be a midwife and hope to help women educate themselves as well!

]]> Comment on Celebrity VBAC: Kate Winslet by Michelle http://vbacfacts.com/2008/05/11/celebrity-vbac-kate-winslet/comment-page-1/#comment-78820 Michelle Mon, 07 May 2012 19:04:07 +0000 http://vbacfacts.com/2008/05/11/celebrity-vbac-kate-winslet/#comment-78820 I was fortunate not to have a c-section. I was told that with my twins that I would most likely. Their reasoning is twins it was safer with twins, I was pre-term. A laundry list. I had my previous 3 boys in a small town. Completely natural, no drugs all labors over 16hrs. The doctors beleived in complete natural, unless emergent. Mine would say "When the fruit is ripe it will drop" God desighned us to deliver naturally. My twins became very medical.I had to sign a paper stating I understood the risk of vaginal delivery.They put an epidural in right as we were going into delivery room. Just in case. It felt abnormal having them slow my delivery & telling me to push.I was terrified of C-Section, I completely sympathize with you. Babies were healthy, boys both 6lb9oz & 19",exact same size,they are'nt identicals. Only problem is their breathing was weak, because of the epi-dural I never wanted. Im so glad you were able to have a successful VBAC. I was fortunate not to have a c-section. I was told that with my twins that I would most likely. Their reasoning is twins it was safer with twins, I was pre-term. A laundry list. I had my previous 3 boys in a small town. Completely natural, no drugs all labors over 16hrs. The doctors beleived in complete natural, unless emergent. Mine would say “When the fruit is ripe it will drop” God desighned us to deliver naturally. My twins became very medical.I had to sign a paper stating I understood the risk of vaginal delivery.They put an epidural in right as we were going into delivery room. Just in case. It felt abnormal having them slow my delivery & telling me to push.I was terrified of C-Section, I completely sympathize with you. Babies were healthy, boys both 6lb9oz & 19″,exact same size,they are’nt identicals. Only problem is their breathing was weak, because of the epi-dural I never wanted. Im so glad you were able to have a successful VBAC.

]]> Comment on Finding a VBAC Supportive OB or Midwife by Jenn http://vbacfacts.com/2008/03/08/finding-a-vbac-supportive-ob-or-midwife/comment-page-1/#comment-78425 Jenn Fri, 04 May 2012 17:37:38 +0000 http://vbacfacts.com/2008/03/08/finding-a-vbac-supportive-ob-or-midwife/#comment-78425 Yes, I am currently in the care of a very good provider, almost halfway through my second pregnancy at this point. She gave me the go-ahead at this point for a VBAC, and the university hospital I am delivering at has a 90%+ VBAC success rate, which is just amazing! I am torn about the requirement for continuous fetal monitoring, because I'm extremely physically active and don't anticipate doing labor well strapped to a bed, but after reading many birth stories realize it's not something to butt heads about ahead of time, but when the time comes I can ask to take a short walk, quick shower, or go to the bathroom as needed. And if the VBAC success rate is 90% with this requirement in place, clearly it's not something that is prohibitive. Yes, I am currently in the care of a very good provider, almost halfway through my second pregnancy at this point. She gave me the go-ahead at this point for a VBAC, and the university hospital I am delivering at has a 90%+ VBAC success rate, which is just amazing! I am torn about the requirement for continuous fetal monitoring, because I’m extremely physically active and don’t anticipate doing labor well strapped to a bed, but after reading many birth stories realize it’s not something to butt heads about ahead of time, but when the time comes I can ask to take a short walk, quick shower, or go to the bathroom as needed. And if the VBAC success rate is 90% with this requirement in place, clearly it’s not something that is prohibitive.

]]> Comment on The Role of Interpretation – ACOG Refines Fetal Heart Rate Monitoring Guidelines by Jenn http://vbacfacts.com/2009/06/24/the-role-of-interpretation-acog-refines-fetal-heart-rate-monitoring-guidelines/comment-page-1/#comment-78423 Jenn Fri, 04 May 2012 17:31:53 +0000 http://vbacfacts.com/2009/06/24/the-role-of-interpretation-acog-refines-fetal-heart-rate-monitoring-guidelines/#comment-78423 Thank you! Oh yes I know about placenta accreta. I am in the situation where my first c-section was medically necessary (severe pre-eclampsia/beginning HELLP) but the hospital/OB was very anti-vbac, so I had to change both to find a vbac friendly environment, but my husband picked up from the previous environment that vbac's are dangerous and my having to change doctors and hospital makes him nervous. Outlining the risks of other things that can go wrong during any vaginal delivery makes uterine rupture not stand out so much as the worst thing in the world or a reason not to try for a vbac. I do have the NIH statement on hand, and also the Department of heath and human services evidence report which gathered the background evidence for the NIH conference - actually I didn't see it on your resource website, so here that is as well (though I'm sure it's in your stash somewhere!). I haven't made it through the whole report yet (400 pages) but what I have read is really interesting. http://www.ahrq.gov/downloads/pub/evidence/pdf/vbacup/vbacup.pdf Thank you again! Thank you! Oh yes I know about placenta accreta. I am in the situation where my first c-section was medically necessary (severe pre-eclampsia/beginning HELLP) but the hospital/OB was very anti-vbac, so I had to change both to find a vbac friendly environment, but my husband picked up from the previous environment that vbac’s are dangerous and my having to change doctors and hospital makes him nervous. Outlining the risks of other things that can go wrong during any vaginal delivery makes uterine rupture not stand out so much as the worst thing in the world or a reason not to try for a vbac.
I do have the NIH statement on hand, and also the Department of heath and human services evidence report which gathered the background evidence for the NIH conference – actually I didn’t see it on your resource website, so here that is as well (though I’m sure it’s in your stash somewhere!). I haven’t made it through the whole report yet (400 pages) but what I have read is really interesting.

http://www.ahrq.gov/downloads/pub/evidence/pdf/vbacup/vbacup.pdf

Thank you again!

]]> Comment on Quick Facts by Jen Kamel http://vbacfacts.com/quick-facts/comment-page-1/#comment-78308 Jen Kamel Thu, 03 May 2012 19:16:55 +0000 http://vbacfacts.com/vbac/quick-facts-vbac-vs-repeat-cesarean/#comment-78308 Renee, I am not a medical professional, but if your OB who did your cesarean said you were a candidate for VBAC, I would trust that. Every birth is different. Just because you pushed for three hours and had a cesarean with your first, does not mean that will happen again. There are many variables at play during labor and delivery. Use the links I gave you above to find the names of VBAC supportive care providers that are in the area you are moving to. Then you can bring your medical records and operative report, ask them the questions I linked to above, and see what they think. I would talk to at least 3 to get an idea of their opinions and see whose policies you like better. As your OB said, all docs are different. This is key! So, shop around and pick a care provider who you like and trust based on their responses to the questions I link to above. Best of luck! Warmly, Jen Renee,

I am not a medical professional, but if your OB who did your cesarean said you were a candidate for VBAC, I would trust that. Every birth is different. Just because you pushed for three hours and had a cesarean with your first, does not mean that will happen again. There are many variables at play during labor and delivery.

Use the links I gave you above to find the names of VBAC supportive care providers that are in the area you are moving to. Then you can bring your medical records and operative report, ask them the questions I linked to above, and see what they think. I would talk to at least 3 to get an idea of their opinions and see whose policies you like better. As your OB said, all docs are different. This is key! So, shop around and pick a care provider who you like and trust based on their responses to the questions I link to above.

Best of luck!

Warmly,

Jen

]]> Comment on Quick Facts by Renee http://vbacfacts.com/quick-facts/comment-page-1/#comment-78286 Renee Thu, 03 May 2012 15:11:20 +0000 http://vbacfacts.com/vbac/quick-facts-vbac-vs-repeat-cesarean/#comment-78286 Finally got an answer, #1 was the gestational diabetes, #2 failure to descend (which confused me they said I stopped dilating, however I pushed for 3 hours...) and because my son was 7 12.2 they stated my son was too large (my midwive here says that's average). I am having the report sent to me, and also the doc as a side note when speaking to the nurse today said her medical opinion was that I could attempt a VBAC but that all docs are different. Any other advice? I'm confused on the whole I stopped dilating but they had me push thing.... Finally got an answer, #1 was the gestational diabetes, #2 failure to descend (which confused me they said I stopped dilating, however I pushed for 3 hours…) and because my son was 7 12.2 they stated my son was too large (my midwive here says that’s average). I am having the report sent to me, and also the doc as a side note when speaking to the nurse today said her medical opinion was that I could attempt a VBAC but that all docs are different.

Any other advice? I’m confused on the whole I stopped dilating but they had me push thing….

]]> Comment on Quick Facts by Renee http://vbacfacts.com/quick-facts/comment-page-1/#comment-78280 Renee Thu, 03 May 2012 14:02:02 +0000 http://vbacfacts.com/vbac/quick-facts-vbac-vs-repeat-cesarean/#comment-78280 Update: They called back and stated even my chart did not indicate why it was needed it only stated i was coming in for an induction and that was it. They said would consult the doctor to see if they can help. So i'm guessing either someone messed up or i'm hitting a dead end apparently they are just as clueless. Update: They called back and stated even my chart did not indicate why it was needed it only stated i was coming in for an induction and that was it. They said would consult the doctor to see if they can help. So i’m guessing either someone messed up or i’m hitting a dead end apparently they are just as clueless.

]]> Comment on Quick Facts by Renee http://vbacfacts.com/quick-facts/comment-page-1/#comment-78264 Renee Thu, 03 May 2012 11:23:48 +0000 http://vbacfacts.com/vbac/quick-facts-vbac-vs-repeat-cesarean/#comment-78264 Hello Jen, Yes we got the operative report and it did not give a reason. The midwife I am seeing stated she thought it sounded like he would not fit because I pushed for 3 hours and was told to have a c section. She also advised it based on the fact that I was a GD the first time and have early GD the second time, however my son was average size last time, but she stated babies get larger with each pregnancy and said that if the first didn't fit the second wouldn't either and said she felt i would be better off not attempting a VBAC. I am not having my second baby here due to moving but my husband wants us to research so we can get a better answer other then based on speculation. The doc who delivered my son did make comments of she didn't know why he wouldn't decend and that she thought it could be becuase i was swelling alot vaginally. she even stated she wasn't going to attempt to assist (not sure what she meant maybe forceps, or such? i don't get why a doctor would be concerned) but short of that never understood why and again this wasn't listed in the report. which the midwive thought was odd, other then maybe a page was missing. I called, but are they allowed to get this info to me over the phone? Hello Jen,
Yes we got the operative report and it did not give a reason. The midwife I am seeing stated she thought it sounded like he would not fit because I pushed for 3 hours and was told to have a c section. She also advised it based on the fact that I was a GD the first time and have early GD the second time, however my son was average size last time, but she stated babies get larger with each pregnancy and said that if the first didn’t fit the second wouldn’t either and said she felt i would be better off not attempting a VBAC. I am not having my second baby here due to moving but my husband wants us to research so we can get a better answer other then based on speculation. The doc who delivered my son did make comments of she didn’t know why he wouldn’t decend and that she thought it could be becuase i was swelling alot vaginally. she even stated she wasn’t going to attempt to assist (not sure what she meant maybe forceps, or such? i don’t get why a doctor would be concerned) but short of that never understood why and again this wasn’t listed in the report. which the midwive thought was odd, other then maybe a page was missing. I called, but are they allowed to get this info to me over the phone?

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