[JulieRN07]

I was hoping to get your input on how common it is that a VBAC ends up causing uterine rupture?- Is this something that you've seen?-and how does it turn out when it does happen?

Thanks!

[eden]

Hmm, I think the rates depend on where you go. I see you are in the US and from what I've read on this board, the US doesn't seem to favour VBACs. If properly monitored they are safe (less then 1% risk of rupture, all things being ideal).

Where I am we do a fair number of them. We have strict guidelines for who can even be a candidate and with proper screening you can eliminate most of those who are poor candidates for a VBAC. They are also very closely monitored and no VBAC are done out in the rural communities.

Ironically the only rupture I've ever seen was on a prime.

[pirap]

I personally had a VBAC and I work PP and have MANY friends in L/D. They have not had a rupture in a very long time. They have had "alot" of pulmonary embolisms and "pulmonary flashes" or something like that name lately.

I pretty much refused a repeat C/S. I am a diabetic and had to be induced with Pitocin-which they did and when I had a prolonged contraction they quickly turned off the Pit and waited. 2 hours later the pit was back on. Delivered fine. I think they say no to ALL cervical ripening agents at our facility on VBAC's though. I don't really think doc's like to do them because its probably easier to schedule the cut. I WAS scheduled for a C/S the day after Thanksgiving last year and I went in on that Friday morning and had a nonstress test..all fine..basically got sick with worry about a repeat C/S and said NO..but I did say yes to induction with a possible C/S(it's always possible!) the following Wednesday. VBAC was the BEST delivery I ever had..Vag with #1, C/S with #2 and VBAC with #3!!

Sorry for the personal story..I am just all for the VBAC when it is appropriate and possible for the woman who wants a vaginal delivery. If you are asking because you are facing a repeat C/S I encourage you to educate yourself but I felt totally safe and never had a regret about it!

[beckinben]

IMO - yes, VBACs are pretty safe. So are c/sections. On the flip side of that - VBACs carry some risks and c/sections carry some risks. Someone who chooses a VBAC over a c/section, or a repeat c/s over a VBAC, is choosing one set of risks over another. What I believe often happens is that the risk of VBACs are "hyped" a little more than the risks of c/sections.

I've seen a few ruptures. So far (knock on wood) all have ended OK for baby and mom. I have also seen one rupture with a pitocin induction - no prior c/section, no uterine surgery. Only risk factor was the pitocin.

[PRESLA]

Depends on the comfort level of the pt and MD at the time of labor. No pitocin used on a VBAC and an OB managing the pt not a GP.

Lisa

[Elvish]

I have personally never seen a uterine rupture with a VBAC. I have, however, seen a uterine rupture along the previous c/s incision (mom was at home, not in labor).

We do many many TOLACs where I am, and most are successful. I am really proud of that.

[SmilingBluEyes]

I think with proper prenatal care and a thorough understanding of patient history, VBAC is VERY safe. We do VBAC/TOLAC where I am and they succeed a majority of the time!

[queenjean]

I had a pp mom today; c-section number 5. I can't believe having five sections is good for your body. I don't know her story--whether she chose the four subsequent sections or if it was because our facility no longer attends VBACs. But wow, 5 sections. That's got to be hard on a uterus. I can't believe she hasn't had any problems thus far. I hope her next pregnancy (if there is on) goes as smoothly.

[JulieRN07]

I agree! 5 c-sections? Wow- I might be more afraid of that then a VBAC.

[queenjean]

I know. I believe that hospitals' decisions not to attend VBACs are directly responsible for many of the problems that women will experience as we see more and more mothers with numerous c-sections. You cannot tell me that under most circumstances a vbac is less safe than pregnancy and repeat section following several previous sections.