VBAC after two C-sections?
We are TTC #3. I really want to have a vaginal birth this time (if I do end up pregnant) but I've had 2 c-sections in the past.
Actually, VBACs are recommended for women with two previous cesareans...
"In keeping with past recommendations, most women with one previous cesarean delivery with a low-transverse incision are candidates for and should be counseled about VBAC and offered a TOLAC. In addition, the College guidelines now clearly say that women with two previous low-transverse cesarean incisions, women carrying twins, and women with an unknown type of uterine scar are considered appropriate candidates for a TOLAC."
Although uterine rupture is certainly a risk, it has to be viewed in conjunction with the risks of multiple cesareans.
"In making plans for delivery, physicians and patients should consider a woman's chance of a successful VBAC as well as the risk of complications from a trial of labor, all viewed in the context of her future reproductive plans," said Dr. Ecker. Approximately 60-80% of appropriate candidates who attempt VBAC will be successful. A VBAC avoids major abdominal surgery, lowers a woman's risk of hemorrhage and infection, and shortens postpartum recovery. It may also help women avoid the possible future risks of having multiple cesareans such as hysterectomy, bowel and bladder injury, transfusion, infection, and abnormal placenta conditions (placenta previa and placenta accreta).
Both repeat cesarean and a TOLAC carry risks including maternal hemorrhage, infection, operative injury, blood clots, hysterectomy, and death. Most maternal injury that occurs during a TOLAC happens when a repeat cesarean becomes necessary after the TOLAC fails. A successful VBAC has fewer complications than an elective repeat cesarean while a failed TOLAC has more complications than an elective repeat cesarean."
It's certainly each woman's decision how she wants her baby to be born but it's important that women get ACCURATE information on the risks of ERCs and benefits of VBACs and vice versa. Any time a doctor makes that decision for a woman (phrases like "not a option," "too risky," or an unbalanced view of risks such as talking up the risks of a VBAC without properly explaining the risks of an ERC, etc), she's not able to give informed consent. How can you make an informed decision if you don't know all the information? As a doula, my rule of thumb is that if a woman is not equally terrified of each option, she's not been given balanced information.
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I am currently pregnant with my third. My first was an emergency and second was elective which was 17months ago. I am due in May and I have researched and found a doc and hospital that are pro vbacs, especially after two c-sections. I also have a doula. I am lucky cause she is also my best friend.
Do your research and get as much information as you can.
A few things I have learnt is that you will be closely monitored throughout the labour and will need to go into labour naturally. They will not induce as it puts added pressure on the uterus.
I will be having a birth plan for both vbac2 and csection.
I hope you find a doc that is supportive of your decision.
My first was an emergency (which ones aren't typically??) but my second was not. Baby was breech and we planned to have a c-section for other reasons. I just don't want to go through that all again. :-(
@Ms.Marrero, it's very likely that a VBA2C isn't an option for your OB, not you... Unless you were less than 3-9 months postpartum when you became pregnant again and/or your incision is vertical, there's no (common) reason why your doctor should recommend against it. Some doctors just don't believe in evidence-based medicine because of their own
limited experience or liability reasons. Have you considered finding a pro-VBAC doctor or midwife?
Just a higher chance of uterine rupture I think. Unjust really don't want to be cut open again. :-(
Thanks ladies! I really hope so but I doubt my doctor will be supportive. Maybe I need to find a new doctor. I really don't want another c-section!!!
^^That's great! I just wish that everyone was so well-informed (regardless of which route they choose to take!). =)