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DP doubting VBAC =/


16 replies to this topic

#1 teddyandarnie

Posted 14 May 2019 - 10:37 AM

I'm wanting to have a VBAC this time around.

My first was an emergency caesar as my DS was having complications. I have no regrets or traumas from my first birth.

When they went to pull DS out, he flipped around and tore a bit of my uterus - after my surgery it was left unclear as to whether I'd be able to have a VBAC or not next time around.

When discussing this with my GP he's recommended quite strongly (and in front of my DP) that I have an elective c-section this time due to the tear, and in my mind, used fear tactics with my partner so he'd try to coerce me into a c-section (told us all about uterine ruptures etc).

Of course DP now wants me to have a c-section as it's "not worth the risk" this is without us having any second opinions or even knowing what staff from my previous birth had said/recommended.

Has anyone been in a similar situation, and how did you handle it?

I'm wanting to talk to other professionals for a second opinion because I personally would love to attempt a VBAC this time. DP doesn't see the point in consulting others. It's really put me in a hard place.

We're only 15+2 so I've plenty of time to research/get additional opinions etc.

Tia

#2 Manicmum

Posted 14 May 2019 - 10:50 AM

I had a vbac. Ob suggested it, only 18 months after cs. It was ok but I wish I hadn’t. Now I’m scarred from two birth types.

#3 Soontobegran

Posted 14 May 2019 - 11:04 AM

If you had a uterine tear then I am afraid the obstetrician was obliged to tell you the risks associated with a VBAC.
It is more complicated than a VBAC following a straightforward C/S. That being said the risks are not huge.... I think 1-500 with a previous tear.
You have every right to decide that you are fine with that risk and insist on your VBAC but please understand that the risk might seem too high to your DH.
Your body, your choice but he probably just needs a lot of reassurance to be fine.
You will be monitored within an inch of your life.... that might sound awful to you but comforting to him.

Lots of good luck and congrats.

Efs

Edited by Soontobegran, 14 May 2019 - 11:07 AM.


#4 Thagomizer

Posted 14 May 2019 - 11:13 AM

I suppose the issue here is that your uterus has two different scars, in two different places, and one of them wasn't a 'controlled' cut, so they can't be sure how it's healed. I think that's a tough decision. The risk of uterine rupture along a previous c-section scar is 1/200 (so one in 200 women attempting a VBAC will tear). With a second scar, your chances may be higher.

What does your OB say? Where is the tear? Is it likely to rupture with labour? What did the OB say post-op about VBAC chances? Can s/he say how contractions are likely to affect the scar tissue of the second tear?

I'd say this is a tough call, and my decision would be based on the likelihood of the second scar also rupturing, and factors relating to it. I tried for a VBAC with my second but ended up with a RCS due to contractions not resulting in dilation, and my OB said my uterine scar was very thin and may have ruptured had I continued to labour.

I think you should definitely consult other doctors before making a call. You should speak to an OB at the very least, preferably someone with experience in VBACs. I don't think a GP is knowledgeable enough to make such a call. But I would be concerned about the unknown with that second scar, and want an OB's opinion before making a decision.

If you do go ahead with a VBAC, you should absolutely make sure you have constant foetal monitoring from the start of labour to the end. The best/only way to detect rupture is via foetal heartbeat monitoring, and given you have two scars on your uterus (one in a location that is usually not scarred in a VBAC), I would absolutely not risk a VBAC without constant foetal monitoring, a 24/7 theatre and a NICU.

#5 dreamweaver80

Posted 14 May 2019 - 12:10 PM

Hi, I'm sorry I don't have much advice but I am in a similar situation. I'm 15+1 weeks and had a c-section in February 2018. Mine was planned due to a few factors that could have caused complications with a vaginal birth but there's no indication that those factors will be present this time. I have consulted several medical professionals in this pregnancy so far (midwife, previous OB, our IVF doctor) and all have said that I could safely attempt a VBAC this time. I know I will be getting extra monitoring towards the end of pregnancy and should things not look ideal, I'll be booked for a section. Which puts my mind at ease.

Our situation is similar in that my partner seems to be on board but he doesn't understand why I just don't go the easy way. An elective c-section is a breeze and there was absolutely no pain, stress or worrying involved in ours. Baby was fine and I recovered beautifully.

I'm guessing your DP sees himself as the protector of your family (as mine and many others do!) and he doesn't want to see you or your baby in any danger or pain. It's very hard for men to deal with feeling inadequate and scared and that's exactly what childbirth is for them! Your previous birth sounds a bit traumatic and I really don't blame your DP for not wanting to repeat that experience. Try not to look at it as he's being stubborn or unreasonable, he just wants to keep you and baby safe. It's a black and white issue for men, go for the less risky option. Maybe speaking to him and addressing his emotions around this decision (as well as yours of course) would be the best way to at least let him agree to seek out a second or third opinion.

I agree with PP's that what a GP has said does not carry a lot of weight in this scenario. When I was pregnant with my son, I went to a GP for a referral and he told me I'd gotten pregnant too soon after a miscarriage. I had to inform him that I was under the care of one of the best IVF doctors in Australia who also is an expert in miscarriages and so would be the one I'd be listening to. Definitely speak to someone who has some expertise in this before you make any decisions.

Good luck and congratulations!!

#6 teddyandarnie

Posted 14 May 2019 - 12:16 PM

I haven't seen an OB yet, just my GP. I don't even know if my tear was a continuation of the cesarean incision, or a completely new rip/tear location.

Thank you all for your input, it has given me a lot to think about. I have absolutely no problem having amother c-section, but if I'm able to try for a VBAC that is definitely my preference.

I guess I need to go find an OB and get some other opinions now.

#7 teddyandarnie

Posted 14 May 2019 - 12:22 PM

Thank you dreamweaver80, I think I needed a bit of perspective, and I definitely think our first birth was more traumatic for DP than it was for me.

We did calm birth the first time around, and the lady who did our classes has been a midwife for 20+ years and is someone both DP and I trust quite a bit, I'm hoping to have a meeting with her about what she thinks in this scenario.

DS will be 2.5 when I'm due with this bub.

#8 Kallie88

Posted 14 May 2019 - 12:32 PM

I'd probably talk to dh, with something along the lines of "i understand your concerns. I feel very strongly about wanting to try a vbac. Let's get a second opinion from a specialist and if they agree with the gp then we'll go with c-sec, but if they say it's a reasonable risk I'll vbac"? That way you're both well informed and you aren't doubting the gp's knowledge and resenting a c-sec because you believe a vbac would have been fine.

#9 Soontobegran

Posted 14 May 2019 - 12:34 PM

View Postdreamweaver80, on 14 May 2019 - 12:10 PM, said:

Hi, I'm sorry I don't have much advice but I am in a similar situation. I'm 15+1 weeks and had a c-section in February 2018. Mine was planned due to a few factors that could have caused complications with a vaginal birth but there's no indication that those factors will be present this time. I have consulted several medical professionals in this pregnancy so far (midwife, previous OB, our IVF doctor) and all have said that I could safely attempt a VBAC this time. I know I will be getting extra monitoring towards the end of pregnancy and should things not look ideal, I'll be booked for a section. Which puts my mind at ease.

Our situation is similar in that my partner seems to be on board but he doesn't understand why I just don't go the easy way. An elective c-section is a breeze and there was absolutely no pain, stress or worrying involved in ours. Baby was fine and I recovered beautifully.

I'm guessing your DP sees himself as the protector of your family (as mine and many others do!) and he doesn't want to see you or your baby in any danger or pain. It's very hard for men to deal with feeling inadequate and scared and that's exactly what childbirth is for them! Your previous birth sounds a bit traumatic and I really don't blame your DP for not wanting to repeat that experience. Try not to look at it as he's being stubborn or unreasonable, he just wants to keep you and baby safe. It's a black and white issue for men, go for the less risky option. Maybe speaking to him and addressing his emotions around this decision (as well as yours of course) would be the best way to at least let him agree to seek out a second or third opinion.

I agree with PP's that what a GP has said does not carry a lot of weight in this scenario. When I was pregnant with my son, I went to a GP for a referral and he told me I'd gotten pregnant too soon after a miscarriage. I had to inform him that I was under the care of one of the best IVF doctors in Australia who also is an expert in miscarriages and so would be the one I'd be listening to. Definitely speak to someone who has some expertise in this before you make any decisions.

Good luck and congratulations!!

The GP’s opinion is just one that would be given by most medical personnel who have done obstetrics.
I would have said the same if someone had come to me.
If this is a long term GP they will have the surgical report from the C/S on the OP’s file.

Of course the Obstetrician might say something quite different.... some are more risk averse and of course the OP can still make her own choice. It’s all about being fully informed.

#10 CallMeFeral

Posted 14 May 2019 - 12:35 PM

He could be right, but in the end that was the opinion of a GP.

Seek out a good obstetrician who is experienced in VBACs (maybe ask around local mum groups as some will say they are supportive of something but the truth may be different). And whatever their advice, treat that seriously.

#11 Pocket...

Posted 14 May 2019 - 12:48 PM

I'd probably say to dh that you're not set on making a decision until you've seen your specialist, ie obstetrician, as they will be in a better position to advise regarding the specifics of your case. A GP isn't in a position to really do that anyway.

You'll be getting a second opinion whether your dh likes it or not as your gp wouldn't be managing your birth anyway.

I had one OB who was very against a vbac without looking into any of my previous birth history. He was well known not to like vbac. The head OB was very supportive of a vbac and spent time actually looking at my history and medical records.

The same OB, was keen for me to have a third child as I'd be a great candidate for a vba2c. He was pretty disappointed that I was definitely done lol.

I'd not worry about your dh for now. Wait until you've spoken to your OB and either their recommendations will be another section anyway, or they'll be supportive of a vbac and are in a good position to ease your DH's concerns.

#12 rosie28

Posted 14 May 2019 - 12:50 PM

I’d seek a second opinion from an OB but I think with a tear they’re likely to recommend a c section. The risks go up significantly with a tear.

Edited by rosie28, 14 May 2019 - 12:50 PM.


#13 Prancer is coming

Posted 14 May 2019 - 12:52 PM

The GP won’t be delivering your baby (well, I assume...) so you need to get the opinion of the person who will be delivering your baby.  Are you seeing the GP for shared care, going for appointments at hospital or have a private ob?  You want to be telling your medical team what you want and see if they think it is possible.  It might be, it might not, but at least if your ob/hospital is also unwilling, you know you have tried all you can.

#14 Luci

Posted 14 May 2019 - 02:10 PM

It is a tricky one OP because risk is such a personal thing. Some people would be fine with the level of risk associated with a VBAC in your situation but others wouldn't touch it with a 10 foot barge pole.

Uterine rupture is a genuine risk for someone in your situation. As mentioned by PP's I don't think it is that common but I assume if it does occur it can become a very serious emergency situation. I don't think your GP was necessarily using "scare tactics" by informing you of a potentially very serious risk.

I agree that it's a good idea to get a second opinion, preferably from an OB. You could also contact the hospital where you had your first baby and obtain a copy of your medical record to see if it mentions anything about the previous tear. Good luck in reaching a decision.

#15 MoonPie

Posted 14 May 2019 - 02:36 PM

OP if you are in WA I can give you the name of a wonderful Ob who would be great to have this chat with.

#16 teddyandarnie

Posted 14 May 2019 - 04:02 PM

View PostMoonPie, on 14 May 2019 - 02:36 PM, said:

OP if you are in WA I can give you the name of a wonderful Ob who would be great to have this chat with.

I'm in NSW, but thank you

It wasn't necessarily telling about the possibility of a uterine rupture that I saw as 'scare tactics' more how it was said and the conversation following. He was definitely appealing to my DP and not at all taking into consideration how I felt (I didn't get told that it happens 1/200 or anything).
He is my long term GP (been seeing him since I was 5, I'm now in my twenties) and dones have a copy of my birth records, but these weren't looked at during my consult with him.

I will eventually have hospital visits with midwives, and I know I'll have to birth at the same hospital I had DS at because I'm high risk.

Thank you again for all your input =)

#17 cabbage88

Posted 14 May 2019 - 09:10 PM

A GP is rarely in a great position to bed making those recommendations, it's an OB you need to ask. Its strange they said the baby caused the tear- how is that any different to a c section wound? It's not like you tore from labour, which is a totally different risk factor.
VBAC has a uterine rupture rate of about 1 in 200. Its extremely low. and when ruptures occur, the incidence of them being life threatening to mum and bub is quite low too.
Talk to the OB and do your research. I'm choosing vbac because the overall risks are better than a repeat c sect, and I will probably have more kids.



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