Risks for VBA3C Vs 4th Csect

[Charmzy]

Can someone please help me out, I'm trying to find out my risks for a VBA3C vs 4th csect.

I also have to include I have a history of Pre-elcampsia / PRegnancy induced hypertension in all 3 prev pregnancys and had gestational diabetes in the last pregnancy.

There were complications with the last csect they said my uterus was thin (a lot thinner than they expected), a lot of scar tissue had pushed things around inside too so I'm actually looking at a classical csect this time they wont do a 4th bikini incision.

I would LOVE to have a VBA3C but dont really know where to start. I'm in melbourne.

can anyone help me please

[BellyBelly]

If you want a VBA3C I think your only chance is with a private midwife... check out http://www.maternitycoalition.org.au and click the link to MIPPs (midwives in private practice). Ridiculously you probably wont find an Ob to do it, rupture rate is 0.7% after the first c/s and 0.9% after that and it doesn't increase anymore no matter how many you have had. Yet the more c/s you have, the much higher the risk of haemorrage, hysterectomy etc, it increases substantially... yet Ob's prefer surgery. Because they are surgeons.

There are loads of links in the VBAC and labour forums to help empower you especially for women wanting a VBAC after several c/s. Its yours for the taking you'll just need a private midwife.

ETA: Sorry just re-read your post. You'll likely have a huge fight on your hands as you'll be classed too high risk with a history of pre-eclampsia, but I would still be talking to private midwives so that you can have the most nurturing and empowered experience, and someone to bounce off the medical questions with who wants to help you have a normal birth as possible. If you have a classical c/s you wont be able to give birth vaginally anymore, the rupture rate is so much higher.

Have you considered acupuncture? They actually can do work on your scar.

[Charmzy]

thanks for the reply ill check out the link you gave me.

Do you know why PE makes it more of a fight for VBAC? if my BP happened to stay ok this time would that help my chances of having a VBA3C?

I've never heard of accupuncture for it,what will that do?

[BellyBelly]

You'd have to speak to some of those midwives I think, to get some accurate medical info, but from a doctors perspective you are a minefield and you'll probably get massive resistance, women get it with standard VBAC's as it is... so you'd need to make sure you do lots of research on this. Grab a copy of Silent Knife if you can and The Thinking Woman's Guide to a Better Birth.... a low GI diet should help you, its good for everyone really, as well as regular exercise... you'll have to bring out the big guns

[gardeningkate]

Go Girl Go!!! I am going for VBAC 2 rather than CS3, and I have no other complications except for big babies (I am tall and not afraid, to me that is not a complication) and I have already experienced plenty of emotional bullying and manipulation of statistics, not just from doctors but from people in the community. I am going to take a private midwife (who I found on the maternity coalition website) with me to the hospital after labouring at home for a bit, to help me interpret with an unbiased eye what happens during my birth, I too have been told that my scar is jagged and too thin, and this is by the doctor I just saw, who had nothing to do with my CS last time, I should have asked him if he had xray vision!!
In short, do what you need to do, whether it be CS or VBAC, as long as it is YOUR CHOISE and you have not been forced into it!!
Good luck, and the midwives I have sought advice from on this website forum and the maternity coalition have been incredibly realistic, supportive and informative!!
Good luck again,
Kate

[gardeningkate]

Oh, the ob at my appt yesterday (I knew I was in for resistance) told me I was recalcitrant, and irresponsible, I just sat there and smiled at him and said "I know, I know, and I'm not changing my mind" His arguments actually got more and more ridiculous, and I just sat there smiling, I was fuming and shaking inside of course, eventually he gave up and said well they couldn't force me but weren't happy, to which I smiled and said, I'm not here for your happiness am I....
However, I have been told to go to another hospital, which will probably be the Royal Women's, so that could work for me anyway, I am not doing it to prove a point, I am doing it because I believe I can and don't need a CS, I guess we'll see how things go!
Kate

[Justin Keane]

Hi All,
Acupuncture helps with scars by facilitating the flow of Qi and blood to the area around and under the scar. Thereby diminishing the total area effected by the scar tissue. Energetically this is very important as a scar represents a type of stagnation and the concept of meridian theory requires gentle, harmonious, uninterrupted movement of qi and blood throughout and around the body.

[Lea79]

I sympathise with the resistance you have encountered. As Kelly said, there will be no way that a Ob will agree to give you a vbac after 3 c/s. They just need to control the situation rather than work in partnership with you as an independent midwife can. Sure, there are risks with your past PE/GDM and 3 c/s but there are ways to do this safely and if your condition deteriorates the latter may be an option but the most important thing is for you to make an informed decision about what is best for you and your baby. Make sure you get all the information you can from professionals who work with you not against you. I hope that you have luck in your quest to have a lovely birth.

Leanne

[hoobley]

This might sound a stupid question, but how did they diagnose your PE?

I only ask because when i was PG i had PIH and they watched my urine like hawks the whole way through (i never even had a TRACE of protien). ANyway, i noticed on my pre-labour notes they had in the home visits of the last few weeks they'd copied out a section from my hossie notes which HAD said "BP up again, PE?" and they had copied "BP up again. PE." and it took a heck of a lot of arguing, a round of blood tests and a trip in for monitoring to convince them i JUST had high BP, NOT PE. I have since learned that even though you're supposed to have at least 2 of the 3 signs (edema, high BP, protien in urine) AND a positive blood test for liver function problems for them to dx PE, they often do it on ONE sign alone, never mind a blood test.

This might not be the case with you, but it might be worth getting your pregnancy notes from the hospital, and taking them to a private midwife. I have a MW friend in Germany who often deliveres previous "PE" women because she says there is zero evidence in their blood results from the time that they ever actually had it.

Bx

[Justin Keane]

Charmzy,
I'm sure you will will birth this child in a way you are at peace with, another note on acupuncture and Chinese med. it can assist in controlling the patterns behind edema and elevated blood pressure. With your desired outcomes I would advise you to recieve constant (TCM) treatment (along w private midwife care) to help create and maintain the environment that these patterns do not arise in this pregnancy. If you are anywhere near BB pg ctr, come in and have a chat, or ask you MW to refer you to an acupuncturist! All the best to you I will follow your story with interest.

[Snacks]

Ooh, great point, Bx. I booked in at the hospital the other day and told the middie that I had PIH last time round. She put 'previous PE' on my notes! I said, 'It wasn't PE, it was just high BP!' But I don't think she changed it...
Good luck to you, Charmzy, in your research. (Hope to catch up with your goss in our belly buddies thread )

[BellyBelly]

Sharmaine one of our other TCM therapists emailed me this about c/s scars:

Hi Kelly

Acupuncture helps to increase the blood and qi flow to the area and surrounding tissue and can help break up adhesions. *Scars are thick fibrous tissue that get little blood flow the scar and to get blood flowing to the area the healing of the scar and surrounding tissue. Treatment can involve needling directly into the scar tissue to help break up adhesions or can be inserted next to the scar angled toward the scar so that it penetrates the layers beneath the surface of the scar (under the scar - where the scar tissue is forming). *Massaging the scar every day will also help to keep the blood and qi moving in the area. The scar will not totally disappear, but there will be visible changes over time and the scarring will usually not be as thick or fibrous.

Cheers

Shar

[BellyBelly]

Sharmaine one of our other TCM therapists emailed me this about c/s scars:

Hi Kelly

Acupuncture helps to increase the blood and qi flow to the area and surrounding tissue and can help break up adhesions. *Scars are thick fibrous tissue that get little blood flow the scar and to get blood flowing to the area the healing of the scar and surrounding tissue. Treatment can involve needling directly into the scar tissue to help break up adhesions or can be inserted next to the scar angled toward the scar so that it penetrates the layers beneath the surface of the scar (under the scar - where the scar tissue is forming). *Massaging the scar every day will also help to keep the blood and qi moving in the area. The scar will not totally disappear, but there will be visible changes over time and the scarring will usually not be as thick or fibrous.

Cheers

Shar