Ask the Birth Guru

Needless to say this has freaked me out!!!!! I have never personally spoke with someone who had this happen.Up until now they were just those stories you would here about from a doctor or an article trying to scare you.Has anyone ever actually heard from someone who has had this happen or a friend of a friend?

I have a 17 year old but could not get pregnant again for years.Then I had one misscarriage and 2 ectopics(one which ruptured and I nearly died from)and was told I could no longer have any children because of the missing tube and other damaged ectopic tube.Three doctors said unless a miracle happened or I did IVF forget it.

Well I got my miracles.My miracle daughter of 4 now and this surprise miracle pregnancy.I had alot of serious problems with both of my other pregnancys.So far I am having a problem free pregnancy this time.I really think I would loose my mind if I lost my baby in such a tragic way.I seriously doubt I could get pregnant again,so this is my last baby.I was all set on having a vba2c until being FREAKED out by this post.Now I am at a loss as to what to think or do about my own pregnancy.
Any suggestions or support would be appreciated.
Chris due 10/9

However, the stats are on your side (and they were on hers too). The BJM has just released a new study that shows that U/R is less common than previously believed. I have not had time to dissect it, and I have not seen any comments from Henci on it yet. However, here is the link:

http://bmj.bmjjournals.com/cgi/content/full/329/7456/19

I was just a doula for a woman who had a successful VBAC (unmedicated) - it was *hard* work. Her baby wasn't in the greatest position and transition and pushing were an enormous challenge. She did it after pushing for 2 1/2 hours. She told me afterwards that she thought about asking for an epidural at the worst point in her labor - she had such a hard time pushing the baby out (and I had her in about 10 different positions which helped the baby move into a better position finally) that I'm pretty sure she would have ended up with a c-section had she had an epidural. She also thought during pushing about just telling the doctor to do another c-section. After the birth, she was *so* happy she had done it.

But she was even happier when she heard what her friend - who was having an elective repeat c-section that very day at the same hospital - went through. There was so much scar tissue that the operation took twice as long as it was supposed to. The doctor had to use forceps AND the vacuum to get the baby out. A nurse in the OR apparently freaked out when she saw how much force the doctor was using to get the baby out that she started screaming for another doctor. After getting the baby out, they spent an hour scraping scar tissue off her uterus. The baby had some injuries, the extent of which are not known yet. The baby was so sleepy (probably from the narcotics in the spinal) that she wouldn't breastfeed, so they had already given her formula in the first day of her life.

Moral of the story: c-sections are *not* the risk-free alternative to VBAC. VBAC is as safe (if not safer) than repeat c-sections for the baby and MORE safe for the mother. I also get REALLY irritated that doctors don't usually bother mentioning the risks of each additional c-section to the *next* baby that a woman might have which are significant.

I think the medical community tends to minimize the risks of c-sections because they feel that they can compensate for any complications they might encounter. The key to having as safe a VBAC as possible is to *minimize* interventions as much as possible (if not avoid them altogether), particularly induction, and particularly induction with prostaglandins (cervidil, prepidil, cytotec).

Your own pregnancy losses could well have resulted from your 1st c/sec. Infertility, ectopic pregnancy, and miscarriage are more common after c/sec as is late fetal death. In fact, there is a new phenomenon actually called c/sec scar ectopic pregnancy where the pregnancy develops within the scar. Placental attachment problems that threaten the life of the baby (placenta overlaying the cervix, placenta coming away from the uterus before birth, placenta invading the uterine muscle and even growing through the uterus) are also more common as are other life-threatening conditions in babies such as persistent pulmonary hypertension. The only difference between your sad losses and this woman's tragedy is that you probably didn't know that your losses could well have been because of your c/sec.

-- Henci