Discuss with OB. I think you are asking if a vaginal delivery is safe after having had a prior c-section. The clinical thinking on this has changed in the past several years, and you should certainly discuss this at some length with the doctor who is going to delivery the baby. Have a good delivery and a great baby.
Risky for baby. A trial of labor after one prior cesarean section has inherent risks for the fetus and the mother, but may be a wise choice if you are planning to have many more pregnancies. The risk of uterine rupture with one prior kerr cesarean section and trial of labor is 1/200 attempts, but the outcome can be very poor in affected cases. This does not apply to twins, vertical scars, or >1 prior cesareans.
I have been doing some research on vbac. If the percentage of uterine rupture is so low, why does it seem like doctors still do not prefer to perform them?
Uterine rupture fear. Because of the fear of uterine rupture (risk is 1 per 110-200 patients trying labor after prior c-section), the american college of obstetricians and gynecologists had recommended that vbac only be "attempted in institutions equipped to respond to emergencies", so doctors were not comfortable doing vbac in case a life-threatening emergency were to result, and some hospitals did not allow vbac's.
Risk. Many doctors still do vbac with proper council. The risk of uterine rupture is about 1% for spont. Labor, 2% for augmented labor and 4% for induced labor. This is low. The concern is the consequence of uterine rupture. 50% catastrophic results, loss of mother, loss of baby or lifetime neurological injury to baby! Many but not all couples are willing to accept those risks.
Immed available. Because the consequences can be catastrophic - death or disability to both mother and child. This is why acog recommends an md be immediately available during a vbac. Since most obstreticians can't be in the hospital 24/7, most prudently decline to vbac. If you have a obgyn who can commit and you are an appropriate candidate, vbac's can be highly successful.
Liability concerns. Although the absolute risk for uterine rupture after one prior kerr cesarean section is 1/200, that risk increases with short inter-pregnancy interval, more than once prior cesarean, non-kerr prior c-section, induced labor and likely with multifetal pregnancy (not clear). Also, if this occurs the outcome is potentially lethal for fetus and/or mother, so you can imagine why it is not appealing.
What are the statistics on fetal demise and permanent damage to baby with uterine rupture/vbac? Not risk %. Actual statistics
1/700-1/1, 000. Great question - the numbers are approximately one order of magnitude greater with trial of labor after a cesarean as compared to a repeat prelabor cesarean delivery: 1/1, 000 vs. 1/10, 000. In other words, rarely is the fetus compromised/dies, but repeat cesarean is clearly safer for the fetus. Talk to your OB to decide on the best plan for you, taking into account how many more babies you want.
How dangerous is a pregancy after uterine rupture? 1st baby born normally, 2nd c-section, 3rd vbac attempt which resulted in stillbirth.
High risk pregnancy. Your physician there will know your specifics and if you are even advised to get pregnant again. Many women in your situation are advised against future pregnancies!
Depends. If you have had a catastrophic uterine rupture with a fetal demise from tolac already, please accept my belated condolences and consider yourself lucky to be alive and well (get op report!). You are now definitely high-risk and merit management by a board-certified maternal-fetal medicine specialist with any future pregnancies - most should turn out well with a scheduled prelabor cesarean @36 week.
Is a 2nd c sec or a vbac prefered? I have heart probs and took atenolol 1st preg. And what are other risks besides uterine rupture?
Not much else. The risk of rupture is not common but is probably the likely risk with a second C section. The decision should be made by the OB considering your risks at and around delivery.
Depends. If you had a low transverse c-section, VBAC can be appropriate, and the risk of uterine rupture is low. Be sure to speak with your OB to determine which option is best for you. Hope this helps!
VBAC safety. Criteria for VBAC: 1.No more than 2 low transverse cesarean deliveries. 2.No additional uterine scars, anomalies or previous ruptures. 3.Your doctor should be prepared to monitor labor and perform or refer for a cesarean if necessary4.no major medical problems.5.single baby, normal size with head down Risk of uterine rupture with VBAC is 1 chance in 500. 60-80% success rate. Hospital may not allow.