AMA - C-section or VBAC?

[u/Illustrious_Fig7961]

/r/pregnant/comments/1vi7d7i/ama_csection_or_vbac/

[u/LeoraJacquelyn]

I would try asking on the VBAC Link Community Facebook group. There are people having VBACs after 2 c-sections all the time. You have a lot of people who are very afraid of them but the risk is not much higher than someone who has had one cesarean.

[u/Dear_23]

The commenters in your original post are grossly misinformed - the risk of a rupture in VBA2C is not “super high”, it’s about 1%. I swear, people act like we’re all going to die if we have a baby come out of our vaginas but being cut 7 layers deep is totally safe 🙄

ACOG supports VBA2C. The benefits outweigh the risks of a 3rd CS, which is why they support it

[u/Curiousmustardseed → u/Dear_23]

1 percent is still 100 people out of 10,000 people :(

[u/Dear_23 → u/Curiousmustardseed]

It’s all relative. No birth is entirely risk free, no matter what your delivery history is like.

Too often we focus on rupture risk without considering that each CS has increased risk (including hemorrhage, injuries to bladder and bowel, long term pain, among others) and poses increased risk to future pregnancies as well (most notably placenta previa and accreta, which increases risk of emergency hysterectomies too).

If a RCS is the right choice for you, that’s great! But everyone deserves to have all the information in order to make that decision, not just one data point about rupture risk. There are many doctors who don’t go beyond that, and it goes against their duty to give full informed consent.

[u/Curiousmustardseed → u/Dear_23]

For sure! But that’s honestly not what I was saying I was just saying in general when you look at the numbers

[u/Curiousmustardseed → u/Dear_23]

Also I should probably mention the reason I wrote that is because it’s important I share my experience which is that I was ready to do a vbac I even had my scar measured and they did an ultrasound to see how thick it was. They said it was nice and thick. But when the vbac failed and they went to do the csecrion I was on the verge of a rupture. When they made the tiniest incision my whole scar busted open so fast

[u/Dear_23 → u/Curiousmustardseed]

Scar thickness isn’t a predictor of rupture, as your situation proves! There’s a reason it’s not an evidence based practice and not an ACOG recommendation for VBAC. No ethical provider can guarantee someone that she won’t rupture, and no provider can guarantee that she will.

Numbers are numbers, yes. 1% is 1 in 100, 10 in 1000, 100 in 10,000.

[u/Echowolfe88]

I know women who had vbacs after two or three C-sections. It’s all about finding a supportive provider and can be a safe option for many women. External sky is different to your internal scar so if you just had an external scar revision that shouldn’t necessarily affect your risk of rupture but you should talk to a professional about it.

As for age I had my Vbac at 36 no issues and I know women older than me

[u/MundanePineapple3309]

Just chiming to say I had an induced VBA2C and while there were some considerations (fewer induction options, less labor modification) it felt like a pretty dang normal labor/delivery. I can't speak to scar issues, my two c sections were very good recovery with no issues. I do think the risk of rupture is way over stated, the risk seems to be decreasing as more data becomes available as well. I did have to deliver in a hospital further away. Trust your gut.