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Mar. 28th, 2006

(I did this up very quickly, so if anyone has anything intelligent to add, please do so).



VBAC and scar integrity,
or "Why my uterus isn't going to explode"


People keep approaching me with "honest concern" regarding risk of rupture in a VBAC. Unfortunately, not a single one of these people has told me something that is true. There are many myths about c-sections and VBACs, most of which are perpetuated by caregivers forced to only offer repeat c-sections for liability and VBAC bans.
I started gathering information some time ago, so perhaps some of it will clear the air regarding certain myths and rumors.

Myth: It takes two years or more for uterine scar tissue to heal.
Fact: Your uterus is just like any other cut that is bound with stitches or staples, and does all the healing it's going to in the first few weeks. While a few studies suggest that the risk of rupture (more on what "rupture" is later) is higher if you get pregnant within 18 months, it is still far less than 1%, and while it is often recommended to wait, this does not reflect whether or not a real risk exists following initial healing.
Most authorities agree that by the time your fertility returns (2-3+ months), conception happens and the uterus begins to expand (12 weeks), healing is done. The gentle pressure of a slowly expanding uterus is unlikely to cause any damage, and since we don't go into labour immediately following conception it's likely a year or more would have passed since the surgery. Healing can continue even during pregnancy.

(taken from Birthlove.com)
From BIRTH AFTER CESAREAN by Bruce Flamm:
"Rumor has it that its safer to wait several years after a cesearen section before attempting a vaginal birth. There's absolutely no evidence for this belief. Studies on wound healing have shown that tissue regains the majority of its strength within a few weeks of an operation. The tissue that gives a healing wound its strength is called collagen. According to a general surgery textbook, 'Collagen content of the wound tissues rises rapidly between the sixth and the seventeenth days but increase very little after the seventeenth day and none at all after the forty-second day.' Since the uterine scar is almost fully healed within weeks after a cesarean section there is no reason to postpone plans for another baby."


Myth: If you rupture, you and your baby will die.
Fact: Catastrophic ruptures are extremely rare, and much more likely if you have oxytocin induction, cyotec, prostaglandins or lay flat on your back unable to move around. Included in rupture statistics is harmless and asymptomatic dehiscences, which unfairly skews the numbers. When people think of rupture they think of a uterus imploding, they don't think of scar tissue pulling away from where it's gotten stuck, or a small break that heals easily and poses no risk to mother or baby. Dehiscences are the most common type of "rupture", by far. It is usually diagnosed when a second c-section is performed or the doctor physically puts his hand inside a woman's uterus and feels around after birth. Some evidence suggests that many dehiscences actually occur before labour begins.

Catastrophic rupture (the dangerous kind) more often happens due to uterine integrity as a whole (with the vast majority following labour augmentation). The cases of true rupture are not the 1-2% figure we hear all the time, that is for dehiscences.
When a true rupture occurs, a cesarean must occur within 30 minutes (ideally 20) to prevent neurological damage to the baby. Death does not occur immediately. Most women attempting a home VBAC are well within 20-30 minutes of a hospital, particularly if 911 is called.

'A Guide to Effective Care in Pregnancy and Childbirth', which is a well-respected summary of evidence-based practice, says that the rate of reported uterine rupture has ranged from 0.09% to 0.8% for women with a single baby, head-down, who planned a vaginal birth after one previous lower-segment cesarean. The authors comment:

"To put these rates into perspective, the probability of requiring an emergency cesarean section for acute other conditions(fetal distress, cord prolapse, or antepartum hemorrhage) in any woman giving birth, is approximately 2.7%, or up to 30 times as high as the risk of uterine rupture with a planned vaginal birth after cesarean"



What does this mean for women who want a VBAC? Up to 99.91% of you will labour normally.
True rupture is not asymptomatic, and the first signs are a steadily falling heart rate (now heavily debated over whether or not this is a true indicator) and/or intense pain that you'll feel even with an epidural. While external fetal monitors, in theory, are meant to catch this kind of thing as it happens - they often do not. External fetal monitoring has not been shown to save any lives, and has only been shown to increase the amount of unnecessary c-sections being performed. It is just as effective, and safer overall, to have a nurse or midwife come in every so often and have a listen with the doppler or fetoscope - particularly during a contraction. This also keeps you off your back, where you are often strictly told to stay if you are hooked up to EFM. This position increases your chances of complications. Move around! Stay hydrated! Stay strong! Avoid drugs! Labour isn't made so you that you can lie back with your feet up.
Home dopplers and fetoscopes are available to rent or buy. Fetoscopes can be purchased online or at any medical supply store for $30 or under, and home dopplers can be rented for as little as $35-$40 a month. Do keep in mind that dopplers, being ultrasound, carry risks. A fetoscope poses no risk to the baby.

Risk of rupture also depends on the type of incision you received. Except in rare cases, modern c-sections are performed by low transverse incision (a horizontal scar just along your pubic bone, usually hidden by a bikini). The risk is highest with a vertical incision over the middle of the stomach. This requires more healing time as well.

VBAC.com reads:
Overall, attempted vaginal birth for women with a single previous low transverse cesarean section is associated with a lower risk of complications for both mother and baby than routine repeat cesarean section. The morbidity associated with successful vaginal birth is about one-fifth that of elective cesarean. Failed trials of labor, with subsequent cesarean section, involve almost twice the morbidity of elective section, but the lower morbidity in the 80% of women who successfully give birth vaginally means that overall women who opt for a planned vaginal birth after cesarean suffer only half the morbidity of women who undergo an elective cesarean section.

What does this mean? A repeat c-section is more dangerous than a VBAC. The problem is we don't hear that very often. Some women are only ever offered a repeat c-section by their doctors. If they are truly only ever done in event of "emergencies", how can one justify the risk of denying a woman a VBAC when it is clearly the safest route for both mother and baby?

A 10-year population-based study of uterine rupture.
Obstet Gynecol 2001 Apr;97(4 Suppl 1):S69
Baskett TF, Kieser KE.
Dalhousie University, Halifax, Nova Scotia, Canada

Objective: To review the incidence, associated factors, and morbidity associated with uterine rupture.Methods: A 10-year (1988-1997) population-based review of 114,933 deliveries in one province.

Results: There were 39 ruptures: 16 complete and 23 dehiscence. Thirty-seven cases had undergone a previous cesarean delivery (34 lower transverse, 2 classical, 1 low vertical). Of the 114,933 deliveries, 11,585 (10%) were to women with a previous cesarean delivery. The incidence of uterine rupture in those undergoing a trial for vaginal delivery (4,516) was complete rupture (3/1000) and dehiscence (5/1000). Induction or augmentation of labor with oxytocics was associated with 50% of complete ruptures and 25% of dehiscence. There were no maternal deaths, but 33% of patients with complete ruptures required blood transfusion. There was one neonatal death attributable to uterine rupture.

Conclusion: Induction and augmentation of labor are confirmed as risk factors for uterine rupture. Fetal heart rate abnormality was the most reliable diagnostic aid. Serious maternal and perinatal morbidity was relatively low.

PMID: 11275210


Shamelessly stolen from Norwegian_wood's journal:
Here are some statistics to put the risk of rupture in perspective:

* Your risk of rupture from a horizontal LSCS scar is: 1% = 1 in 100 VBAC deliveries (this is the highest statistic)
* Your risk of being diagnosed with dystocia (baby too big) is: 10 - 12% = 10 in 100 vaginal deliveries
* Your risk of a breech baby at full term is: 3 - 7% = 3 in 100 deliveries
* The risk of your baby being diagnosed with fetal distress during labour: 2% = 2 in 100 deliveries
* Your risk of having twins is : 0.4% = 4 in 1000 births
* Your risk of dying from a rupture of the uterus is: 0.0095% = 9.5 in 100 000 VBAC deliveries
* Your risk of dying during any vaginal delivery is: 0.0098% = 9.8 in 100 000 vaginal deliveries


( re-read that one, "Your risk of dying in ANY vaginal delivery is 9.8 in 100,000, compared to a death risk of 9.5 in 100,000 with a VBAC" )

* Your risk of dying during an uncomplicated vaginal delivery is: 0.0049% = 4.9 in 100 000 uncomplicated vaginal delivery.
* Your risk of dying during any ceasarean section is: 0.0409% = 40.0 in 100 000 ceasarean sections
* Your risk of dying during an elective repeat ceasarean section: 0.0184% = 18.4 in 100 000 elective csecs
* The risk of your baby developing cerebal palsy is: 0.25% = 2.5 in 1000 births
* The risk of your baby developing cerebal palsy after fetal distress: 2.84% = 2.8 in 100 fetal distress births
* The risk of your baby dying from a rupture of the uterus is: 0.095% = 9.5 in 10 000 VBAC deliveries
* The risk of your baby dying during any VBAC delivery is : 0.2% = 2 in 1000 VBAC births
* The risk of your baby dying during any type of delivery is: 0.12% = 1.2 in 1000 births



Articles & Links:
Vaginal Birth after 2 or More Cesareans
An excellent and informative research-based read analyzing studies, pitocin use and risks of true ruptures versus that of dehiscences. Addresses risks in both VBA1C and VBA2+C.
Twin VBAC not associated with increased risk of rupture
VBAC safe for women with twin pregnancies
Mothering: Fighting VBAC-lash
The Integrity of Caesarean Scars - Originally posted as a reply in a forum, is now an article with a thought-provoking look at the idea that the uterus doesn't heal the same way the rest of the human body does.
Mothering: Cesarean and VBAC index
Birthlove: VBAC is safe!
ICAN: International Cesarean Awareness Network

For those of you convinced that a doctor would only ever have your best interests in mind, I suggest you read articles like this one published in October 2000 entitled, "Getting a Stubborn Patient to Say Yes". This article has since been reposted in many VBAC communities to make women aware of the manipulation tactics that may be used against them.

Don't take your doctor's word for it when he says, "You can't have a VBAC" or, "A VBAC is dangerous". Don't take anyone else's word for it when they say "no one in this town will let you have one". Interview, ask, push and shove - you have the right to the safest birth for your baby.
Many midwives will oversee a home, center or hospital VBAC and you can switch to a midwife at any point during your pregnancy, even when your due date is approaching.
Remember, home is safest as far as your risk for dangerous interventions. There's no chance of pitocin induction, epidurals or being kept on your back when you're pacing your own bedroom. Homebirth has been proven to be as safe if not much safer than hospital birth.

Read, educate and inform yourself of the facts so you can be prepared the next time someone tries to scare you out of the best birth for your baby with myths and wives tales. Knowledge is power.

Comments

( 117 comments — Leave a comment )
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prime_radiant
Mar. 28th, 2006 10:53 pm (UTC)
I love your livejournal. I do have to say this though:
"Labour isn't made so you that you can lie back with your feet up."

But pregnancy is! Hahaha no, just kidding. Although it's nice to lie around, but mainly because I'm lazy.
babyslime
Mar. 28th, 2006 10:58 pm (UTC)
Heh. ;)

If you were a marathon runner, about to enter your first big race, would you sit on the couch eating junk food for the nine months prior to your big day? Probably not, and if you did they'd all laugh at you. Your body would be weak by comparison to your competitors who had been training both mentally and physically for their race. You could get lucky and win anyway, but chances are you'd tire out really easily, your legs would be cramping up, you'd be out of breath and want to just give in.

Birth is your marathon: we should be "training" for it. Exercise and a great diet are our track and field, then we'll have no doubts about making it to the end. :)
(no subject) - prime_radiant - Mar. 28th, 2006 11:12 pm (UTC) - Expand
(no subject) - jeannegrrl - Mar. 29th, 2006 02:08 am (UTC) - Expand
(no subject) - babyslime - Mar. 29th, 2006 03:49 am (UTC) - Expand
(no subject) - habibekindheart - Mar. 29th, 2006 08:40 am (UTC) - Expand
(no subject) - breakableheart - Mar. 29th, 2006 04:15 am (UTC) - Expand
cerise_blue
Mar. 28th, 2006 10:55 pm (UTC)
thank you so much for posting this. mind if i add it to my memories? i'm planning a VBAC [of course, i'm not even pregnant again yet] and will probably want this for reference. :)
babyslime
Mar. 28th, 2006 10:59 pm (UTC)
Hell no, memory away!
I'm just so sick of, "Did you know if you VBAC you'll hemorrhage and die?" and "I'm a nurse/was a nurse/know a nurse/have once spoken to a nurse and therefore know without a doubt that VBAC is the most dangerous thing you can do" that I had to put this up to reference people to.
(no subject) - cerise_blue - Mar. 28th, 2006 11:50 pm (UTC) - Expand
(no subject) - habibekindheart - Mar. 29th, 2006 08:45 am (UTC) - Expand
(no subject) - babyslime - Mar. 29th, 2006 06:14 pm (UTC) - Expand
preachan_sidhe
Mar. 28th, 2006 11:00 pm (UTC)
Thank you so much for posting this. I don't usually comment, though i do read you regularily. :) But I had to say something this time. I'm hoping to have one more child and getting my gumption/resources together ahead of time to plan a VBAC and this is both encouraging and will be useful artillery.
erinmdmd
Mar. 28th, 2006 11:05 pm (UTC)
Thanks for compiling all this info in one place. I don't judge women who research and choose a repeat C-section, or who are told VBAC is not a possibility. I do despise misinformation, and the seemingly endless number of people that honestly believe that VBAC=death wish.

I already had n-w's post in my memories, now I'll add this one :-) I love all the things you both take the time to write out :-)
babyslime
Mar. 28th, 2006 11:08 pm (UTC)
I don't like to judge informed choices either, but some of them I just don't understand. For instance, elective repeat c-section.

To me it just seems like, "Instead of going the safest route for myself and my baby, I think I'll undergo major surgery and up both of our chances of dying by 10-fold, prolong and worsen my recovery time, and put any future children at higher risk for complications."
I guess I just really, really don't understand that mindset.
(no subject) - prime_radiant - Mar. 28th, 2006 11:13 pm (UTC) - Expand
(no subject) - babyslime - Mar. 28th, 2006 11:15 pm (UTC) - Expand
(no subject) - miriam_torason - Mar. 28th, 2006 11:21 pm (UTC) - Expand
(no subject) - prime_radiant - Mar. 28th, 2006 11:49 pm (UTC) - Expand
(no subject) - miriam_torason - Mar. 28th, 2006 11:55 pm (UTC) - Expand
(no subject) - babyslime - Mar. 28th, 2006 11:56 pm (UTC) - Expand
(no subject) - miriam_torason - Mar. 28th, 2006 11:59 pm (UTC) - Expand
(no subject) - prime_radiant - Mar. 29th, 2006 01:41 am (UTC) - Expand
(no subject) - miriam_torason - Mar. 29th, 2006 01:53 am (UTC) - Expand
(no subject) - erinmdmd - Mar. 28th, 2006 11:22 pm (UTC) - Expand
(no subject) - prime_radiant - Mar. 28th, 2006 11:47 pm (UTC) - Expand
(no subject) - erinmdmd - Mar. 28th, 2006 11:19 pm (UTC) - Expand
(no subject) - babyslime - Mar. 28th, 2006 11:29 pm (UTC) - Expand
(no subject) - erinmdmd - Mar. 28th, 2006 11:32 pm (UTC) - Expand
(no subject) - babyslime - Mar. 28th, 2006 11:37 pm (UTC) - Expand
(no subject) - erinmdmd - Mar. 29th, 2006 01:21 am (UTC) - Expand
timmytm
Mar. 28th, 2006 11:11 pm (UTC)
One ceaserean section is dangerous. I fail to see how a second is somehow "better". It's still the same dangerous open surgery.
on_a_hill
Mar. 28th, 2006 11:11 pm (UTC)
oh PLEASE post is birth_is_normal........this entry ROCKS!
babyslime
Mar. 28th, 2006 11:41 pm (UTC)
:) Okay.
ever_abstract
Mar. 28th, 2006 11:27 pm (UTC)
Slightly OT: Do you have any links regarding plus-size women homebirthing and/or unassisted birthing? I just found out last week that a lot of people seem to think that being chubby contraindicates normal childbirth.

I've always been under the impression that anyone can develop gestational diabetes or hypertension and both of which can (to some extent) be prevented with good diet, exercise, etc. I know I'm still 7 months away from TTC, but I'm all freaked out about it.
babyslime
Mar. 28th, 2006 11:32 pm (UTC)
http://www.plus-size-pregnancy.org/ Has lots of information geared toward just that. And you're right about diet and exercise.
update - ever_abstract - Oct. 6th, 2007 01:02 am (UTC) - Expand
Re: update - ever_abstract - Oct. 6th, 2007 01:11 am (UTC) - Expand
butting in... - ivymae - Mar. 29th, 2006 02:02 am (UTC) - Expand
Re: butting in... - ever_abstract - Mar. 29th, 2006 02:08 am (UTC) - Expand
Re: butting in... - ivymae - Mar. 29th, 2006 02:21 am (UTC) - Expand
Re: butting in... - kellyagain - Mar. 29th, 2006 04:55 am (UTC) - Expand
Re: butting in... - ivymae - Mar. 29th, 2006 05:29 am (UTC) - Expand
Unassisted Plus Size... - (Anonymous) - Oct. 5th, 2007 11:29 pm (UTC) - Expand
Re: Unassisted Plus Size... - ever_abstract - Oct. 6th, 2007 01:06 am (UTC) - Expand
Re: Unassisted Plus Size... - ever_abstract - Oct. 6th, 2007 01:07 am (UTC) - Expand
Re: Unassisted Plus Size... - crustyshoes - Jan. 15th, 2010 07:27 am (UTC) - Expand
Re: Unassisted Plus Size... - ever_abstract - Jan. 15th, 2010 02:23 pm (UTC) - Expand
our_nest
Mar. 28th, 2006 11:29 pm (UTC)
i added you to my friends list. i hope you have no objections.
babyslime
Mar. 28th, 2006 11:31 pm (UTC)
Of course not. :)
raisangrrl
Mar. 28th, 2006 11:38 pm (UTC)
Awsome!
Thank you so much for this. I can't tell you how many people have given me sort of crap over a VBAC. I'm going to print this out, and link it in my journal too.

Thank again, hun!
kris1225
Mar. 28th, 2006 11:45 pm (UTC)
awesome! great list - i look forward to sending it along to my vbac friends.
becke1084
Apr. 1st, 2006 06:53 pm (UTC)
What kind of sling/wrap is that in your picture?
(no subject) - kris1225 - Apr. 1st, 2006 07:36 pm (UTC) - Expand
hoodwink
Mar. 29th, 2006 12:44 am (UTC)
May not have any children, but the information is interesting anyway. Thanks for posting.
freshgroundfemm
Mar. 29th, 2006 12:50 am (UTC)
If you want more links...I didn't see this article cited in some of the links you referenced and it's a pretty good "scientific" article in support of VBAC.
VBAC and the risk of uterine rupture in California. The authors concluded that VBAC was safe with respect to uterine rupture. Rupture rates were higher with c-sections than vaginal births. I also like it because it has good comparison charts, the most interesting statistic was that payment method was a risk factor for cesarean(self-payers had lowest rates)!

This is great--I'm studying to be a doula and will bookmark this as a reference for my future VBAC clients :) I see you around some of my communities and jbarbie23's journal a lot, I enjoy reading your journal as well.
babyslime
Mar. 29th, 2006 01:09 am (UTC)
Ha, it's funny 'cause I had that article in the rough draft and then took it out for some reason. Thank you!
(no subject) - freshgroundfemm - Mar. 29th, 2006 01:30 am (UTC) - Expand
luscious_orchid
Mar. 29th, 2006 12:55 am (UTC)
I think I mentioned this to you before, but I just don't understand why people would electively have their uterus CUT open to PREVENT the slim chance that it could tear/rupture/open/do a cartwheel/whatever in childbirth...
I love your unassisted birth icon BTW:)
darkenedminds
Mar. 29th, 2006 01:44 am (UTC)
-Excellent- essay.

My SIL's response to her midwife-attended VBAC -

"I live 5 minutes away from a hospital anyways. I'm not going to die of uterine rupture in 5 minutes."

Seriously, though. Some people worry too much.
patricedw
Mar. 29th, 2006 01:57 am (UTC)
That was very interesting to read. After I had my son (my 2nd c-section) I started doing some research on VBAC2C "just in case" I had another. So of course when this baby is ready in Sept. I plan for a VBAC2C. Most people think I'm crazy and ask me "Why?".."Why go through all that pain when you don't have to?". As if c-sections are painless. It may be painless during the delivery but that is more than made up for when all the feelings in your body comes back and you feel like somebody split you in half and beat you up from the inside (which is practically how it is).

Recovering from a normal vaginal childbirth is rarely as complicated and painful as recovering from major surgery
(c-section). Also I want to spend my 3rd baby's first few days enjoying and adjusting to him/her...not in agony with every move I make and popping percocets every 4 hours!

My OB and nurse practioner are encouraging me to give it a try. I was surprise that military hospitals were so open to VBACs after multiple c-sections. So now my challenge is ignorning all the nay-sayers and going for the vaginal delivery I would LOVE to be able to experiance.
babyslime
Mar. 29th, 2006 03:48 am (UTC)
Having had an "easy" c-section recovery (only a few days of meds, was up to sex in under 2 weeks), and recovery from a 44-hour natural birth - I'd do the ENTIRE 44 hours over again any day!

Good luck; you can do it. :)
raving_liberal
Mar. 29th, 2006 03:28 am (UTC)
My mother had a VBAC in 1982 (three years after my cesarean birth in 1979), and was one of the first VBACs in our region (Southern Louisiana). She had to travel approximately 45 miles during labor from Baton Rouge to the hospital in Covington because that was the only hospital that allowed VBACS. She was interviewed and her VBAC birth story appears in The Vaginal Birth After Cesarean (VBAC) Experience : Birth Stories by Parents and Professionals by Lynn Baptisti Richards. She became something of a mascot for the local natural birth/midwifery group.

Her c-section was very traumatic. I was a high breech, and the doctors at Women's Hospital in Baton Rouge refused to allow her to labor naturally with me. She was told if she did not consent to a c-section, she would be refused treatment. My father was not allowed to view my birth, nor was he updated on our condition for quite a while after the birth. My mother experience PTSD symptoms from the experience for years afterwards, until she was able to have a vaginal birth with my brother -- my 9 lb. 6 oz. brother. Despite severe back labor for most of the 13 hours she was in labor, she says that nothing on earth would ever have made her have a repeat c-section. She remains a staunch advocate for VBAC.

I just wanted to let you know how glad I am that you are choosing the safer, healthier option of birth. I am even happier that you are making an effort to educate other women about the safety of VBAC. Your journal reaches a lot of eyes, and I hope that seeing your story and reading your research will have an impact on women who might otherwise have chosen a repeat section because they have been misled or fallen victim to the fear mongering.

THANK YOU!





babyslime
Mar. 29th, 2006 03:54 am (UTC)
Wow, thank you so much for all of that. :)
housepoet
Mar. 29th, 2006 03:52 am (UTC)
I love you.

Hey, findarticles.com is a great freaking resource too. :)
t0xicmadness
Mar. 29th, 2006 03:59 am (UTC)
I was sent to your journal a while back, when looking for information on unassisted pregnancy/birth. I just started doing my research on VBACS (I had a totally unncessary c-section thanks to my doctor telling me he was *too big*), and then I came across this. Do you mind if I print it out and keep it for reference?
babyslime
Mar. 29th, 2006 04:00 am (UTC)
Go ahead!!
(no subject) - t0xicmadness - Mar. 29th, 2006 04:01 am (UTC) - Expand
breakableheart
Mar. 29th, 2006 04:08 am (UTC)
I remember I asked you about it before you got pregnant. I was honestly curious, and when you answered me I believed you. *nod*
babyslime
Mar. 29th, 2006 05:14 am (UTC)
I don't even remember when you asked... which probably says it wasn't rude. ;)
I've had some people be rather rude about it.
bazo0ka
Mar. 29th, 2006 04:10 am (UTC)
I loved LOVED my nearly-unassisted home birth :) . By nearly unassisted I mean waking up at 3am, transition hitting at 4:30am, and pushing my baby out at 5:45am while the two ambulance women read the birth kit instructions! If I hadn't haemorraged I wouldn't even consider going to a birth centre if/when I have another.. then again - do YOU know the statistics on haemorraging from retained product twice? ;) It might change my mind again ;) lol

Great research, now research THAT for me :)

Love your belly too, I miss mine already :(
collette21
Mar. 29th, 2006 04:15 am (UTC)
That was a great read.
maylea_moon
Mar. 29th, 2006 04:25 am (UTC)
*thumbs up*
therealocelot
Mar. 29th, 2006 05:15 am (UTC)
In the one uterine rupture story I've heard, the mom survived and the baby died.

It happened out of the blue. Perhaps she was having an easy early labor, but the first she was aware of it was when she woke up suddenly in terrible pain. Nothing short of being hospitalized throughout late pregnancy would have helped.

(If they started mandating that, I expect the c-section rate would immediately drop out of necessity!)

In any case, I'm not entirely sure what my point is in sharing that story. Just basically that yes, shit can happen, but it can happen regardless.
babyslime
Mar. 29th, 2006 05:56 am (UTC)
Your point is the same one Curtis was bringing up earlier regarding VBAC.

He's a chef: therefore his job is considered dangerous. He could be burned, have fingers cut off, have exposions of fire in his face, etc. Hell, there's even a chance he could die on the job from some freak fire/gas/malfunction accident.
I could be paranoid and say to him, "Don't you ever work in a kitchen". Or I could accept that the serious risks are slim and let him go about his day.

My brother freaked out and talked about life insurance and loan insurance because it was "so dangerous" to be a chef, and while he had good points, I found it rather paranoid. That's the kind of person who would run and get a repeat c-section.
annin_fire
Mar. 29th, 2006 05:32 am (UTC)
Wow. I love your writing even when it doesn't yet apply to me. Slight grammar correction though. I'm taking it 'seventieth (70th)' is suppose to be seventeenth (17th) in the below quote.

'Collagen content of the wound tissues rises rapidly between the sixth and the seventieth days but increase very little after the seventieth day and none at all after the forty-second day.'

babyslime
Mar. 29th, 2006 05:58 am (UTC)
I noticed that. I copied the quote as it appears instead of re-writing it, so I wasn't sure if it was cool to make corrections.
cerulean_me
Mar. 29th, 2006 05:55 am (UTC)
IT should be noted that the risk of uterine rupture go up greatly during a VBAC with the use of pitocin... Also, in a hospital birth (which is why a VBAC at home is safer), they will want continuous monitoring because of the risk of uterine rupture. Which means that sitting still (so they keep the heart beat) could make labor harder or stall it some. Then they'll want to augment with pitocin- spiking the risk of uterine rupture.

Seems to me that they ought to nix the pitocin, not the VBAC, but with those golfing hours, and not wanting to work at night... that would be harder. ;-)

babyslime
Mar. 29th, 2006 05:57 am (UTC)
I put in both those things, I'm pretty sure - were they not clear?
(no subject) - cerulean_me - Mar. 29th, 2006 06:00 am (UTC) - Expand
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