Any uterine ruptures?

• 11-27-2008 1:12 PM

  K's mom Joined on 11-27-2008 Posts 2

  Any uterine ruptures? Reply Contact I'm pregnant with my second daughter, due at the end of January 09. I had a c-section with my first daughter, 2 1/2 years ago, because she was breech and turning her did not work. I feel like I did not recover from my c-section well and ended up getting really sick with 2 breast infections, 3 breast abscesses (1 right after another), and ended up being hospitalized on IV antibiotics by the time my daughter was 2 months old. I feel like my lack of rest/healing from the c-section contributed to my being so sick. Anyway, that is why I want to try a VBAC this time around. However, I am not a risk-taker at all and I am very nervous about the prospect of a uterine rupture because of its effect on the baby. Has anyone heard of any stories where the uterus did rupture during the VBAC? My doctor says the chance is 1 in 200 of a rupture and she has never had one rupture before although it has come close. She implied that I could try a VBAC if I go into labor before my due date but if my due date arrives and I am not in labor, I will need to be induced. I'm not sure why induction would be necessary on my due date, I'll have to clarify that with my doctor when I see her on Tuesday. I don't want to increase my chances of a rupture by being induced but I would really like to try the VBAC. Also, has anyone had a successful VBAC without an epidural, just curious. Any replies would be appreciated, thanks!

• 11-30-2008 9:37 AM

  In reply to

  ~Karma~ Joined on 03-12-2006 Nova Scotia; Charlotte May 19/07; #2 Apr 1/09 Posts 1,155

  Re: Any uterine ruptures? Reply Contact I would be careful if you really want a VBAC about staying with this doctor.  Giving you an ultimatum to go to your EDD, then inudcing does not sound overly VBAC supportive- your risk of rupture is higher with induction and there is no known benefit to doing it.  You have as good of a chance as any first time mom in labour since your baby was breech the first time. I have not had my VBAC yet, hoping for in April.  I know several people who have done it with the epi.  Again, you need to be careful because the epi can cause your contractions to decrease (in which case they often use pitocin to increase them) and can also cause fetal distress (mimicking a rupture).  But it can be done and has been done.  Of people having a rupture, the proportion with ill effect to the baby is small, I can't remember the stats.  Many ruptures are more or less asymptomatic and baby and mom do fine, so keep that in mind too.  You might want to look at ICAN website to find some good studies.

• 11-30-2008 11:44 AM

  In reply to

  stacib2to3 Joined on 09-25-2005 Illinois Posts 40

  Re: Any uterine ruptures? Reply Contact  I only know of two people who have had uterine ruptures. I know them both in real life, so it's not something I read online. The first is my cousin who had a uterine rupture with no previous c-section. It was her first baby and she ruptured while pushing. Her doctor did not believe her when she said something was wrong and by the time they got her into a c-sec it was too late to save the baby. She has had a repeat c-sec for her second baby.  The other was my childhood neighbor. I'm not sure if it was a VBAC, but I think that it was. She ruptured and the baby went out of the uterus into her abdomen and was drowning in blood. The doctors were able to save both mother and baby, but the baby does have some mental problems related to the birth, otherwise fine. These are both pretty extreme cases, and I'm sure not what you are wanting to hear. But, they did happen. My cousin's rupture was only 3/4 of an inch and it was the top of the back wall of her uterus. So it does happen, and not only with VBACs. I did however have a successful VBAC in March, so they are very possible too! My advice would be to do as much research as possible, and when it comes time to give birth avoid as many interventions as possible, since they will increase the risk of rupture.

• 11-30-2008 4:31 PM

  In reply to

  Mrs Garcia Joined on 09-03-2007 The ax forgets; the tree remembers~African proverb Posts 219	Re: Any uterine ruptures? Reply Contact I had a dehiscence with my twins. It wasn't a full blown rupture, but it was pretty close. I also had a classical incision with my first c-section, so my scar wasn't as strong as most.

• 12-03-2008 6:24 PM

  In reply to

  K's mom Joined on 11-27-2008 Posts 2

  Re: Any uterine ruptures? Reply Contact Thank you for the replies. I saw my doctor on Tuesday and told her I'd like to try a VBAC but not be induced. However, if I don't labor by the time I'm 41 weeks, then I'll just get a c-section. My doctor was fine with that b/c I told her I don't want to be induced no matter what. Anyway, it seems like my baby is sideways right now so I hope she will turn before I go into labor or I'll have to have a c-section again.

• 12-27-2008 7:15 PM

  In reply to

  lncooper Joined on 10-09-2004 Geneva, NY Posts 1,682

  Re: Any uterine ruptures? Reply Contact Hey K's Mom! :) Awww, I'm sorry to hear that healing from your previous cesarean & your postpartum time was so rough :( Poor mama! I understand not being a risk taker. So, let's reframe the way we look at this. A normal, vaginal birth is what's shown to be safest for mom, baby, & future babies. A uterine rupture in a VBAC mom is less than one percent. With only one previous cesarean, if you aren't induced or augmented your risk of rupture in labor is only 0.4-0.7%. You have an OVER 99% chance of NOT rupturing. With these numbers as low as they already are, remember that these numbers are actually higher than for real anyways because often times something like a dehiscence or 'window' (a thin spot in the uterus) is coded as a rupture when in fact a true rupture didn't even occur. In the rare instance of a rupture occuring, MOST of these are NOT catastrophic ruptures where the baby dies or has irreperable damage. With those odds, I certainly wouldn't look at going for a VBAC as taking a risk. I'm not sure of your doctor's initial recommendation of induction. If she's so concerned about uterine rupture, why would she want to induce based on estimated dates alone? Induction increases the risk of uterine rupture. I'm wary of any doctor that makes 'one size fits all' recommendations. To recommend induction at X weeks just based on hitting that time, espeically so far in advance, is NOT providing individualized care. It's NOT making recommendations specific to YOU and YOUR BABY and YOUR PREGNANCY, yk? I had a successful VBAC without an epidural. It was my second VBAC attempt. My first VBAC attempt turned into a repeat cesarean. I planned a natural hospital birth. Labored naturally without interventions or drugs (not even an IV, wore my own clothes, refused to be stuck in bed) until hour 36 when I let in & let them artificially break my bag of waters (*slaps self in head*). After 42 hours of labor, I had a repeat cesarean after being flat out lied to about my progression during labor & my baby's position, along with continuously being threatened & having to fight off interventions that I was told prior to labor I wouldn't need to have. It was a constant fight & the support I had been promised was pulled out from underneath me. My husband, doula, & family were all there. . . all of that support didn't matter when we were being flat out lied to. Lots of fun unnecessary iatrogenic post traumatic stress. Anyways. Second VBAC attempt, third baby. No drugs, epidural, or intervention of any kind except for some holding back of my cervix which was swelling due to a malpositioned baby. Longer labor. Bigger baby (over 9 1/2 lbs with both hands by his head). Intact perineum. The difference? I chose a care provider & a setting with a less than 5% cesarean rate. ;)

• 12-27-2008 7:19 PM

  In reply to

  lncooper Joined on 10-09-2004 Geneva, NY Posts 1,682

  Re: Any uterine ruptures? Reply Contact Oh & I forgot to add that I obviously didn't have a uterine rupture with my successful vba2c, even though I had many risk factors that usually leads to supposed increased rupture risk & repeat cesarean in the hospital. . . less than 2 years in between births, single layer suturing on my uterus, big baby, 'sticky' shoulders, prolonged labor. . . our bodies are amazing & have the ability to heal wonderfully. But without a doubt, had I been any other place than in my own home, I would have had another cesarean. . . & it would have been completely unnecessary.

• 01-13-2009 7:12 PM

  In reply to

  galenseigne Joined on 01-13-2009 Posts 1

  Re: Any uterine ruptures? Reply Contact I haven't had a uterine rupture, but thought I'd share my story anyway. Right now I'm pregnant with my fourth child (due in April!) With my very first baby, I had an induced vaginal birth at 41 weeks, no epidural, no episiotimy, awesome, great recovery! With my 2nd babe, I had a complete placenta previa, requiring an emergency CS because of extreme hemmoraging at 34.5 wks. Definitely, the recovery from the CS was hard compared to my first birth, although my CS recovery was uncomplicated, really. The main things I didn't like after the CS, were that, for me, it was hard to have a bowel movement, and just moving and doing regular things brought pain. It just took a very long time to heal. I felt pain even over a year later. This made me worry that my uterus might be too weak for a VBAC with the 3rd baby. My greatest fear was rupturing, but also I did not want to go through the long hard recovery of a CS again... I read way too much about CS vs VBAC during my 3rd pregnancy. I'd say that mothers need to be informed but also follow their gut instincts. The best things I learned that helped me feel confident about a VBAC were: I was a good candidate because I had a horizontal, low lying, double sutured uterine incision, I had already had a vaginal delivery, I also learned that if a woman is induced, whether with pitocin or prostaglandins/cervical gels, or manually breaking bag of waters, she greatly increases her risk of uterine rupture, because the contractions are not natural, they can be much stronger and much more straining to your uterus than going into labor normally. Studies have shown that when a woman attempts a VBAC, if she refuses induction the chances of rupture are about 1 in 1000 rather than the typical 1 in 100 that you'll usually hear. When I signed a VBAC release form at my docs office, it said the chance of rupture was 1 in 100. These studies which say your chance of rupturing is 1 in 100 are including the inductions. Studies that seperate the women who DON'T get induced from those that DO get induced show that the numbers are much different. It's also true that induction in a woman who has never even had a CS greatly raises her chances of having a uterine rupture. Stacib2to3 said in her reply to you that her cousin had no previous CS and that the rupture was up high on the back of the uterus. That is a good example of rupturing that is likely due to induction. So, to finally tell you, with my 3rd baby, I was hoping that I would deliver around 38 weeks, fearing the baby would be too big the closer I got to my due date. Well, it didn't happen when I wanted Then, when I reached my due date, my doctors were so mad at my refusing both CS and induction, but I was determined to try a VBAC and to do it the safest way I could, without induction. Soon, I was walking around dilated to 5 cm and not going into labor, (very rare). I tried lots of sex, curb walking and stairs, even tried castor oil. Nothing did it. During those last few weeks, I did consider another CS, but ultimately decided against it, because I felt so strongly the best thing for me and my baby would be VBAC. I read a ton more and learned that a bigger baby doesn't mean a greater risk of rupture. After my due date passed, I was going for fetal non-stress tests and monitoring every 2 -3 days, and lots of extra ultrasounds to make sure that there was nothing going wrong. Believe me that if at any point, there was anything that was appearing to be wrong, I would've just done a repeat CS, although I wouldn't ever have considered induction at all. At each appointment, there was always a healthy fetal heartrate, lots of fetal movement, plenty of enough amniotic fluid, etc... I was being very careful to eat as healthy as possible (no junk) to keep my placenta healthy, etc... The one thing that did scare me was they said the baby was measuring about 9 lbs, which I thought sounded big. That was a couple days before I went into labor on my own (OK, not to be crude, but I have to say here that having my DH do nipple stimulation for a few hours might have been what helped things along, although I'm not sure, it might've happened anyway that night w/out nipple stimulation.) Back to the point I was at, I immediately went to the hospital of choice, where there was a surgeon in house 24/7 in case of a uterine rupture. I didn't want to take any chances. My labor progressed well, and about 5 hours and 5 pushes later, I gave birth naturally at 43 WEEKS (!) to a perfect 7lb 8oz girl! (goes to show that ultrasounds don't always measure accurately) Also on the subject of birth weight, I know people who had VBACs no problem with babies over 10 lbs. Greater weight doesn't mean greater chance of rupture. Sorry this is so long, but I wanted to say a couple more things... Having had an induction with my first baby, when I compare those induction contractions with the natural contractions I had during my VBAC, I would say for sure that induction brings stronger contractions. On the subject of going overdue, and I know this could really be a whole separate conversation, but I wanted to say that I truly think some women do take longer to grow babies...I'm sure that if I'd refused induction with my first baby at 41 weeks, I may have very well gone to 43 weeks with him too. Genetics may have something to do with how long a woman gestates. We are not all the same. My mom gave birth vaginally to 9 children, 8 of those deliveries were induced because of the due date. My sister also was induced with her kids because of the due date. Makes me wonder if that due date really should globally be determined the same way or if the due date is really such an important issue. In my opinion, the health of the growing baby inside is the most important issue, not the due date. My daughter, (the VBAC baby at 43 wks) was so healthy and content. She never had any problems, like spitting up or 'colic' and she was such a good eater and sleeper. I don't think it would've been best for her to be born by the due date. Back when I had my first baby, being induced, I never thought of doing anyting other than what the doctor told me I should do. Now I know better. Many women don't realize they have a choice. Yes, we must use careful judgement when making these kinds of choices, but we shouldn't let doctors bully us into anything, or even assume that our doctors know everything. We have a right to go against what our doctor says, it is the woman who is in charge. Too many times I hear women saying,"My doctor says I have to have a c-section because of...." or "My doctor is going to make me be induced if I don't go into labor in the next few days." That kind of thing. These women need to realize doctors can't make them do anything. Make your choice carefully, but let it be your choice.

• 01-14-2009 4:08 PM

  In reply to

  joymarie Joined on 10-10-2005 Ava Jade 5/23/06 Isaac Lee 12/26/2008 Posts 135	Re: Any uterine ruptures? Reply Contact I just had a VBAC on Dec 26th of 2008. I did get an epidural but not till I was almost 9cm. I have to say it was the most AWESOME experience of my life. :)

• 01-14-2009 5:21 PM

  In reply to

  BrookeDrewson Joined on 01-15-2009 Posts 1

  Re: Any uterine ruptures? Reply Contact Congratulations on your second pregnancy. I just gave birth to my second son and had a successful VBAC at home with a birth tub to a 10.3 baby boy. My water broke, labored for 9 hours. I pushed at a freestanding birth center for 3 hours with my first and ended up being transferred to the hospital and had a c-section. For my second son, I transferred from the birth center (they wouldn't be able to follow me as a VBAC client) to a "limited intervention VBAC supportive" D.O. The conditions of my birth we had agreed to suddenly changed and I was not comfortable staying with her. After much research I decided that with the D.O. my chances were greater of a repeat c-section and the complications that go along with that- to myself and to the baby. The D.O. would use mild pitocin to induce if I reached my due date. Otherwise it would be a c-section. I knew that I did not want to be induced at all- two previous posters mentioned the risks. I decided after interviewing doctors and midwives that the best and safest place I could have my child would be at home. I found an amazing midwife and hired a doula to come to my home. I labored for a long time in a birthing tub and although I did not birth in the tub, it was amazing pain relief in dealing with contractions and in my opinion (as well as several articles I had read leading up to the birth) the best pain relief for a VBAC woman. Yes, my baby was big, the pushing was long and childbirth hurts but he was healthy and alert and the recovery so much better than the c-section. I understand you are not a risk taker so you are unlikely to seek out a home birth midwife but I wanted to share my experience with you because it is possible to have a successful VBAC and a safe one. Keep in mind that the scary statistics are for an epi and without you've got more of a risk for things not going well with any of the interventions doctors and hospitals like to do. Our bodies are made for this! It's amazing! Good luck, mama. I wish you a happy healthy birth!

• 01-23-2009 7:08 AM

  In reply to

  Laura1754989 Joined on 10-10-2006 Posts 1

  Re: Any uterine ruptures? Reply Contact I know that many people have had successful VBACs and I thought I would be one of them. I was overdue and my Doctor was concerned about the size of the baby, so she wanted to kickstart labor. I was given Cervidol to ripen my cervix, which I now know shouldn't have happened. Before I started the ripening, my daughter's heartrate was good. After 4 hours of conractions, I started having intense pain and my daughter's heartrate started dropping rapidly. They took me for an emergency c-section, but by the time they got in, my uterus had ruptured and the placenta detatched and my daughter had been without oxygen too long. She never took a breath on her own and now I am left with empty arms. Fortunately, they were able to save my uterus and the Doctor has said after a year wait we can try again, but it will never bring my daughter back. I had read all the info and trusted my doctor. I knew induction of labor lead to more uterine ruptures, but I trusted my doctor to do what was needed. If I could go back to December 22, I would insist on a repeat c-section over an induction so I would be holding my little girl instead of looking on the internet for information to help me make sense of the tragedy.

• 01-23-2009 9:51 AM

  In reply to

  kitkat5505 Joined on 01-18-2004 Utah Posts 371	Re: Any uterine ruptures? Reply Contact  (((HUGS))) Laura. I'm so sorry that happened to you.

• 01-23-2009 11:06 AM

  In reply to

  jennifer34RN Joined on 05-24-2007 Dayne Kyler due nov. 14, 2009 Posts 1,450	Re: Any uterine ruptures? Reply Contact I have had 3 successful vbacs (2 without epidurals)  A woman with a previous c-section shouldnt be induced, pitocin can bring on to harsh of contractions thus increasing your risk of rupturing. Good luck:)

• 02-02-2009 12:01 PM

  In reply to

  Donna1132498 Joined on 01-07-2006 Posts 1	Re: Any uterine ruptures? Reply Contact Thanks for sharing your story. The information was very helpful.

• 03-31-2009 1:59 PM

  In reply to

  surfergirljen Joined on 06-02-2008 Toronto, Canada Posts 44

  Re: Any uterine ruptures? Reply Contact I just wanted to say this has all been really helpful to me to read... I'm 37 weeks now and it's looking good for vbac (one c-section previously for breech baby) but the info about induction vs. C-section is really helpful. Laura I'm so sorry that happened to you - I cannot imagine. Like you I tend to really trust my doctors (as you should be able to!) but they DO make mistakes... I'd rather do another C than induction too. Why take a chance right? Sigh. Hopefully everything will happen naturally and I'll make it through this!