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VBAC after classical c-section?

Hi all, I am looking for information regarding whether it is safe or possible to have a natural birth after a classical c-section. My DD was born at 29 weeks due to HELLP syndrome and was growth restricted due to early on-set pre-eclampsia. Because she was so small the doctors couldn't do a low transverse cut and opted instead for a classical incision. Basically they said my uterus looked like I was no more than 24 weeks pregnant.

So now I'm thinking about getting pregnant again and I am wondering if it is at all possible to have a VBAC (thinking positive that I will actually make it to term) considering that 1-my incision is vertical rather than low transverse, and 2-the cut was made on a very "underdeveloped" uterus (would there be more scarring or a higher risk of tears?)

Thanks for your responses, and links to information would be great.

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Gooberzilla

Asked by Gooberzilla at 2:40 AM on Dec. 13, 2009 in Pregnancy

Level 6 (122 Credits)
Answers (4)
  • You can have a VBAC regardless of your scar. Go to childbirthconnection.org. They tell you how. But basically, you tell your doctor how it is. That your going to have one and that's that. And if he says no, you show up at the hospital in labor and refuse surgery. They can't force you into anything.
    SaraP1989

    Answer by SaraP1989 at 2:50 AM on Dec. 13, 2009

  • Honestly, I had a v-bac with my second (though my cut was different than yours). If you're wanting to have another baby, then, assuming you have an OB/GYN or a Gen. Pract. that you see for your annual exams and that you trust, I would make an appointment with them and discuss it. They will be able to look at your records, see exactly what was done, what the surgical notes say about your uterus, etc (or be able to get access to that info), and discuss the specifics of your situation with you.

    Then, depending on what they tell you / how comfy you are with it, you can always get a second opinion. Not to mention research what they tell you for yourself once they give you an answer :-)

    Even if it's not the same Dr that did your c-section, they can get access to that info, you just have to sign a release. I've had several surgeries where they accessed what previous Drs in other places did.
    sailorwifenmom

    Answer by sailorwifenmom at 4:39 AM on Dec. 13, 2009

  • I didn't have a c-section but I did have a uterine surgery so I'm being treated like a VBAC. My doc says I there is a 1% chance of uterine rupture with VBACs. I want a home birth so I've been advised to have a well defined transport plan in writing. I am seeing a midwife who specializes in these cases. We are doing a lot of therapies to strengthen and tone my uterus.

    You might have to doctor shop to find someone who supports your choice. Many doctors are flat out afraid of malpractice suits, and the development of the modern c-section has done a great deal to decrease their legal hassle. A good doctor or midwife can prep you starting right now to improve you chances of having a vaginal delivery for a very healthy baby.
    ecodani

    Answer by ecodani at 8:48 AM on Dec. 13, 2009

  • Thanks for the replies.

    And thanks for the link, SaraP1989. According to the website you gave me, VBAC is not recommended for my type of incision-all care providers would recommend against a trial of labor-because the rate of rupture is up to 8-12%. That rate is definitely too high for me, so I think I'm just going to have to come to terms with a repeat c-section.
    Gooberzilla

    Answer by Gooberzilla at 1:26 PM on Dec. 13, 2009

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