RCS vs. VBAC

I was searching for something to post in my ICAN group this morning, and came across this great blog post on a blog I follow, written by one of my ICAN of North Texas friends.  I love the charts she incorporated from the ICAN of Omaha page and wanted to share them here, for those looking for the hard statistics of Repeat Cesarean (RCS) vs. VBAC.

Make an informed choice about the risks of Repeat Cesareans vs. VBAC's

1st C-section
 Risk of hysterectomy: 0.65%
Risk of blood transfusion: 4.05%
Risk of placenta accreta: 0.24%

2nd C-section	1st VBAC
Risk of major complications: 4.3%	Chance of successful VBAC: 63.3%
Risk of placenta accreta: 0.31%	Risk of uterine rupture: 0.87%
Risk of hysterectomy: 0.42%	Risk of hysterectomy: 0.23%
Risk of blood transfusion: 1.53%	Risk of blood transfusion: 1.89%
Risk of dense adhesions: 21.6%

3rd C-section	2nd VBAC
Risk of major complications: 7.5%	Chance of successful VBAC: 87.6%
Risk of placenta accreta: 0.57%	Risk of uterine rupture: 0.45%
Risk of hysterectomy: 0.9%	Risk of hysterectomy: 0.17%
Risk of blood transfusion: 2.26%	Risk of blood transfusion: 1.24%
Risk of dense adhesion's: 32.2%

4th C-section	3rd VBAC
Risk of major complications: 12.5%	Chance of successful VBAC: 90.9%
Risk of placenta accreta: 2.13%	Risk of uterine rupture: 0.38%
Risk of hysterectomy: 2.41%	Risk of hysterectomy: 0.06%
Risk of blood transfusion: 3.65%	Risk of blood transfusion: 0.99%
Risk of dense adhesion's: 42.2%

NOTE: "Major complications" include one or more of the following: uterine rupture, hysterectomy, additional surgery due to hemorrhage, injury to the bladder or bowel, thromboembolism, and/or excessive blood loss.

All VBAC stats for this chart are taken from the Mercer and Gilbert study, 2008 which includes induced and augmented labors. Additional studies have shown lower uterine rupture rates (especially with spontaneous labors) and higher VBAC success rates with non augmented or induced labors.

Sidenote: It's pretty awesome to know if I decide to have another baby, my chance of success for a 2VBAC is 87.6%!! :)

36 Weeks and the VBAC Debate

A friend of mine posted about how many days were left in her pregnancy and that made me realize there are only 28 days until my "guess date" (as she calls it!).  That's crazy!

I've had some good contractions that I hope are causing some kind of change on my cervix.  I've definitely reached that uncomfortable part of pregnancy.  Sleep is getting harder and harder during the night and this baby has its little bum so high up in my ribs on the right side that it's really hard to sit upright in a chair.  Baby C never "dropped," but I'm hoping this baby does at some point to give relief to my lungs, stomach and ribs.

Here's my belly comparison from two weeks ago.  I can see the change!

I got a couple great kicks on video the other day:

There have been a lot of great things posted lately on different pregnancy sites and facebook that I've enjoyed.  As the push for VBAC is rising, the push back is rising too.  Many c-section moms who did not have a traumatic experience can't understand why some of us want to try to have a vaginal birth the second (or third, or fourth, etc.) time around.  It is really frustrating to hear something like "I don't understand why it's such a big deal.  I had a great c-section experience and all that matters is a healthy baby.  How I have my baby doesn't affect you."  Well yes, on one hand that is true.  But on the other, it does affect me.  It affects ALL women.  The more women who go through the labor and delivery experience not educating themselves and just blindly trusting our medical system, the more our national c-section rate will just continue to be the atrocious number it is.  There are some of us actively fighting the system to try and reclaim our rights as birthing mothers and demand fully INFORMED consent for all patients.  Yes, there will always be some moms who would rather just take their doctors word for things, but I have to believe in my heart that if more women did their own research or were given full information on risks and reasons from their care providers, many c-sections would be avoided.  

This was a recent blog post.  It is a women try to put "humor" on an elective repeat c-section.  The article is appalling (in my opinion), but the debate in the comments is definitely something worth reading:

http://www.modernmom.com/blogs/jill-simonian/yes-i-m-actually-excited-for-my-c-section

I love the site www.vbacfacts.com, whose author made many comments in the above debate.  It is a great site to go for statistics for BOTH sides of the risks of repeat c-section vs. VBAC.

Also, I've had a lot of friends and family use the phrase with me, "I hope this birth goes the way you want it to."  I feel I need to set the record straight on something I thought I had been communicating all along...

I'm okay with a repeat c-section.  I've done my research, I trust my doctor and I'm giving my body every chance to do what it needs to do naturally.  The main thing I want out of this experience is an EMPOWERED birth.  That birth does not come with the requirement that this baby be born vaginally.  That birth comes with the requirement that I feel I am fully informed on each step of the process and if Dr. C tells me we need to head to the OR, it is a discussion of options and not an order that is prefaced by scare tactics.  I have confidence in the decisions I've made and feel myself and this baby are both set up for the best possible outcome.

If anyone in the birth world is solely focused on vaginal birth over c-section, they've missed the point.  I just wanted to make that clear.

Articles on VBAC

In an online community I take part in, a fellow mom replied to a someone's inquiry about choosing an elective c-section over a VBAC with this response:

 "I have never seen compelling evidence that vbac is safer than a repeat c-section - that is an opinion not a fact. In fact, most doctors will not do vbacs because they are not considered safe. Repeat c-section still seems to be the prevelant recommendation. (Some will say "because it is convenient for doctors." Yeah - because they are ALL selfish monsters? I don't think so, but that's my opinion.) 

The body is meant to give birth, yes. However, labor was the leading cause of death for women before the advent of the c-section. When they are medically necessary, they save lives of women and babies. With the technology we have today, it is possible to have a planned c-section for medical reasons. Thank God!"

I responded with this:

"You are grossly misinformed about VBAC.  You should NOT give advice to someone based on your opinon and not based on research.  Want some compelling info on VBAC?  Here ya go:

ican-online.org/vbac/postion-statem...

ican-online.org/vbac/fighting-vbac-...

www.childbirthconnection.org/pdfs/A...

wellroundedmama.blogspot.com/2009/0...

vbacfacts.com/

I could keep going, but I think you may get the point.  

Have you been through an UNWANTED c-section because of a doctor pushing you in to it when it wasn't truly medically necessary?  If not, you cannot imagine what it feels like to be passionate about changing your birth options."

It is frustrating to me that people so carelessly influence others in to thinking a c-section is no big deal.  Her information is wrong, plain and simple.  

P.S. Sorry about the formatting.  It messed up when I copied and pasted from the other website.