VBA2C/3rd Cesarean Comparison
“Trust in the Lord with all your heart; do not depend on your own understanding. Seek his will in all you do, and he will show you which path to take.” Proverbs 3:5-6
You can read my hba2c birth story here > http://birthwithoutfearblog.com/2012/04/16/hba2c-birth-story-50-hours-of-labor-after-srom/
Vocabulary:
VBAC = Vaginal Birth After Cesarean
VBA2C = Vaginal Birth After 2 Cesareans
Complete Rupture – Uterine Rupture most common in Classic Scars, in which scar tears open completely and baby is at high risk of death.
Incomplete Rupture – Uterine Rupture most common in Low Transverse Scars, in which scar tears slightly and surgery is required, but is not associated with death to infant.
Classic Scars – Vertical scar in the high segment of the uterus.
Low Transverse Scars – Horizontal scar in the low segment of the uterus. (*mine)
Perinatal Death – Death to infant prior to labor, during labor or within 7 days of birth.
VBA2C Facts:
Hysterectomy – 0.6%
Uterine Rupture* – 0.9%
Major Complications – approx. 3%
Maternal Death – 0.004%
Perinatal Death – 0.13%
*Only half of those are complete ruptures; of the 0.9% only 5% of those will result in perinatal death.
3rd Cesarean Facts:
Hysterectomy – 2.4%
Uterine Rupture – 0.026%
Major Complications* – 8% or greater
Maternal Death – 0.013%
Perinatal Death – 0.05%
*The risks of placenta accreta, cystotomy, bowel injury, ureteral injury, and ileus, the need for postoperative ventilation, intensive care unit admission, hysterectomy, and blood transfusion requiring 4 or more units, and the duration of operative time and risk of maternal morbidity significantly increased with increasing number of cesarean deliveries.
Breakdown of Uterine Rupture (VBA2C:
Complete Uterine Rupture - approx. 0.45%
Incomplete Uterine Rupture - approx. 0.45%
Perinatal Death - 1.7%
Induced Labor - 2-8% (dependant on type induction)
Spontaneous Labor - 0.5%
Additional Info:
A woman is more likely to experience placental abruption, cord prolapse or shoulder dystocia during a vaginal birth (including VBAC) than a uterine rupture. Placental abruption and cord prolapse carry risks of death to baby. The perinatal death rate (including all reasons) for vaginal birth is 0.62%. There are always risks in birth. VBAC’s are more likely to succeed at a homebirth(>80% success) than in the hospital (approx. 50% success).
Resources:
http://midwifethinking.com/2011/02/23/vbac-making-a-mountain-out-of-a-molehill/
http://www.midwiferytoday.com/articles/homebirthaftercesarean.asp
http://www.birthbythenumbers.org/united-states/state-by-state/#.UXwWw6I3uSo
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