Uterine Rupture in labour

[TheRoomWithAView]

Appreciate very much this may be a sensitive subject; apologies if this is upsetting

Would anybody feel comfortable telling me about their experience of uterine rupture during labour? I’m considering a vbac and whilst I understand the risk is small I’m hoping to understand more of what it actually means/what happens in a real life situation

I had a ruptured womb during labour but nothing to do with a vbac so not sure if my experience is what you are looking for. Mine was due to a previous c section scar rupturing.

Happened to my friend, lost her baby and then went on to adopt. She was pushing and ruptured, had to have hysterectomy to save her life.

She said all going well until just before crowning when womb came out not baby.

Thank you, very helpful. I’m trying to understand if there were any warning signs of it happening

Uterine rupture would be an emergency situation for both you and baby although, as you you’re aware, it is very rare.

Warning signs would probably be scar tenderness and pain during labour prior to the rupture, maybe bleeding, and there would be signs on the trace of the baby’s heart rate.

I had a uterine rupture during VBAC. I was rushed through for a crash section and came round 3 hours later with a baby girl in the crib next to me. DD had a cut from the scalpel on her back, but otherwise fine. No lasting damage. She is nearly 7. I took much longer to recover, about 9 weeks of not being able to stand up straight properly, slow shuffling walking etc) and needed a lot of support in the first month or so after DD was born. Largrjy because I also had 3 yo DS to deal with!

I ruptured because I dilated very quickly, 0-10 cm in about 2 hrs. I had argued fir a mobile labour, but we’d compromised in 20 mins monitoring an hour. Thank goidbsss DD’s heart rate flatlined when I was hooked up ! So I would recommend monitoring.

The labour itself was excruciating, it felt one big long contraction, with no let up. The MW kept trying to fob me off with paracetamol, and only took me seriously when I had to crawl to the toilet, and then there was blood everywhere when I went for a wee. I lost 500 ml blood. I needed some minor surgery a few days later too. Dd and I were in hospital 5 days.

So that is my tale of woe, even though it has a happy ending. Dd is 7 next month, super sporty and great at school). I’m nit suggesting that all VBAC eve like this, just saying that occassionally they do. My hospital were on the case and all went well (they put a precautionary cannula in my have the second things looked like they might be going wrong). My hospital really pushed VBAC, and I like the idea of quicker recovery, cuddles with DC1 etc, but in retrospect, maybe my medical history should have advised against it, as I dilated very quickly with dc1 aswell.

By contrast, I had no pain relief when dc1 had been born 3 years earlier. I was ready to go home on day 3, walked 5 miles after 2 weeks, was driving at 4 weeks, swimming at 6 and running at 11. He was emcs due to undiagnosed tootling breech, but the birth and recovery were very straightforward.

Good luck, whatever you choose.

Hi op, what was the reason for your first section? I ask because I had an emergency section with dd 1, she was in the back to back position and basically got stuck. I tried for a Vbac with dd 2, a decision that took me sometime to make as uterine rupture was a big concern for me, despite the risk being small. Anyway it turned out dd2 was back to back too, and although I went into labour naturally, I ended up with another emergency section. I wish now I had opted for an elective, then things would have been much calmer! Good luck whatever you decide.

Thank you so much for the experiences.

My first labour was spontaneous and without pain relief, but fast (for a first - fully dilated within 3 hours) with over 4 contractions every 10 mins from the first contraction (so this is a concern for me in case the strength and speed of my contractions cause a rupture).
My section was nothing to do with me - the baby needed to come at 34 weeks due to anaemia.

@BikeRunSki - that’s interesting that you’re speculating about the speed of dilation as that is one of my main concerns, especially if this labour is likely to be faster than my first. Also interesting that it felt “wrong” from the get go - whilst I don’t want to rupture (obv) I’d be more comfortable if I suspected i might have an indication that something was wrong

This is a bit of a hazy memory, so sorry if it's not useful but maybe other posters can confirm if this is right or not.
I had a c section for my first baby, as I was fully in labour, contracting a lot but not dilating. 2nd baby, I was guided towards a vbac but with staff made aware it would likely end in a c section as I may not dilate again.

I didn't dilate (well, I got to 3cm then stopped!) and suddenly there was no gap between my contractions. The consultant had said that back to back contractions could be a sign of uterine rupture so I needed to make them aware asap. I was hooked up to a monitor as soon as I told a midwife, and rushed for a c section within 20/30 minutes.

I wasn't told that I was about to rupture, and the c section went fairly smoothly, so I don't know if I misremembered what the consultant said about back to back contractions - does that sound right to anyone else? If it is right, that could be something to watch out for in labour.
Good luck!

OP, i’m not speculating about the speed of dilation being the cause of my rupture, it was discussed with me by the MW and OBGYN afterwards. The quicker it is, the more powerful it will be.

I remember thinking about this afternoon my first. He was breech and a c-section. I decided to have a VBAC for my second but my waters broke a bit early and labour didn’t progress smoothly so they suggested a c-section, I think partly because of higher risks of uterine rupture, partly because I was happy to have another one.

So definitely planned a c-section for third DC. But he came really early. I went into labour, they gave me drugs to stop it, but it was in and off for three days. When he decided to arrive, it was in 30 minutes. They kept asking me if I had any shoulder pain which is a sign of uterine rupture.

Luckily we were both ok though DS2 spent 2 months in NICU. I think it’s just one of those unknowable things - all you can do is gather information and decide what you’re comfortable with.

I had a CS for DC2 after a previous VB and wanted a VBAC for DC3. I went overdue and was offered the choice of induction or elective section, as induction increases the chances of rupture I opted for an elective section. I'm very glad I did because when the surgeon came to see me on the ward the next morning she told me that the lower segment of my womb had been incredibly thin with a high number of adhesions and that it almost certainly would have ruptured if subjected to labour. It's not something that could have been predicted or known about without opening me up to take a look.

Sorry if this is a silly question but does uterine rupture only happen when you've had a previous c section? Or can it happen if you've only had a natural birth?

It can happen in any labour/delivery although factors like previous section(s) can increase your risk.

Not an experience of a rupture (you should be aware that the statistics don't distinguish between dishiscence and rupture).

I had a emcs with ds1 and a hbac 16 months later with ds2. Labour took 3 hours from first signs to delivery, no complications.

Pain between contractions is the main sign that there's a problem with your scar. There's an excellent book on vbac by AIMS (you can buy it from their website) that you might find useful.