Anyone had a HBAC and had scar rupture?

[Manoo]

Hi

Am considering a home VBAC at the mo, and just wonder if anyone has had the bad luck to go for a HBAC and have their scar rupture?

If so, what was the outcome?

Thanks!

don't know anyone with a scar rupture full stop - heard of one on here though, but that;s all, good thread yesterday about the odds of scar rupture compared to lots of other things - think toady posted the list from a uk midwives website 0-can't do links sorry! could bump and ask Toady for it?

Hi Manoo

I had a home vba2c last year with no problems. You might like to join this yahoo group There are loads of people on there who've had vbacs and/or have supported others through them. I have anecdotally heard of two scar ruptures at home. In one both mum and baby were fine and in the other the baby died. I've also heard of a hospital vbac though where the woman was complaining of scar pain but because the monitor said everything was fine, she wasn't given a c-section, her uterus ruptured and the baby died.

I chose a hba2c partly because I believed that scar rupture was less likely if I had a normal, mobile, unmedicated birth and the chances of that happening at home were higher. At home I was also guaranteed one to one midwifery care which may be more likely to pick up impending signs of rupture. It's all very well having continuous monitoring in hospital, but if there's nobody there to interpret the results it's not much good!

HTH

Here it is

The talk of how much more likely you are to die in a car on the way
to hospital than have a uterine rupture brought back the following to
me, and this is widely acknowledged to be fact (Henci Goer):

Your risk of dying in a car accident, over the course of your
lifetime, is between 1 in 42 and 1 in 75. This is roughly 4 to 5
times greater than the risk of uterine rupture.

You're about twice as likely to have your car stolen (that's an
annual risk) than to experience a uterine rupture.

Your odds of being murdered are 1 in 140 over the course of your
lifetime. That's 2 times more likely than the risk of rupture.

The annual risk of having a heart attack is 1 in 160, 2 times more
likely than rupture. Your risk of dying from heart disease is
roughly 1 in 6, or 55 times greater than your risk of rupture.

If you're a smoker, your risk of dying from lung cancer is 1 and a
half times more likely than a VBAC mom rupturing during her labor.

You're about 17 times more likely to contract an STD this year than
you are to have a uterine rupture; more likely to contract gonorrhea
than to rupture, as well.

You're 13 times more likely to get food poisoning than to rupture.

You're more likely to have twins than a uterine rupture. Odds of
twins: 1 in 90. That's about 3 1/2 times the likelihood of rupture.

If you ride horseback, you're 3 times more likely to die in a riding
accident than you are to experience a uterine rupture.

If you ride a bike on the street, you are 4 times more likely to die
in an accident (annual risk) than you are to suffer a rupture.

Having a serious fire in your home during the next year is twice as
likely as experiencing a rupture.

You're ten times as likely to win at roulette as you are to have a
uterine rupture.

If you flip a coin, you'll be more likely to get heads (or tails) 8
times in a row than to rupture.

The risk of cord prolapse is 1 in 37 (2.7%), or nearly ten times more
likely than that of rupture.

And a final irony (heads up, those of you who want a doc to give
his/her opinion on your likelihood of rupture next pregnancy!)...

You're 6 times more likely to have a doctor who is an impostor than
you are to suffer a rupture.

So, logically, we should worry more about almost EVERYTHING else ...
including that your own consultant never even went to university ...
than uterine rupture.

Daisymoo, you said that very well. Why is it that hospitals seem so unable to see this? It seems so stupid.

Thank you lulumama for asking Toady for the great info.
Thank you Toady for the great facts! (Very reassuring)
Thank you Daisymoo for your success story and for the yahoo groups link.
And Mazzystar agree with you - why can't hospitals see that POV (although to be fair, I haven't yet seen my consultant, I found out through other routes that they don't allow VBAC without constant fetal monitoring).

Manoo, they cannot insist of constant monitoring whatever they say - it is assault to do it without your consent! Of course, that doesn't mean you won't get lots of hassle if you decline their offer

apparently a home water birth would be good for VBAC as water takes pressure off the uterus and scar......and if at home, no constant monitoring - a good midwife will pick up the signs of a rupture from your condition , not solely the trace off the machine...

My friend suffered a uterine rupture with her second child. It ruptured as she was being given an epidural in theatre so it happened at the best possible time really, luckily her and Ds where fine.

I know a first time mum (so no previous section) who had a uterine rupture... too much oxytocyn (drip)!
I read somewhere that you are at a higher risk to have a cord prolapse (cord coming out before baby's head) than a uterine rupture... is anyone worrying you about a cord prolapse ????

rupture is the worst possible outcome - the best possible - and more likely one - is a natural birth - an empowering and amazing event! focus on what will go right!

Thanks again for the all the helpful thoughts, stories and support.
Lulumama thanks for mentioning the water birth idea - I hadn't realised that it would help there be less pressure on uterus and scar.
Pupuce you are so right about cord prolapse.

What's odd is that I haven't even seen my consultant yet, the reason I know what the hospital policy is on VBACs (continuous fetal monitoring/not allowed into the midwifery led centre) is because I was talking to a doula who has worked at that hospital. She knows my consultant and says she can be fairly flexible (might allow labour in birth pool, but deliver on 'dry land').

So strangely, it's not my consultant putting fear of god into me at the mo - it's me and my overactive imagination! Because my first c/s went wrong, and I had to be opened up again next day under a general a and nearly died, I don't feel 'lucky'. Also, I was pregnant earlier this year, and had to terminate at 17 weeks for an abnormality. So those things that I used to think 'could never happen to me' did happen, so I'm feeling a bit negative and thinking it'll be me that scar rupture happens to too.

I'd LOVE a home birth, but am so scared that if the scar ruptures I'll end up with a dead or brain damaged baby, and regret my decision for ever.

I suppose I'll try and get as much info as I possibly can, visit the hospital and check out how far I'd be able to move whilst 'tethered' to the monitor thingummies etc before making a decision.

This is a fairly comprehensive bit of research

click on full text in the box on the right

I found it when I was looking for the differences between dehiscence and rupture. I've had the dehiscence and had a consultant scare me about the chance of a rupture next time. Lots of research just says "rupture" when they mean " the scar area got really thin or the top layer of the scar started to separate a bit at one end". This can happen without causing problems.

Toady's list seems to say that the risk of scar rupture is 1 in about 300; I think it is better than that if you don't count all the symptomless, problem-free dehiscences that get included in the research.

But I am wary when people say "oh, its very rare". The chance of a baby coming feet-first at term is quite rare, 1% or so. The chance of the placenta completely covering the cervix at term is is a lot less than the chance of a scar rupture. I've had both of those though. I've also had a scar dehiscence (was planning an HBAC for that one). Hey-ho.

There is a lot of research that shows that a late 2nd-trimester scan of your scar is worth doing. If your scar is quite thick, you almost definitely won't rupture. If it is quite thin, that doesn't mean you will rupture - i.e. if they scan you and it is thin you're no worse off than you were before. I can do some links if you like.