Vbac vs elcs with unusual scar - any experience please?

[missmillimentscardigan]

I'm feeling a bit confused about my birth options (if I actually have an option) and would really appreciate some advice.
Am currently 37 weeks pregnant with DC2. DC1 was born 2.5 years ago by emcs at 27 weeks due to sudden placental insufficiency (luckill all fine now). I was kind of expecting that I'd need to have another c-section due to the circumstances of my dc's birth, but after my hospital requested my old notes, I was told on several occasions throughout my pregnancy that I could try for a vbac if I wanted, and I was keen to do this.
Last week I saw a different consultant at 36 weeks who looked through my notes and said that I had a t-shaped incision on my uterus and so would not be a good candidate for a vbac, and was I happy to book am elcs for 39 weeks. I agreed to this as it was recommended by the consultant and because I was kind of in shock to only find out this information at this late stage.
Has anyone experienced anything similar? I really wanted to avoid another c-section if possible, but if it's safer then it's obviously the right thing to do. I've been trying to do a bit of my own research and I can find much about more unusual scars and the likelihood of rupture.
Also I really want to have one more dc after this one and I'm worried that I won't be about to if I have too much scar tissue etc. I just want to make sure I have all the relevant information I can and I don't know anyone irl who has experienced anything similar. Also, in a more selfish way, I feel sad that I won't be able to experience a vb.
Thanks

Apologies for typos. I 'can't find much about more unusual scars.

I sort of have experience of this. In a nutshell: DC1 was born via EMCS. I attempted VBAC with DC2 but ended up with a ruptured uterus and EMCS under GA. Thankfully DC2 survived and is fine. However, due to the rupture my scar is bigger and longer than a standard scar, therefore DC3 was born by elective CS at 37 weeks, idea being to avoid me labouring. All went to plan.

I did feel sad about having not experienced 'natural' childbirth but having nearly lost DC2 and now having three beautiful DC thanks to the wonderful surgeons who are skilled enough to deliver babies by CS I am honestly just grateful to live in the modern age with all the benefits of medical science and equipment.

Obviously, I would go for CS every time and I imagine that is why they have recommended you for CS. it will be to limit the risk of rupture, which will be higher if you have a T shaped scar - so at least part of it is vertical. It is hard to find real statistics on actual scar rupture in all the different possible circumstances.

For me potential sadness at not experiencing vaginal birth is outweighed by the potential of rupture because the outcome of the latter is potentially so awful.

My original scar that ruptured was a normal one btw, and my third CS was fine.

I do understand how you feel though.

Thanks so much for sharing your experience, Sue. That sounds so traumatic, so I appreciate you sharing it. I'm glad it all worked out in the end.
Yes, it is the risk of scar rupture that is the concern. I completely agree that being able to safely deliver babies is the most important thing. My t shaped scar gave me my lovely dc so I don't resent it at all.
I guess I just feel like I want a bit more information /stats etc. The consultant was quite brusque and it was all sorted out in about 10 mins.

This site is american, but says between 4 and 9% of T or J scars rupture

www.obgyn.net/articles/what-about-uterine-scar-ruptures

Thanks for that, Topsy. 4-9% is really high. That's made me feel a lot better about the elcs.

If you have a look on RCOG or similar websites for studies about vertical scars you might find some stats. I know you're is T shaped but I think the stats for vertical scars would give you a good guide as part of it is vertical and that's what causes the higher risk.
I was looking at VBAC stats on RCOG and like a PP said the risk of rupture is a lot higher with other types of scars. I guess your hospital just assumed yours was the typical one without checking until the last minute

You could ask the clmsultant for the data that they base their practise on, I did this when i went to see a consultant.

I think it depends how you look at data too, to me 4-9% isnt that high, when you think 91-96% is completely fine. When you look at data, you needto look at both sides, many studies re funded by pharmaceutical companies meaning its in thei benefit to make the data work in their favour.

Hooe you manage to come to a conclusion that you are happy with

Gah, fat fingers! Should say consultant!!! :)

Thanks, Topsy. I know what you mean - 91-96% is pretty good odds, but it's a lot lower than the 'normal' vbac stats. I don't know whether I'd be able to labour effectively anyway now, without worrying about a rupture. It's very difficult because I don't want to take unecessary risks, but a c-section is still major surgery. I don't think I have a choice anyway, but I still want to know as much about it as I can.