Also, some women don't want to risk even a small chance (0.5 percent)
of uterine rupture during childbirth, which can lead to the death of the mother and child.
Several studies have noted an increased risk
of uterine rupture in the setting of induction of labor in women attempting TOLAC (5, 6, 89, 100 — 102).
If you, or the baby's mother, were at risk of suffering a uterine rupture and / or exhibited
symptoms of a uterine rupture that a reasonable doctor would've been able to diagnose and treat, then the failure to diagnose or treat the uterine rupture could be considered medical malpractice.
But if you have a similar risk
of uterine rupture of 1/200, these parents are willinging to accept the risk for their unborn child.
The Journal of Obstetrics and Gynecology reports a three-fold increased risk
of uterine rupture for women who attempt to have a VBAC with a pregnancy that began fewer than six months after the end of the last one.
Since then, I've been encouraged to give my child the gift of a vaginal birth and not be scared by the seemingly small
odds of uterine rupture or the chance of a repeat emergency C - section.
I had feared this meant a repeat c - section because the OB's office had said they really wouldn't do much in way of induction
because of uterine rupture chances.
This study was limited by reliance on the International Classification of Diseases, Ninth Revision, coding for
diagnosis of uterine rupture and was unable to determine whether prostaglandin use itself or the context of its use (eg, an unfavorable cervix or need for multiple induction agents) was associated with uterine rupture.
The practice has come under scrutiny recently because several
cases of uterine ruptures and deaths of babies and mothers have prompted lawsuits.
Some of the
signs of uterine rupture include heavy bleeding, acute pain in - between labor contractions, the baby receding back into the uterus during birth, as well as shock and loss of consciousness on the mother's part.
Yet, as the number of women pursuing TOLAC increased, so did the number of
reports of uterine rupture and other complications related to TOLAC (17 — 19).
Mother had an
area of uterine rupture from the scar from the midline to the right side going down toward the cervix and uterine vessels on the right side.
Any hospital that says they can not support a VBAC mother because they aren't prepared to handle the
consequences of a uterine rupture are not safe places for any birthing mother to give birth.
Studies addressing the risks and benefits of TOLAC in women with more than one cesarean delivery have reported a risk
of uterine rupture between 0.9 % and 3.7 %, but have not reached consistent conclusions regarding how this risk compares with women with only one prior uterine incision (6, 70 — 73).
Uterine rupture often is sudden and may be catastrophic, and no accurate antenatal
predictors of uterine rupture have been identified (129, 130).
However, the potential increased risk
of uterine rupture associated with any induction and the potential decreased possibility of achieving VBAC should be considered.
They offer the
statistics of uterine rupture with two previous cesareans as 1.36 %, and ultimately state that provided the woman is fully informed of the increased risk and has undergone an individual risk assessment with her provider, then planned VBAC may be supported in women with two or more previous lower segment cesarean deliveries (NICE, 2015).
The risk
of uterine rupture appears to be inversely related to the length of time between deliveries (the longer the interval between deliveries, the lower the risk of rupture).
It's widely thought that a VBAC (vaginal birth after cesarean delivery) is unsafe, because of the risk
of uterine rupture along the scar line.
And if we opt for the VBAC, my experience will vary greatly from the natural childbirth I experienced with my daughter, and I will need to learn how to mitigate the
danger of uterine rupture.
Acute signs and
symptoms of uterine rupture are variable and may include fetal bradycardia, increased uterine contractions, vaginal bleeding, loss of fetal station, or new onset of intense uterine pain (27, 81, 124).
NICE (2015) discusses a study by Landon et al (2006) that showed no significant difference in the
rates of uterine rupture in VBAC with two or more previous cesarean births compared with a single previous cesarean birth, and states that these findings are consistent with «other observational studies,» (p 7).
Women who attempt VBAC who have interdelivery intervals of less than 24 months have a 2 - 3 fold increased risk
of uterine rupture when compared with women who attempt VBAC more than 24 months after their last delivery (ACOG, 2004; Esposito et al, 2000).
In addition, there is evidence that the use of intrauterine pressure catheters does not help in the
diagnosis of uterine rupture (127, 128).
In addition, recent data indicate that regardless of incision type, periviable cesarean delivery results in an increased risk
of uterine rupture in a subsequent pregnancy (24).
reports a three-fold increased risk
of uterine rupture for women who attempt to have a VBAC with a pregnancy that began fewer than six months after the end of the last one.
The greatest disasters that bring fear and cause barriers to care for VBAC are the cases in which no one knew the
signs of uterine rupture and the staff did not act quickly, causing harm to the mother / baby.
You have an increased risk
of uterine rupture with a VBAC if your previous birth was less than 18 months from the when the next birth will be.
While many providers inform women of the
risk of uterine rupture when attempting a VBAC, women are almost never informed of the risks of repeated cesarean surgeries.