PREGNANCY-BIRTH Messages for March, 1999: Re: VBAC success?

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Re: VBAC success?

From: D. Ashley Hill, M.D. (anonymous@obgyn.net)
Tue, 30 Mar 1999 21:04:09 -0600 (CST)

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At Tue, 30 Mar 1999, hanna wrote: >
>I am curious what is considered a successful VBAC delivery?
>
>I gave birth to my son VBAC 4 years ago. He did survive but it was
>close. They let me labor way too long and then needed to use forceps to
>get him out. I am now left with my cervix and bladder protruding
>through my vagina which will need additional surgery to correct. The
>Doctors considered this successful but, I'm sure you can tell;-), I do
>not! Have there been any studies in this area? What percent of VBAC
>patients develop uterine prolapse or some form of pelvic prolapse?

To my knowledge there have been no studies directly looking at uterine prolapse and VBAC. It is probably no higher or lower than a "regular" vaginal delivery. However, even patients who have c/sections can have uterine prolapse, loss of urine with coughing or laughing, or other problems that most folks think only come from vaginal delivery.

I want to be very clear that I am not arguing with your assessment of your labor and delivery. However, every day I hear "horror stories" about labors that were "too long," etc. When I review the records, this is rarely the case. Patients often have perceptions about their labors and deliveries that are not always based on scientific evidence. Plus, there is a significant art to delivering babies. If we performed a c/section every time labor stalled, many women would needlessly die due to operative complications from cesarean delivery. And, despite what is published in many women's journals, pregnancy can be extremely hard on a woman's body. As you suggest, vaginal prolapse is fairly common after vaginal delivery, VBAC or otherwise. The only real way to prevent this is to not get pregnant. Obviously, this is not acceptable to most couples. Thus, many women end up "carrying" the results of their pregnancy for many years.

Best wishes,

-- Ashley Hill David Ashley Hill, M.D. Associate Director Department of Obstetrics and Gynecology Florida Hospital Family Practice Residency Orlando, FL http://home.mpinet.net/dahmd

The above is intended for general medical education, and is not for specific medical advice. I apologize, but I am unable to answer personal e-mail due to time constraints.

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