Re: prior c/s's and want VBAC

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snipped.....pregnancy- at 17 weeks I was told- by same OB- that I neede a >scheduled c/s- no reason given except that my only dialating 5 and then
>stopping was indicative of a labor yet to come. c/s scheduled and
>carried out.

snipped....> >third pregnancy- I am now 24 weeks pregnant and much better prepared. I
>went into my first prenatal meeting with the same OB practice/ different
>doctor- he was excited I wanted a VBAC. We discussed and planned this.
>I recieved a call mid week of the same week from the OB that delivered
>both prior pregnancies- he protested my VBAC and convinced the other 6
>doctors of this.
>
>My questions: I realize that the unterine rupture rate is higher because
>of 2 prior c/s's by around 1%- but is that worth sched. a c/s?

Only YOU can decide if the risk of uterine rupture is worth the POSSIBILTIY of delivering vaginally. The job of your doctors is to inform you of hte risks (about 1 -2% risk of uterine rupture which could possibly lead to death of the baby -- and you) and the benefits (less pain, less bleeding, faster recovery) of a successful VBAC. And remeber VBAC is not succesful 100% of the time -- across the board, teh success rate is about 70%, with wide variation depending on the reasons ofr the first c-section (very high suces if prior cection was for fetal distress or breech, for example, and abysmally low if prior cection was done because you pushed, and pushed and pushed and the baby wouldn't come out)

>
>Also- is this a valid reason: the spines not opening during labor
>before?

If you really have a contracted pelvis, you may not be able to deliver vaginally. Ask your doctor about CT or Xray pelvimetry to measure the pelvic outlet.

>
>Is stopping at 5 cms in a prior labor that my body was not ready for-
>indicative of another labor?

Getting stuck at 5 does not mean you can't deliver vaginally.

>
>I want to get another opinion- but do not want to hurt my baby.

Getting another opinion will not hurt anyone.A second doc may agree with the first.

>I do love this doctor- and feel he is only doing what he thinks is best-
>but with really wanting a trial of labor- do I have reason to seek
>another practicioner?

You have reason to sit down and talk to your doc about how much you want to TRY to deliver vagianlly. Your doc has to explain the risks and benefits to you. If you and your doctor cannot come to an agreement, then you may want to seek care elsewhere. ALso, your doctor has the right as well to refer you elsewhere if he is not comfortable taking care of you if you insist on a trial of labor.

The bottom line is this is your body and your pregnancy. Of course you do not want to do anything ot harm your baby, but a carefully supervised trial of labor, assuming you have been counseled about the potential risks, is within your rights. You may decide after all the discusions that you want to go ahead and have a repeat section. That is within your rights as well. It is all aobut informed consent and choice.

--
Kelly Shanahan, MD, FACOG

Replies are for educational purposes only. They do not take the place of a consultation with your own doctor, nor do they construe any doctor-patient relationship.
Private e-mails WILL NOT be answered due to the fact that I am answering this question after my baby is in bed and I do need some sleep myself! Plus, my husband is getting jealous of the computer.

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