Re: UD & Vaginal birth

[Guest guest]

Hi ,

It's nice to see you " pop " in here and there, I hope you're slowly

feeling better. You sound like you're getting your old spunk back,

that's for sure

As you know from my history, I've had two vag births with a UD, the

only limiting factor was if there was breech presentation. HOWEVER,

my OB/GYN did have this infuriating attitude throughout my pg's - I

call it the " wait and see " - as in, we'll wait and see how far along

you get - ie. how many weeks, then we'll wait and see if you go into

labour, then we'll wait and see if it's " productive " and progressing

or whether you need a section, we'll wait and see what happens with

the vag septum .... you get the idea. I did often feel like one

giant experiment

But to her credit, my OB/GYN did have the approach to the delivery

of treating it as " normal " until/unless signs indicated otherwise.

She is also a fertility specialist and has had numerous UD patients -

in the double digits, I forget how many exactly - and she ALWAYS

attempts vag deliveries if not breech. I never did question her

about how many of those are vag vs ending in a section, but you get

the idea.

She also DID say that the would discourage a VBAC with UD, as the

previous section scar increases risk of rupture, however, that won't

be an issue for me and obviously also not for Barbie.

I am continually amazed at how divergent the medical profession is

about treatment - one doc will say " no problem, we'll do surgery and

you'll be fine " , while another says " nothing can be done, look to

adopt " , it's just so difficult to know whom to trust, you can get

three opinions and they are all different. Being a first-time mom-

to-be, I can see how the " rupture " scare tactics can really work

their magic. But as always, the best defense is INFORMATION,

INFORMATION, INFORMATION.

Sorry to be so long, HTH.

Lia

UD

[Guest guest]

Just to chime in here with some of my thoughts on this - I wonder how much

other factors contribute to failure to progress/problems with UD that are the

same as with a " normal " uterus such as - mom not feeling safe and supported

with minimal fear, mom not being able to labor in an optimal position (being

able to move around, walking around, labor ball, etc. - anything but the most

idiotic position of flat on your back!), epidural, interfering/unsupportive

medical personnel, mom's previous bad experiences, etc.

Maybe with a UD, it's even more important to have an optimal environment to

support what's going right and keep the momentum going.

31

???

[Guest guest]

et al.....

My current OB (whom we have all discussed at length) doesn't think vaginal

birth is possible for UD either. She also sites the big word (rupture) and

fear that the correct cervix won't dilate. I must also add that several

other OB's I have seen have negated the possiblity of a vaginal

delivery...I have to assume this is simply and effort to err on the

conservative side? My RE on the other hand feels that there is no problem

with attempting vag birth with an UD....he did mention that sections were

pretty common among MA's, primarily due to the increased likelyhood of

abnormal lie.

I haven't yet worked up the energy to fight that partcicular

battle....intending to cross that bridge when I come to it. But, In light

of the fact that I know darn well it is possible (thanks to this group) I

will be trying my best deliver vaginally (asumming normal lie) when the

time comes.

D

At 08:36 PM 4/28/2003 +0000, you wrote:

>Hey folks ...

>I just mainly want to start a discussion. A new member, Barbie, is 29

>wks pg with her first baby and has been told (by the head high-risk

>OB at a major teaching hospital) that A) she is HIGH-RISK and that

>a vaginal birth is not a safe option, even if the baby is vertex.

>Forgive me if I'm wrong, Barbie, but I *believe* she has no history

>of m/c, IC or any other extenuating circumstances.

>

>So ladies, what the heck is this?!?! They brought out the big guns!

>Uterine rupture! Has anyone here EVER known anyone or had a doctor

>treat anyone who had this? *I* certainly don't remember any. Methinks

>it harks back to the abdominal metroplasty days.

>

>What do y'all think?

>

>(...really needa nap...)

>

>

>

>

[Guest guest]

She also sites the big word (rupture) and

> fear that the correct cervix won't dilate. ...snip

,

You know already that I am living proof that vag delivery IS

possible. As far as the rupture risk, I think it's comparable to a

normal uterus delivering twins. If fetal lie isn't a problem, they

don't usually wave the " rupture " flag in those circumstances, so why

for us?

What I really wanted to comment on was this whole cervix dilation. I

mean, you've got one cervix that has a baby's head pressing on it,

along with the weight of a full uterus, while the other one has none

of the above, plus it's pushed over to the side and relatively

obscured. So hello!!! How could the " incorrect " cervix dilate?

Basic anatomy makes this HIGHLY unlikely. It's possible that the

appropriate cervix can't dilate " enough " because it's

smaller/compromised whatever, but that is a different issue. In my

mind, that at least warrants a TRIAL of labour, which is what I had.

I agree with you about worrying about it when the time comes, I am

just amazed how our OB's give these pat answers. Oh well, I know for

a fact that my own OB thinks I am the patient from h*ll - as far as

questioning and pushing back is concerned. Take care,

Lia

UD

[Guest guest]

I am currently 27 weeks with UD and have also been told I will need

a c-section to avoid a possible rupture of my uterus. My doctor said

they don't know what my other uterus will do during labor and it is

better to be safe then sorry. I have had no complications with this

pregnancy and didn't even know I had UD until I was 10 weeks

pregnant and had an ultrasound. The baby is head down and has been

the whole time. I have been questioning the need for a c-section

most of my pregnancy, and everyone tells me why risk vaginal birth.

Your email has me thinking again though. I am interested to see what

others have to say. Thanks!

[Guest guest]

Hi Ladies,

Thanks for your input. To answer Beth's question, I have not had any

uterine surgery - just the vag. septum removal, although they

couldn't get it all (reason unknown to me). To answer 's:

this is my first pregnancy.

The scare tactics worked well...especially for my husband. I have

talked to him about what I have learned from this group but he

remains convinced that I shouldn't be considering a vaginal birth. I

understand ... My only concern is for the baby, whereas he's worried

about both of us.

I believe the Doctors are afraid to say what they really think

sometimes. Perhaps it's because they're afraid of legal

repercussions. Did any of you see Good Morning America this morning.

A group of OB's in PA have closed their practice & are refusing to

deliver any more babies because their insurance premiums have gone up

so much. Evidently, OB's are highly susceptible to malpractice suits.

Lia is right about the frustrations of " wait & see " . In some measure,

I don't mind being labeled high risk because it means I don't have to

wait so long between appointments and I've had the opportunity

to " see " my son more often due to frequent ultrasounds.

To my OB's credit, he has not put me on automatic bed rest. In this

respect, I appreciate his wait & see approach! Of course, I will

gladly stay in bed if doing so is best for my baby, I simply dodn't

want to be unnecessarily confined.

As I have mentioned to , I will be addressing this issue at my

appointment tomorrow. I will not be rushed or feel guilty about

asking too many questions.

Sorry this is long.

Barbie

UD – 30 weeks tomorrow!

P.S. , this is totally irrelevant, but the new Director of

High Risk at Vanderbilt is Dr. ph Bruner. You may recall " The

Hand of Hope " photo from National Geographic. (See link.) Turns out

he was the Doctor my friend's daughter went to. Perhaps I could call

him & ask a few questions. (I wonder if insurance would pay? They

didn't when I saw the other Director.)

http://www.greaterthings.com/News/hand.htm

[Guest guest]

> Just to chime in here with some of my thoughts on this - I wonder

how much

> other factors contribute to failure to progress/problems with UD

that are the

> same as with a " normal " uterus such as - mom not feeling safe and

supported

> with minimal fear, - snip

,

You are sooooo right!! I can't emphasize enough how much the " fear

factor " permeated my PG and delivery experience. First, my doctor was

CERTAIN I wouldn't get to term, then, she was non-committal about vag

septum removal, due to a likely c-section. She basically couldn't

provide any level of support or reassurance, only " we'll have to wait

and see how it goes and what happens " . Any kind of suggestion of a

home-birth, a midwife, or doula support was treated with absolute

resistance, I was made to feel like I was criminally irresponsible to

even mention the possibility.

Soooo, if you are going into labour/delivery, having no idea what to

expect, no idea what your body can, will or will not do, how long it

will all take, what kind of pain/intervention etc. is in store for

you, only to be endlessly examined, and STILL not given any answers -

well, does all this increase your odds of a section -OF COURSE.

However, even with all that, and all the interventions that modern

obstetrics has to offer, I still beat the odds and had a vag birth

TWICE - and each time from a different uterus, so the odds of that

are even more remote. So I KNOW it can be done.

I also had an emergency c-section for my third son and they got him

out literally in minutes, so I know that if an emergency situation

occurs, the medical team CAN react very quickly. Given that, I would

be hesitant to agree to an elective section, without at least a trial

of labour. However, that is with the 20/20 hindsight I have today.

Luckily my doctor was supportive of trying a vag delivery. But then,

if she hadn't been, I would have looked for someone else. Just my

$0.02, I know that everyone has different circumstances and a

different tolerance for risk and a different level of faith in

medical advice. Best of luck to the UD moms-to-be out there.

Lia

UD

[Guest guest]

Hi there,

For what it's worth, my cousin (who has a UD) gave birth vaginally

to both of her sons. Both went full-term.

Take care,

Mindy

SU resected

[Guest guest]

<Given that, I would

<be hesitant to agree to an elective section, without at least a

<trial of labour. However, that is with the 20/20 hindsight I have

<today. Luckily my doctor was supportive of trying a vag delivery.

<But then, if she hadn't been, I would have looked for someone else.

Hello to everyone who has responded on this thread. I have a

question for you, Lia. Regarding the above from you, is the reason

you would be hesitant to agree to a elective c-section because you

just would prefer a vaginal birth, or is there some other reason or

downside, I should say, that you see to c-section with UD? Other

than the obvious recovery pain, of course.

The only reason I ask is that I had a c-section with Peyton, but it

was not elective since she was breech. At the time, my doctor said I

might try VBAC with my next baby. Well, now that I am pregnant

again, he says that I absolutely should NOT try VBAC due to risk of

rupture. Obviously, I was confused as to his change of opinion,

however, at the time, I thought I would prefer a c-section again,

anyway. Now, I am the one who has changed my opinion and wish that I

could try a vaginal birth. Has anyone here tried a VBAC with UD? I

know that so many doctors have varying opinions about EVERYTHING

under the sun with MA's, but was wondering what the MAJORITY of them

feel about this (VBAC with UD)?

Thanks....just wondering if I should pursue this further or just

accept that it will be another c-section. One good thing about a c-

section, I guess, is that I will know exactly what day and time I

will be delivering. And, no labor pain.

Neal

UD-edd 12-10-03

mom of Peyton, 17 mos.

[Guest guest]

,

Having had both a vag birth and a c-section, I would NEVER choose to

have a section, if presented with the option. The recovery process is

so much different between the two, and it's not just about the pain.

I was up and about almost immediately post-delivery and was out of

the hospital within 24 hours, vs. being much less mobile and in the

hospital for 2 1/2 days, needing much more help with the baby. I know

that a lot can be done to make a c-section a positive experience, but

it still is surgery and it was much harder on me from a recovery

perspective, including bonding with my son, dealing with my older

children, breastfeeding - the whole bit. That may not be the case for

everyone, but was true for me.

The second downside as I see it, is the overwhelming medical opinion

I've seen is " once a section, ALWAYS a section " for MA's, or maybe

just UD specifically. As you may recall, I have three kids, with the

last being a c-section. I can say with great certainty that I would

not have gone through three c-section births, I don't think I could

handle that.

Now I have a question for you that you may want to think about asking

your doctor. If the VBAC is prohibited due to risk of rupture, which

I assume is due to the scarring of the uterus, what if you are PG in

the OTHER uterus, which has not been cut and therefore is like a 1st

pregnancy in a sense? I would NOT buy the rupture argument in that

case, meaning that I don't think your rupture risk should be any

higher than with your first baby. Having said that, I remember

Peyton being quite a big baby (9lbs+) and I wonder what your OB's

opinion of vag delivery would have been if she was head-down? It may

be that he/she would be hesitant to try a vag delivery just because

the baby was so large. I have heard of women with " normal " uterii

delivering by c-section just because the doctor thought the baby

was " too big " which may or may not have been true.

Although women are always in a rush to avoid labour pain, being in

labour is actually GOOD for you and your baby, even if you end up

having a section. I don't want to go into all the details why here.

I would think that if you don't get any labour-boosting meds like

oxytocin, your rupture risk shouldn't be unduly high if you are PG in

the other uterus than with Peyton. You should ask your doctor about

it. Each time I delivered, my OB agreed to a " trial of labour " with

an epidural in place, that could be topped up instantly for a c-

section if the baby showed distress or things were not progressing.

Anyway, that's my perspective, best of luck to you and keep in touch.

Lia

UD

[Guest guest]

Well, now that I am pregnant

> again, he says that I absolutely should NOT try VBAC due to risk

of

> rupture. Obviously, I was confused as to his change of opinion,

> however, at the time, I thought I would prefer a c-section again,

> anyway. Now, I am the one who has changed my opinion and wish

that I

> could try a vaginal birth. Has anyone here tried a VBAC with UD?

I

> know that so many doctors have varying opinions about EVERYTHING

> under the sun with MA's, but was wondering what the MAJORITY of

them

> feel about this (VBAC with UD)?

>

Hi ,

I have an SU so this probably isn't relevant, but I will be trying

for a VBAC with this birth (I'm 33 weeks now). My OB said that the

resection surgery does not increase the risk of rupture since the

uterus is untouched. She told me the risk of rupture is 1-2%. I

also just attended a VBAC class at the hospital and they confirmed

those stats, but the instructor said the risk of a catastrophic

rupture is much less (I guess you can have degrees of rupturing -

sometimes the docs don't even know it has happened). She also said

that you cannot be induced with a VBAC - your body must enter labor

naturally, although you might be able to get drugs to help it along

once you start. And, of course, there's always the epidural. I'm

pretty nervous about trying for a vaginal birth since I never made

it to the classes last pregnancy (my daughter came too early) but I

think it's the right decision for me. I'm not scared of a rupture,

I'm more scared of 48 hours of labor and 5 hours of pushing!

So, I'm sorry I don't have any info on UD but I hope this helps a

little.

Take care,

Mindy

SU resected