12 Week OB Appointment
Matt and I went over to Walnut Creek today for my ob appointment. Met the doctor for the first time and he is very cool. I like him a lot. He's very relaxed and easy going and attentive and easy to talk to. We heard the baby's heartbeat, too. Doctor called it perfect. He's thinking we should maybe induce the baby a little before its due date so it doesn't get as HUGE as Jack was and I might have a shot at delivering it myself. I had a good experience with the c-section last time, but I'd rather avoid surgery if I can. And if you're wondering, I'm still really sick.
posted by Casa Cornett @ 8:01 PM
4 Comments:
At 10:08 PM,
Christie said…
I am completely ignorant on this topic, but I thought that once you had a c-section, the doctors recommend/make you continue to have c-sections for future kids? Just curious...and sorry you are still sick :(
At 11:12 PM,
Casa Cornett said…
In the early 1980's it used to be "once a c-section, always a c-section" but women started questioning this and The American College of Obstetricians and Gynecologists (ACOG) responded in 1982 by recommending a trial of labor in selected cases and in '88 expanded those guidelines to include more women. In 1995, ACOG published updated guidelines saying "physicians are strongly encouraged to counsel and encourage women to plan labor rather than schedule a repeat surgery. Based on current evidence almost all women with prior cesareans can plan a VBAC."
Back in the day they used to do an up and down incision which carried with it a high risk of uterine rupture during VBAC's. This type is rare nowadays and usually reserved for breech babies and those with uterine abnormalities. The most common incision these days is a transverse incision done low in the uterus and side to side. It has a much lower risk of rupture. Also, doctors have discovered that using prostaglandins to induce women with previous c-sections isn't a great idea and also has a higher risk of rupture, so inducing by more mechanical means is better.
Less than 1% of VBACs result in uterine rupture and only a fraction of those require a hysterectomy. My doctor in particular has performed more hysterectomies in his career in women who delivered vaginally having never had a cesarean than he has for complications of a VBAC.
So, a long answer to a short question: No, most doctors do not make you have a c-section just because you've had one before. A few doctors won't do VBACs because they don't want to get sued, but I wouldn't want a doctor like that, anyway.
At 8:02 AM,
Casa Cornett said…
A "VBAC" being a Vaginal Birth After Cesarean...
At 11:07 PM,
Christie said…
Thanks for the explanation! That's pretty cool, and good to know.
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