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VBAC or RCS?

"ACOG is clear that women shouldn’t be forced to have cesareans."

It's really sad & pathetic that in this day & age women have literally NO say in their health choices. If you have more than 1 cesarean you are now considered "high risk". If you were lied to or mislead as to why you needed to have a RCS in the first place, your right to experience a natural birth is stripped away from you. If you are wanting a vbamc almost NOONE will take you on.

Know that you have RIGHTS & when a RCS is given to you as a recommendation based on "certain situations" unless the baby is decelerating during labor or you have an incomplete cervix 9/10 YOU CAN BIRTH NATURALLY.

RCS are paid out more than natural births & more "convenient" for the OB. I was LIED to 3x & stripped of being able to birth my children the way my body was built. Bicorneate uterus & septum is NOT a reason for a RCS. Even ACOG CLEARLY says that a 4th cesarean is much higher risk in maternal death than a vba3c. As well as hysterectomy, rupture & fetal death. Why in the world aren't women given more support when they want less medical interventions?!

It goes without saying emergencies are different & there is a time & place for CS. However, more times than not it's an unnecessary intervention & it's time to stand up for what is right & NOT be bullied by the medical industry!!



http://onlinelibrary.wiley.com/doi/10.1111/j.1471-0528.2010.02498.x/abstract


Results Of 25 005 women, 860 had three or more prior caesarean deliveries: 89 attempted VBAC and 771 elected for repeat caesarean. Of the 89 who attempted VBAC, there were no cases of composite maternal morbidity. They were also as likely to have a successful VBAC as women with one prior caesarean (79.8% versus 75.5%, adjusted OR 1.4, 95% CI 0.81–2.41, P = 0.22).


Conclusion Women with three or more prior caesareans who attempt VBAC have similar rates of success and risk for maternal morbidity as those with one prior caesarean, and as those delivered by elective repeat caesarean.


Saldana LR et al. Am J Ob-Gyn 1979 overall UR rate 0.0%, included 4/38 VBA3Cs

Martin, JN et al. Am J Ob-Gyn 1983 overall UR rate of 0.0% 6/19 VBA3Cs

Phelan, JP et al Am J Ob-Gyn 1987, 0.3% overall UR, 159 VBA2+C, cannot find the number of VBA3C TOLs but shows 90% success rate for VBA3C

Farmakides, G et al. Am J Ob-Gyn 1987 TOLs overall 51 VBA2+C, 0.0% UR, 18/57 were VBA3C TOLs

Stovall, TG et al. Ob-Gyn 1988, UR 0.0%, cannot find the number of TOLs specific to VBA3C, but notes 100% success rate in VBA3C with low transverse and 100% success in VBA3C with low-vertical scars.

Flamm, BL et al. Am J Ob-Gyn1988 UR 0.0%, 7 VBA3C TOLs, 71% VBA3C success rate

Novas, J et al. Am J Ob-Gyn 1989 total TOLs for VBA2+C is 36, 0.0% ruptures, 89% VBA3+C success rate (cannot find the number of VBA3C TOLs)

Veridiano, NP et al. Int J Gyn OB 1989 overall UR rate 1%, study included 4 VBA3Cs, 2 VBA4Cs, 1 VBA5C

Hansell, RS et al. Birth 1990 study of small sample size showed 60% VBA3C success rate and 100% VBA4C success rate with 0.0% UR

Cowan RK et al. Ob-Gyn 1994 3 TOLs after 3 c/s, 100% success rate, overall UR rate of 1.4% in VBA2+C

Miller, DA et al. Ob-Gyn 1994 overall TOLs 1827 for VBA2+C, UR rate for VBA3C 1.2%, 79% VBA3C success rate


The WHO on woman’s choice & informed consent.

https://www.theguardian.com/lifeandstyle/2018/feb/15/do-not-intervene-to-speed-up-birth-unless-real-risks-involved-advises-who

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