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Topic: APS and C/S

Posted By on 05 Dec 2005 01:29 PM
Hi Henci,
I am on ICAN email group and it was suggested I write to you to see if you have info on this. I am 38 wks preg. Have had 5 miscarriages and 2 full term live births. 1st one v/b at 36 weeks 11lbs and second c/s at 38 wks for fetal distress, 8.6 lbs, cord was wrapped 3 times. who knows if it was needed.
They have done tests for the miscarriages and found antiphospholipid syndrom to be the cause. My Dr says he is supportive of VBAC but says if I don't go into labor by 40 wks he would do a c/s the following day. He said the risk of placenta breakdown is to great with APS. Do you know if that is true? Is that the best way to go with APS. as he said he won't induce because of prior c/s. Just want to make sure a c/s is realy needed and not just agree cause he says so. I haven't found much on the internet regarding this issue.
Thanks for any info
Laurie By: flowergirl348

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Topic Review

Archived User User is Offline

Posts:354

06 Dec 2005 03:23 PM
I am not neither a dr or a midwife nor do I have any knowledge of antiphospholipid syndrome (although I have heard of it), so on both those grounds, I am not qualified to give you any advice. What I can do, though, is give you the means of determining whether you can trust your ob's judgment: Ask him what percentage of women in his practice with prior cesareans have VBACs. If you don't hear "about three-quarters," you know that he doesn't encourage VBAC because numerous studies have shown that rates over 70% are readily achievable. You may also wish to ask what his cesarean rate overall is, which I would phrase diplomatically as, "How often do you find it necessary to perform a cesarean?" If you don't hear a number of 15% or less, again, a rate that studies have shown can be achieved in a run-of-the-mill obstetric population--some women high risk, most women not--then you know you can't trust his judgment in recommending a cesarean in your case. If he doesn't know or won't tell you these numbers, consider that a red flag. If your ob doesn't pass the test, I recommend looking for one who does and getting a 2nd opinion. Talk to the doulas and home birth midwives in your community. They are likely to know who the progressive obs are. I also recommend you read Should I choose VBAC or repeat cesarean? on the Maternity Center Association website. It doesn't seem as if your ob has told you any of the risks of either any individual cesarean surgery or the risks of accumulating cesarean surgeries. Before you make any final decision, you will want to weigh those against the risks of awaiting labor. Please write back and let us know how you are doing. -- Henci By: Henci Goer

Archived User User is Offline

Posts:354

05 Dec 2005 06:29 PM
Hi Henci, I am on ICAN email group and it was suggested I write to you to see if you have info on this. I am 38 wks preg. Have had 5 miscarriages and 2 full term live births. 1st one v/b at 36 weeks 11lbs and second c/s at 38 wks for fetal distress, 8.6 lbs, cord was wrapped 3 times. who knows if it was needed. They have done tests for the miscarriages and found antiphospholipid syndrom to be the cause. My Dr says he is supportive of VBAC but says if I don't go into labor by 40 wks he would do a c/s the following day. He said the risk of placenta breakdown is to great with APS. Do you know if that is true? Is that the best way to go with APS. as he said he won't induce because of prior c/s. Just want to make sure a c/s is realy needed and not just agree cause he says so. I haven't found much on the internet regarding this issue. Thanks for any info Laurie By: flowergirl348

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