Hi Henci! Thank you for providing this resource. I got in touch with Amy Romano after reading the guide to the new NIH recommendations and she suggested I put my question to you.
Four months before I got pregnant with my first, I had an intrauterine fibroid removed via abdominal myomectomy. I don't know exactly where the fibroid was (I could find out fairly easily, I think); I do know it weighed close to a pound. Because of this prior surgery, my OB (who is in the same practice as the doctor who performed the myomectomy) recommended a C-section. I talked to her tentatively about a vaginal birth and her answer was, in essence, "If the fibroid had been smaller or in a different place, we could consider it, but not with what you had."
I tried doing research on post-myomectomy vaginal birth but found very little. Even very pro-VBAC sources I found (a book of Ina May Gaskin's, for example) had nothing about prior non-C uterine surgery. To make a long story short, my daughter was born by planned C at 39 weeks. (And compared to the myomectomy recovery, the C recovery was a breeze!)
I'm not pregnant now, but we're considering having a second child sometime in the next few years, and I'd like to go into that pregnancy more informed about VBACs and my situation than I was the first. My initial reading about the new recommendations gave me hope that I would be a possible VBAC candidate even given the prior surgery (my scar is horizontal; it would be more than 18 months between births; I have a lot of choices for hospital care). But reading about the higher risk of uterine rupture makes me think that even with the new guidelines, I am just not a good VBAC candidate. But if you can point me to further resources or information, I would be very grateful.