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    Find out what other moms-to-be are asking. Join in the discussion with Henci Goer, whose expertise is determining what the research tells us best promotes safe, healthy birth. If you would like to contact Henci outside of the Ask Henci forum, send an email to Goersitemail@aol.com.

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    Feb 25
    2011

    myomecomy, csection...vbac?

    Archived User

     

    Hi my name is Kellie, I'd like to give you my history and get our opinion.  I have a 10 and 8 year old both vaginal deliveries no complications, labor started on it's own at home with my water breaking.   I had another vaginal delivery, Jan. 2009 at 14 weeks due to a large fibroid, which I never had before or since.  The fibroid was found at 7 weeks with me complaining of right side pains at that time it was the size of an orange.  By 14 weeks the pain was 24/7 and I was put in the hospital and 3 days in I went into labor with my water breaking.  April 2009 I had a myomectomy with the Da Vinci Robot to remove the fibroid that grew to the size of a cantaloupe it was NOT inside my uterus it was on top of it but not on a stalk.  My doctor and my OR notes state "a skin flap was pealed back and fibroid completely removed and skin flap tacked back down"  They did NOT go into uterine muscle or puncture through uterus.  I was shocked when I was told yes I had to have a csection for any future pregnancies.  One reason I got was because it was on top of my uterus and the other because the hospital and or my insurance did not practice "VBACS" and since i had a uterine surgery it was considered that.  I conceived July 2009 no complications BUT was a scared wreck through whole pregnancy from fears told by doctors that women can have uterine ruptures during pregnancy from any uterine surgery and I quote, "you would bleed out within ten minutes and death high for mother and child if that occurs"  So I had a csection March 2010 to a healthy baby boy no problems.  I asked my doctor during the csection IF my uterus looks bad or at risk then I need my tubes tied.  Her exact comment was it looks perfect I can't even see a scar where we did the myomectomy.  GREAT so is this a csection for NOTHING.    We have a strong faith and believe it having a large family and repeat csections is NOT the way we want to go unless it just has to be and NOT because of liability reasons.  So I would like your opinion as much as you can just hearing my story and not seeing my chart.  I do have my complete medical records and since all this we have moved from FL to VA and although I'm not preg. I would like to find a ob or midwife someone that would listen and atleast look and research my chart and give me a chance for a VBAC. 
    Thanks for listening and any advice I'd appreciate.
    Kellie Boyles

     

    Henci Goer

    I am not a midwife or doctor, so I cannot give you an opinion. I can, however, tell you what the research says and apply logic. If your doctor said she couldn't even see a scar from your myomectomy, then you are essentially a woman with a history of a single cesarean and two prior vaginal births, which makes you an excellent candidate for VBAC. I have 10 studies of women planning VBAC with a history of vaginal birth, and the VBAC rate was 90%, give or take a few percent in all 10. I have five studies reporting percentages of the scar giving way. In all cases, it was substantially lower (2 to 6 per 1000 VBAC labors) than in women in the same population without prior vaginal birth. And it must be remembered that in all but a few, rare cases, scar rupture means no more than having an unplanned cesarean. Mother and baby are fine. On the other hand, each cesarean surgery increases the likelihood of having life-threatening placental attachment complications in the next pregnancy, and you say you want a large family.  I suggest you get in touch with the International Cesarean Awareness Network people closest to your new home. They'll know who is doing VBACs.

    ~ Henci


    All Times America/New_York

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