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    Questions? Ask Henci!


    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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    Jana Stump

    Hi Henci,

    I have read through several of your forums and noticed you do rec. waiting 15 months to conceive after a csection to allow for a better chance of vbac success... my question is I conceived 13 months post section but miscarried 1 month later on... I conceived again 15 and a half months post csection.  My question is did the miscarriage (natural) put extra stress on my uterine scar? And also since I did end up pregnant again after the 15th month mark, but only by a few weeks, am I in the low risk .5 percent chance of rupture or do I fall into the 1-3 percent... I am thinking of a homebirth and would rather be in the .5 percent category. I am also wondering if the miscarriage could up that risk with added stress of contractions during the miscarriage. I feel like homebirth is my only choice besides induction because with my first baby I did not go into labor until 42 weeks and 4 days (refused induction) and I know I would be under too much pressure to be induced this time. Do you feel it is reasonable to attempt a homebirth with this history or do you think the risk or meconium and rupture might be too high? There was meconium with my first birth... I hope this isn't asking too many questions.. Thankyou so much for your time.

    Henci Goer

    I'm actually just reporting what the research has to say about the association between scar rupture in a subsequent pregnancy after cesarean and length of time between the cesarean and, depending on the study, the next conception or the next delivery. Unfortunately, that means I can't be of much help to you since I am not aware of any research on how an intervening miscarriage might affect matters. The best I can do is tell you that investigators theorize that the reason scar rupture rates go up with a short interval between the cesarean and the next labor is because the scar takes time to heal. I don't know that this gets you much further, though. 

    One thing that might help you make your decision is to find the hospital-based care provider in your community who is the most supportive of VBAC and have a heart-to-heart with her or him about your concerns, including that since you seem to run long pregnancies, you are worried that you might be pressured to agree to a repeat cesarean. I say "repeat cesarean" because most clinicians are leery of inductions when a woman has a uterine scar. The research shows that nduction can increase the risk of scar rupture. (FYI: it doesn't necessarily, but that is a post for another time.) Then see what this person says.

    ~ Henci


    All Times America/New_York

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