How you can avoid the catastrophic consequences of a uterine rupture while undergoing a vaginal birth after cesarean delivery (VBAC) in Kingston, New York
So, what's so bad about a VBAC? There's only one thing you need to know. Once you have had a cesarean delivery, you have a scar on your uterus from the site of the surgical incision. With most cesarean deliveries, the uterine scar is horizontal on the lower part of the uterus. The scar on your uterus can be prone to separate and rupture during a subsequent vaginal delivery when the forces of uterine contractions stretch and push on the scar.
When too much pressure is exerted on the uterine scar, it can separate and rupture. The consequences to mom and baby can be devastating. When the uterus ruptures, the baby and sometimes the placenta are expelled into the abdominal cavity. When the baby is completely outside the uterus, he/she receives no oxygen and must be delivered on an emergency basis by C-section within minutes. Every second counts when the baby is free-floating outside of the uterus.
The rupture of the uterus poses big risks to mom as well. The uterine rupture causes internal bleeding in the mother, which can lead to maternal death. Thus, uterine rupture can cause death for the baby and mother.
What are the warning signs of a uterine rupture? The rupture of the uterus is sometimes preceded by the partial separation of the uterine scar (known as uterine scar dehiscence). The partial separation of the uterine scar during labor can cause severe abdominal pain between contractions (mom should not ordinarily have any pain between contractions), vaginal bleeding and sharp pain at the site of the previous C-section scar. When a mom has any of these symptoms during a VBAC, these are big-time warning signs of an impending uterine rupture.
The risk of a uterine rupture increases with the use of labor inducing medications or drugs that stimulate uterine contractions. Remember, the stronger the uterine contractions, the more force that is exerted upon the uterine scar and thus, the higher the risk that the scar will separate. Medications to induce labor or improve contractions (pitocin) should be used cautiously since they can increase the risk of uterine rupture.
Here's the key for any mom considering a VBAC: If you discuss the risks of a VBAC with your obstetrician and you want to accept the risk of a VBAC, that's fine, but you must make sure the facility where you deliver is ready for an emergency cesarean section! VBAC should only be considered if a physician capable of performing a cesarean delivery, nursing staff, anesthesia and an operating room are immediately available in case an emergent cesarean delivery is necessary.
Every second counts when you have a uterine rupture. Your life and the life of your baby may hinge on whether your hospital and obstetrician are watching carefully for signs of a uterine rupture and are ready for an emergency C-section when you show the signs of a rupture. Make sure you get the facts about uterine rupture before you choose a VBAC.