Would you have a VBAC... home birth?

[Anonymous]

Anonymous wrote:VBAC with uterine rupture doesn't automatically mean death for mother and baby.

Have you ever managed a uterine rupture clinically? Trust me, it's a true medical emergency with potentially massive amounts of blood loss. This is medical emergency where both the mother and baby are in a life-threatening situation. I'm not opposed to VBAC if someone is an appropriate candidate but one should be in an environment where the complication can be managed.

[Anonymous]

I'm very pro home birth and hate hospitals in general. Honestly, hate them. That said, my first delivery was very cesarean and my second (assuming this one does not become breech like the first) will be a VBAC in a hospital. Sadly, too many risks for me to attempt a home birth.

[Anonymous]

I'm a nurse midwife and had a VBAC but would not have a home VBAC. Home birth absolutely, home VBAC no. In my career I have seen 2 VBACs rupture and I would never want to deal with that outside of a hospital.

[Anonymous]

A logistical issue is that her health plan may not cover it. ACOG does not recommend home births (regardless of what you feel about it the obgyn specialty society is against it for now, I suspect that will change with more studies) and I can't imagine a health plan would pay for it (I used to be a health educator for a large national health plan so I know about coverage policies).

That means, if something happened and the mom and baby were rushed to the hospital, the plan would NOT pay the costs. Plans like to cover evidence based practices, and VBAC at home is not one.

[Anonymous]

Anonymous wrote:

Anonymous wrote:No way. I had a VBAC with a nurse midwife in a birthing center. The birthing center was connected to a hospital in case of emergency.

You probably would not have made it there in time if something went wrong.
VBAC w/ uterine rupture means death of mom and baby.

I would have. When I say "connected". I mean literally down the hall. And there was always an OB on the floor.

[Anonymous]

I am extremely pro homebirth, pro midwives, and pro VBAC. That being said, I would not attempt a VBAC at home with a midwife.

[Anonymous]

VBAC w/ uterine rupture means death of mom and baby.

Not usually, no. If you read the literature, uterine rupture happens in about 1 in 200 VBACs. Death of baby happens in about 1 in 2000 cases. Death of mother less often than that.

I had a VBAC with a uterine rupture. My baby did die. I was able to go on to have another child, for which I feel blessed. I am somewhat plugged in to the on-line uterine rupture community. (Isn't the internet a wonderful and terrible thing? ) But I know many, many, many people who have had beautiful home VBACs with absolutely no problems.

[Anonymous]

I would not attempt a VBAC at home. The risks are statistically small, but very quickly become life-threatening.

[Anonymous]

Anonymous wrote:

VBAC w/ uterine rupture means death of mom and baby.

Not usually, no. If you read the literature, uterine rupture happens in about 1 in 200 VBACs. Death of baby happens in about 1 in 2000 cases. Death of mother less often than that.

I had a VBAC with a uterine rupture. My baby did die. I was able to go on to have another child, for which I feel blessed. I am somewhat plugged in to the on-line uterine rupture community. (Isn't the internet a wonderful and terrible thing? ) But I know many, many, many people who have had beautiful home VBACs with absolutely no problems.

I'm very sorry for your loss. I assume from your post that your VBAC took place in the hospital, and yet still had such a tragic ending. I am really sorry.

[Anonymous]

Thank you.

Yes, my VBAC was at a hospital. There are no guarantees in life. Not about anything.

[Anonymous]

Anonymous wrote:
I had a VBAC with a uterine rupture. My baby did die. I was able to go on to have another child, for which I feel blessed. I am somewhat plugged in to the on-line uterine rupture community. (Isn't the internet a wonderful and terrible thing? ) But I know many, many, many people who have had beautiful home VBACs with absolutely no problems.

Oh wow. I am so sorry for your loss. That's so sad.

May I ask, though: did you get a lot of "I told you so" and "You shouldn't have...". And also, was your subsequent birth a VBAC?

[Anonymous]

I wanted a home birth for our first. I ended up with an emergency C-sec so our VBAC is going to be at the hospital

[Anonymous]

May I ask, though: did you get a lot of "I told you so" and "You shouldn't have...". And also, was your subsequent birth a VBAC?

Never to my face, although I know people did say things occasionally behind my back. But no one could blame me more than I blamed myself. But that is also a normal part of grief processing, and I worked through it with my therapist.

And no, my younger child was a planned c-section from the get go. It was a very complicated, high risk pregnancy anyway, on top of being a pregnancy after a full term loss, and there was no way that we could have with withstood that level of stress.

[Anonymous]

No... but I would never try a VBAC. Seriously, your uterus could rupture. The previous incision has made it weaker in that area, and strong contractions could be too much for it.

[Anonymous]

Anonymous wrote:

May I ask, though: did you get a lot of "I told you so" and "You shouldn't have...". And also, was your subsequent birth a VBAC?

Never to my face, although I know people did say things occasionally behind my back. But no one could blame me more than I blamed myself. But that is also a normal part of grief processing, and I worked through it with my therapist.

And no, my younger child was a planned c-section from the get go. It was a very complicated, high risk pregnancy anyway, on top of being a pregnancy after a full term loss, and there was no way that we could have with withstood that level of stress.

PP, I am so very sorry for your loss. I'm so happy that you have another little child. It is so sad to think that folks would dare to think (let alone voice to your face or behind your back) that you did something to cause it. I'd think most everyone knows the benefits and relatively low risks of most VBACs. My heart hurts that you were one of the rare negative outcomes. But as for what others thing - my god, there but by the grace of god go them! While not everyone attempts a VBAC, we all face a risk in childbirth (some higher, some lower). I'm thankful you went on to have another healthy child. Sending hugs.