Reply to Dr Beer recommends planned c/section at 38 weeks

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[quote=Anonymous]There are two issues, one is the risk of stillbirth (rises after 39 weeks) and the other is the risk of the VBAC. How old are you? Older moms tend to have a higher risk for stillbirth as pregnancy gets to term and beyond. Also, if you have any other underlying conditions or pregnancy complications that would make vaginal birth more risky for you/your baby, those are important factors to weigh in your decision.

The labor/VBAC itself does not pose an added risk, it's when labor is induced, particularly if your body hasn't started preparing for labor yet (no dilation or effacement) that can increase your risk of uterine rupture during a VBAC. Studies have also shown that women whose pregnancies go postdates are at an increased risk of emergency c/s, but women who deliver by 40 weeks with an induction are NOT, even if they had a prior c/s. In other words, there's no reason to believe you will have an emergency c/s just because you had a prior c/s. Check out the Evidence Based Birth site for info on this.

Knowing how presumably hard it has been for you to carry a baby to term, your OB probably wants to take every possible measure to prevent a stillbirth (and while stillbirth risk is very low before 39 weeks, for a large percentage of stillbirths we don't know the cause). But c/s carry some risks too, and even at full-term/38 weeks some babies aren't as healthy as they would have been at 39 or 40 weeks (from an OB's perspective that's ok because they will get more immediate treatment if necessary, rather than having to wait to come out naturally).

Would your OB be open to a gentle induction, with cervical-ripening drugs first, in week 38? I think I'd at least ask if that was a safe option, and have a discussion about risks. This is if you want to try for a v/b and it's safe for you and your baby. These are not easy decisions but they're so important. Good luck.[/quote]

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