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Monday
Apr072014

Uterine Rupture Birth Stories

It’s very difficult to find uterine rupture (UR) birth stories. The moms who have them say they are shuffled off into the dark side of the Internet where they huddle together in isolation from the support they’d once had when they were pregnant. Told they need to go to Loss Groups, they are left almost alone in their grief. 

I’ve decided, after talking to several of these moms, that enough is enough. Their birth stories deserve to be heard, even if they ended in tragedy. And not all did, thank goodness, but enough have that it will surely make the reader uncomfortable and sad going through the stories. 

I am pro-Vaginal Birth After Cesarean (VBAC) and pro-Home Birth After Cesarean (HBAC). I get a little more woogily when it comes to Vaginal Births After Multiple Cesareans (VBAmC), but do support them if they are done in the hospital. 

I believe in order to do a VBAC, the client needs to have a very skilled and experienced provider, one that knows the signs of UR in its beginning stages. These are fetal heart tones going down with or without uterine contractions, the uterus looking divided, the baby crawling up in the uterus, pain in the mother, not necessarily over the scar, a mother’s feeling of panic or fear, her blood pressure crashing and finally, and the least likely to be seen first, is bleeding. The blood doesn’t often come until the abdomen is opened during a cesarean. 

URs are rare, but are, as far as I can tell, happening more and more. Whether that’s because there are more women wanting to VBAC or because the cesarean rate is also climbing, I don’t know. Maybe I’m just hearing about them more. I’ve only seen two URs and both were in primip(aras –first time moms) when they were given too much Pitocin. I’ve never seen a UR in a VBAC mom. I know midwives that have, however, and they become skittish about attending VBACs ever-after. I wonder what I would have done as a home birth midwife if I’d have had a client experience a UR. Would I have stopped attending them at home? I often say that a midwife is a product of her experience, so very well could have stopped servicing HBAC moms and only doulaing them in the hospital. 

I’ve attended about 40 VBACs in the hospital, about 20 in birth centers and about 15 HBACs. I’ve attended VBAmCs in the birth centers, but none at home. The most previous cesareans a woman had was four, VBA4C and there were two of them at the birth center I was at in El Paso many years ago. I doubt they would do that again today. 

Concurrently being published is a piece by Dani Repp at “What Ifs and Fears Are Welcome.” She wrote a post regarding the risks and benefits of VBAC, Elective Repeat Cesarean Delivery and HBAC. I took part in the Q&A on the post and you can read it here

If any of you need more information or support from UR moms, you can contact me and I can put you in touch with a Facebook group or a UR mom.

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