Midwife Appointment

I saw the midwife today, and it was awesome! My hubby got to come along, too, which was cool. I talked to the midwife about doing a VBAC. She had read the surgical notes and 100% agreed with me that VBAC was the way to go. (Yipee!) She said that the prior C-Section was totally fine and that the placental abruption was probably a "twin thing". (That's what I thought too.) She also assured me that we would do ultrasound cervical checks for as long as I wanted to, since we don't have a clear idea of whether or not my cervix is truly incompetent and when it might start to funnel (if at all). This way we will catch something if it happens early. Luckily, I don't have any history of pre-mature labor, since I didn't even really go into labor with the twins...although I might have been at 35 weeks, it doesn't count since that's in the normal range for twins. Also, the fact that I had no cervical change from 33 - 35 weeks with the twins (while holding out at 2 cm dilated) is a great sign. We also got to hear the baby's heart beat, which was a perfect 155bpm. All in all it was a fantastic appointment, and I am *so* glad that I'm switching over to the midwife practice.

Update from The Doc

I talked to the C-Section OB today. He was SO nice when he called, and talked to me for several minutes about my questions. Here's the scoop:

My C-Section incision is 100% normal. It's just like any other low transverse scar, and it doesn't extend outside of the normal range for that type of incision. So in terms of uterine rupture, my risk is no higher than any other woman doing a VBAC.

The vein that "sprung a leak" was not the uterine artery (hence it being a vein), and it was on the entire opposite side of the uterus from the incision. So that had nothing to do with my incision, and could've come from any number of places...he couldn't give me a straight answer because he had no idea where the "leak" came from, he just fixed it. :-)

Having had a placental abruption puts me at a higher risk for having another one, but I don't have any risk factors for abruptions with this pregnancy. In my last pregnancy the only risk factor I had was being pregnant with twins. I don't have that risk factor now, so I think my risk would be lower than any other woman who had a placental abruption with a singleton. The studies say the rate of recurrence is 10%, but mine is probably lower than that because I don't have any risk factors now (except of course the prior abruption). There is a higher risk of it happening during labor, since the uterus is contracting and all, but I would already be in the hospital and on monitors. I know what it felt like the last time, and with everyone watching me like a hawk they would probably catch it VERY quick. So, that's really the least of my worries.

Now that I have all of this info, I think VBAC is the best choice. Having a C-Section comes with its own bag of possible complications, especially when you have multiple C-Sections. Since I want to have a lot of kids, having several C-Sections would be *much* riskier than attempting (and hopefully being successful at) a VBAC. My risk for uterine rupture is as low as anyone else's, and that was my biggest worry. So with that gone, there's really nothing saying I shouldn't try it. I think you guys probably agree, right? :-)