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Old 07-09-2013, 02:49 PM   #21
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Re: Am I a good candidate? (Sorry, long!)

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Originally Posted by 4boys1girlforme View Post
My section was a single layer closure because at that hospital once a section, always a section. I was never notified or given an option. When I first went to an OB for my next pregnancy- he told me he wouldn't VBAC me with a single layer closure and neither would any other OB. He was wrong! I had 2 successful VBAC's with no complications!
Also studies seem to be disagreeing that it makes much difference:
http://www.ncbi.nlm.nih.gov/pubmed/10796177
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3421916/
Neither of those studies includes definitive information regarding impact of scars on future births. Both point out that further studies are needed. I wouldn't take anything from them other than even the professionals don't know quite enough about the topic. From all I've read, single stitch has best immediate outcome regarding quick healing, but the double is best long term and for VBAC/multiple future pregnancies. But again, there's not nearly enough info to base the decision of whether to attempt VBAC on any of these factors.

*I* definitely think VBAC is the best choice in this matter, regardless of what stitch was used. I only mentioned it because the use of uterine stimulants is quite controversial when attempting VBAC in general, but especially with single stitch.
OP should allow labor to begin spontaneously and avoid labor modifying drugs. To avoid intervention and hopefully a repeat, labor at home as long as possible and spend as little time in the hospital as possible. If possible, I would recommend homebirth, but sounds like the hubs would be very against that uncertainty lol.
If cesarean were to become necessary, I think that a double stitch is best for the body's long term healing and future pregnancies. That doesn't mean the single stitch eliminates anyone from attempting VBAC. Only I wouldn't recommend having singles multiple times.

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Old 07-09-2013, 02:57 PM   #22
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Re: Am I a good candidate? (Sorry, long!)

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Originally Posted by sublime.mommy View Post
Neither of those studies includes definitive information regarding impact of scars on future births. Both point out that further studies are needed. I wouldn't take anything from them other than even the professionals don't know quite enough about the topic. From all I've read, single stitch has best immediate outcome regarding quick healing, but the double is best long term and for VBAC/multiple future pregnancies. But again, there's not nearly enough info to base the decision of whether to attempt VBAC on any of these factors.

*I* definitely think VBAC is the best choice in this matter, regardless of what stitch was used. I only mentioned it because the use of uterine stimulants is quite controversial when attempting VBAC in general, but especially with single stitch.
OP should allow labor to begin spontaneously and avoid labor modifying drugs. To avoid intervention and hopefully a repeat, labor at home as long as possible and spend as little time in the hospital as possible. If possible, I would recommend homebirth, but sounds like the hubs would be very against that uncertainty lol.
If cesarean were to become necessary, I think that a double stitch is best for the body's long term healing and future pregnancies. That doesn't mean the single stitch eliminates anyone from attempting VBAC. Only I wouldn't recommend having singles multiple times.
I was given pitocin inductions for both my VBAC's- maybe not ideal but it kept me out of surgery!
It seems that doctors are more comfortable with performing either the single or double layer closure- I'm not sure that it's up for debate directly before surgery. Certainly something to speak to your OB about at a routine visit though.
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Old 07-09-2013, 03:20 PM   #23
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Re: Am I a good candidate? (Sorry, long!)

Your wishes for a double layer closure should be on your birth plan, I guess. Or you should at least find out what your doctor's "standard procedure" is.

Pitocin is used for VBACs, but the risk of rupture does go up fairly substantially. I don't know why so many doctors can't seem to leave well enough alone! If the baby is starting to suffer in a post-dates pregnancy, that's one thing, but most don't bother doing the non-stress testing - they just say "you're overdue, we're inducing."
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