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Childbirth/Repeat cesarian risks

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Expert: - 3/23/2010


Question
Hello,

I'm planning to have a fourth caesarian, but the obstretrician who did the third said that I was going to die if I were to have another one as my uterus was paper thin and asked if I wanted to have my tubes tied. I turned down that request.  A year later, I told him of my plans to have a fourth child and this time he said it was possible for me to have another one so long as I don't go into labour and have another caesarian at 37 weeks, no later than that!

My question is what is the risk of my uterus rupturing in the weeks leading up to 37 weeks?  I'm also thinking of staying in a high risk birth hospital for two months prior to this: would that be safer than being pregnant at home?

Sylvia

Answer
The studies that I can find dealing with uterine rupture of a thin uterine lining all had to do with ruptures that occur during labor.   I can't find any studies that measure if you are more likely to have a uterine rupture before labor. And even with labor with a thin uterine lining, the rate of uterine rupture is not high.

I'm guessing that one of the reasons I can't find any studies dealing with a paper-thin uterus rupturing before labor is that it probably is very rare.

I'm not sure how staying in a hospital for 2 months would lower your risk.
Ask your doctor what signs to be aware of that might indicate that there might be a problem.

Sincerely,

Dorothy H.

Childbirth

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Dorothy H, LCCE

Expertise

As a certified childbirth educator and birth doula, I can answer questions dealing with preparing for birth, childbirth classes, pregnancy, what happens during labor and birth, doulas, VBAC, natural childbirth, cesarean birth, interventions in labor, labor, birth, helping someone through labor, concerns or fears about labor and birth, doulas, breastfeeding, and other topics dealing with pregnancy, labor, and birth.

Experience

Since 2004, I have taught childbirth education classes focused on helping couples gain confidence, make decisions for their birth, and give them tools for helping them get the birth they want. Since 2004, I have also attended births in local hospitals as a birth doula (as of 8/10, I have attended 120 births) so I am able to see firsthand what is working in helping couples deal with labor. I am also a mom of five children, and have various birth experiences myself, including unmedicated birth and a cesarean.

Organizations
Lamaze International DONA International

Publications
International Doula Magazine

Education/Credentials
I am a Lamaze-certified childbirth educator. I am a DONA-certified birth doula.

Past/Present Clients
I work with approximately 4-6 couples a month with my childbirth classes. I attend 2 births a month with doula clients.

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