HBAC – How I was almost led to believe the hype

After writing the first three follow up posts to my ‘Why I am so against HBAC – DS2 birth experience’ post I joined a group on facebook. The group is for women wanting a natural birth after caesarean, and for those who have attempted and want support. I thought it would be a good place to share my story, especially as the group supports VBAC, HBAC and Home Birth.I initially asked if I could share my story prior to posting it and mentioned that I was anti HBAC but pro VBAC as long as it’s in a facility equipped to deal with any eventuality. This much to my surprise went down like a ton of bricks!When I did post my birth story (which I edited heavily) I was still targeted despite the fact that I am very much pro VBAC (which is one of the factors the group supports). I was given information and links to show that had I had my VBAC at home then the likelihood was that I would not have ruptured, and that I would not have needed intervention.Here are some of the things I was told:

  • If I had had a HBAC instead of a hospital VBAC the risk of rupture would have been much lower as I wouldn’t have had all of the interventions.
  • Ruptures have early signs – a trained home birth midwife would have picked up on the rupture in time to transfer me to hospital.
  • Epidurals reduce the awareness of a rupture.
  • Home birth midwives are more ‘hands off’ so tend to watch you rather than monitor, so they can detect a change in behaviour or appearance far better than a hospital midwife.
  • Uterine Rupture is a rare occurrence and the chances increase with intervention.
  • Having your waters broken for you can increase the risk of Placental Abruption.
  • Epidurals are proven to lesson your chance of a successful VBAC
  • I should have spoken to a Midwife who specialised in home birth and not my consultant obstetrician

With the above being planted in my mind I actually started to question my thoughts in regards to HBAC! Would I have been better off at home? Would I have still ruptured?

I sent a message to Amy who runs ‘The Skeptical OB’ blog, I already knew the answer to my question, but I needed someone to snap me out of the doubts that were now forming in my mind.

Here is my message and her reply:

Hi,



Sorry to message you directly, I hope you don’t find it unacceptable.
I’ve been writing about my birth story (failed VBAC/Uterine Rupture/Placental Abruption in hospital – outcome positive)

I joined a VBAC group who also support HBAC, on joining I was very anti HBAC. I felt it important to tell my story, that had I homebirthed, my baby (and potentially myself) would have died!

I couldn’t understand how any mother would take the risk of a HBAC when there is a chance that if something were to go wrong they could lose their baby (to me their own life is irrelevant, that’s their choice, but to risk the life of an unborn was beyond me)

Upon joining I posted my story, and I did mention that I was anti HBAC but also edited my story heavily so as not to offend anyone (although I did still manage to offend a lot of people)

I’ve been told and given links that apparently show that had I birthed at home I would probably not have suffered the complications, and that even if I had I would have been transferred in ample time as home midwives are trained to spot these things happening far better than hospital midwives….

I’ve been told that the epidural I had would have contributed to the rupture, and that having my waters broken could have caused the abruption. Combine these together and hey presto that’s why I suffered my rupture.
I’m struggling with this in my head! My heart is saying that maybe had I been left alone I could have birthed naturally. But my head is still saying that there is a risk, and if there is any risk to an unborn then surely we should put that first, over and above what we view as our ‘ideal’ birth! Surely the outcome is all that matters. A healthy mother and baby!
I would really appreciate your input on this as I’m no going stir crazy and wondering if the epidural and waters being broken could have contributed to my rupture….

Also I’ve been advised by my consultant that I shouldn’t have any further children now, as the risks are too high and I may not carry full term without rupturing. Again to me this made sense, and in all honesty I have never wanted more than two children. But I’m being told now that it is possible to birth after a rupture…
Please set my mind at rest and tell me I am not crazy. That my doctors are right and that my original opinion is the one I need to go with.
The women in the group are all wonderful women, and I can certainly relate to them in a lot of ways, but I am still struggling with the concept of HBAC ever being a safe option, and surely that’s something I need to be spreading awareness of?

Many Thanks in advance.

Louise
——

Dear Louise,

There are many different factors that can affect the success of a VBAC and the risk of rupture. However, neither epidural or ruptured membranes are among those factors.

This issue has been looked at multiple times and there is NO evidence that VBAC is safe let alone safer than hospital VBAC. The risk of death of baby and/or mother is much higher at home.

Those who insist that what happened in the hospital would not have happened at home are trying to deal with their own cognitive dissonance. It is extremely important for them to believe that homebirth is safe as hospital birth and when they are presented with evidence that shows they are wrong, they will do almost anything to discount it so they can preserve their beliefs.

The important thing to understand about the women offering you false information is that it has nothing to do with you and nothing to do with the truth. If’s all about them and their need  to justify their own dangerous choices.
As regards your consultant’s advice, it’s difficult for me to evaluate it without studying your medical records. The odds of a future rupture are higher than before, but it is possible to have a successful pregnancy and an early C-section (before labor ever begins) to reduce the risk somewhat.
I hope this information is helpful.
Sincerely,

Amy

I know that there will be many HBACers who will read this and think to themselves, oh she spoke to Dr Amy and then dismiss any common sense they may have gained from reading this blog! This is the sad reality of these groups. Dr Amy is a well know medical professional, she gave up her career to have her family and now blogs on various subjects including home birth and HBACs.

A lot of the HBAC community don’t like her, she is labelled as a troll and a fear-mongerer! The reason behind this hatred is purely because Dr Amy tells it how it is! She doesn’t beat around the bush trying to be nice when the facts are simple. HBAC mums are risking their children’s lives in order to have the birth they choose! They blind themselves with the success stories and when someone comes along with a negative it is either swept under the carpet, dismissed or removed.

They lead the way for others to follow, armed with rose tinted glasses and ready to attack anyone who may have a different point of view.

SO after much thought on the matter I’ve revisited the comments that were raised in regards to my story:
  • If I had had a HBAC instead of a hospital VBAC the risk of rupture would have been much lower as I wouldn’t have had all of the interventions – Interventions do not increase the chance of rupture. If you are going to rupture you will, be that at home, in the car or in a hospital. The main difference is that if you rupture during a HBAC your child is three times more likely to die than if you had VBAC’d in a hospital
  • Ruptures have early signs – a trained home birth midwife would have picked up on the rupture in time to transfer me to hospital – Every rupture is different, I felt my pain through my epidural. When it happened it happened fast and I was bleeding out straight away. There would not have been enough time for anyone to have got me to hospital. My baby and potentially myself would have died.
  • Epidurals reduce the awareness of a rupture – I can’t vouch for everyone, and I’m not a doctor, but I can assure you my epidural did not mask the pain of my rupture! It is a pain I never want to experience again, and I would not wish it on anyone.
  • Home birth midwives are more ‘hands off’ so tend to watch you rather than monitor, so they can detect a change in behaviour or appearance far better than a hospital midwife – I was quite happy the minutes leading up to my rupture. Although babies heart rate had started to drop. This is something that a hands off midwife would not have picked up on!
  • Uterine Rupture is a rare occurrence and the chances increase with intervention – When you think of rare what figures pop into your head? 1 in a million? 1 in ten thousand maybe?? What about 1 in 200! Does that still sound rare? Because to me thats a pretty real figure, and an accurate one at that 0.5% of women attempting a VBAC WILL rupture. Don’t think it will be you? Well I didn’t think it would be me either and it was! Now if you played a lottery where the odds were in your favour at 1 in 200 how many extra tickets would you buy? Because those are pretty good odds. But turn them against you and they are rare? Come on wake up and smell the coffee. Uterine Rupture is not a rare occurrence, its a common one, and thats why your doctor, your consultant, your friends, family and most other people are asking you to please go into hospital for your VBAC! They are not scare mongering you! The statistics are there. Please look at them, read the stories of the women who lost their children to HBAC and Uterine Rupture. It’s very real and it happens more often than anyone cares to think about. How many babies need to die before this is taken more seriously!
  • Having your waters broken for you can increase the risk of Placental Abruption – I can’t comment on this as I’ve not seen the statistics. I would imagine if your placenta was already starting to come away then having your waters break in general could cause an abruption.
  • Epidurals are proven to lesson your chance of a successful VBAC – Rubbish!
  • I should have spoken to a Midwife who specialised in home birth and not my consultant obstetrician – So I should trust a nurse over a Consultant OB who has spent 15 years of schooling and training to get to consultant status and has over 30 years experience under her belt? (talking in reference to my consultant). Consultants are not their to make our life hard, they don’t want us to end up with a repeat section! Mine was fully VBAC supportive, stressing that if you can do it its much better for mum and baby. She also explained the risks to me, and I was fully aware of what could happen when I tried. Hence trying in a facility that was equipped to cope when my uterus ruptured.
So there we have it! I almost believed the hype that is HBAC! I’m leaving the group now as I can’t stay there and read stories of mums going into labour! I don’t want to be privy to the next death by HBAC! It’s too heartbreaking to even contemplate.
Bella xxx

1 thought on “HBAC – How I was almost led to believe the hype

  1. Had this comment on my blogspot blog in response to this post, so wanted to share it here too:

    jugoslava yugaya1 hour ago (edited)
    1Reply
    I have nothing to add to your own insights and the facts with which you repelled their deadly nonsense except this:

    “I should have spoken to a Midwife who specialised in home birth and not my consultant obstetrician.”

    I’m guessing they mean “midwife” as in underqualified, undertrained, unable to work in any other developed country CPM/LM/DEM with no risking out criteria or scope of practice. Someone who with her knowledge cannot work in any hospital or medical institution. They are saying that someone like that, who has never in their life performed a c-section or was the person in charge of trying to save lives when VBAC attempt goes downhill in a matter of seconds, is supposed to have a level of knowledge about risks of uterine rupture that surpasses a consultant obstetrician. That could not be further from the truth. I’m so glad you made it out of that group unharmed. It is a bunch of birth socipaths manipulating vulnerable women around with devastating consequences. Had you stayed, you would have probably been able to find a “midwife” with the help of the admins willing to attend a home birth after rupture. And they would have cheered on such a homebirth all the way to the cemetery.
    —————
    This was my response:

    It is certainly frightening to think that women are actively encouraged to risk both their babies and their own lives! I had started to seriously question my birth, even to the point where because my contractions were so hard and fast from the onset that maybe that was an initial sign of the rupture! The truth of course is that the rupture happened when the pain hit me, the amount of blood I lost within minutes was insane! At the same time the rupture took my placenta out! No warning at all, one minute everything was great (albeit a little slow to progress) and then out of the blue and with no warning I ruptured! If I had been at home I would certainly have bled out and my baby would 100% have died. There was no time for me to have been transferred, the theatre was two doors away from my delivery room and already prepped, I was in there within minutes being knocked out! They didn’t even have time for me to sign a disclaimer (which I had to sign when my first birth resulted in an emergency section), they were catheterising, masking and ventilating me before I was even in theatre. My son was born minutes later with an apgar of 9!!! Incredible considering the circumstances of his birth. I remember being told they had to give me a general as they didn’t have time to top up my epidural or do a spinal as that could take 15 – 20 minutes and they didn’t have enough time… That puts things into even more perspective as even if I lived 5 minutes from the hospital a transfer in would take longer than that to get me into theatre!

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