The VBAC study (which was so controversial but caused the BIG change re  VBAC) was done on retrospective birth record data in Washington State USA. It looked at para 2 women: women who had had a second pregnancy to term after a c/s for the first pregnancy. There was a birth interval specified too I think but can't remember. It was the way the data was reported that made it all seem so scary. The really significant finding was that they shouldn't have been using prostaglandins to induce women with a previous uterine scar, which is a good thing because I don't think anyone does anymore. That the data has been interpretted the way it has re VBAC is nothing short of a tragedy.
 
marilyn
----- Original Message -----
From: Rhonda
Sent: Wednesday, October 22, 2003 5:25 AM
Subject: RE: [ozmidwifery] A few questions. (sorry long answer)

Hi Sonia,
I agree with Cas, I think that the doctors really do need a wake up call based on the fact that if they have an 'accident' during a c/s they seem to say well - there was a risk.  But, they feel that is not good enough if there is a probem with a vaginal birth - as they probably feel that they have less control of a vaginal birth than they do of a c/s delivery.  (Big difference!)
You can also say that your c/s may not have been needed as baby had 2 weeks to turn or more before there was any real danger and may have done so on his own.  If you had been told that the baby was only 9lb and 11 lb's what would you have done?
 
I have also (as a body piercer) just been through the receiving end of a court case.  We didn't do the piercing at all - very complicated (fraud) etc,...  However, I did learn a lot about the legal system and civil cases.
The cost of a court case (civil) would be about the $20,000 - I know it is a lot but I think a good lawer would do it on a no win no fee or some other basis for you.
You may be looking at getting between $100,000 to $1 million.
Now, as far as winning a court case - well, in a civil matter you don't actually need proof - all you need to do is to make it likely - 51% your way that you may not have had these problems had you not been convinced that a c/s was the best option.  You would need to explain that the risk of this happening was never told to you prior to it - did they 'scare monger' you and say - a lot of women get PND after a c/s or there is a risk of cutting the baby or there is a risk of damage to your uterus that may result in it not being advisable to have any more children.  By law they have to tell you of all the risks prior to performing any procedure.  You don't have to prove thay didn't you just need to make the judge believe that they didn't. (something to think about for everyone).
 If it seems likely to the judge that you were not told of those risks and that you agreed to the c/s without full knowledge of these risks then the dr's were negligent.
You don't need complete and total proof like you would in a murder trial - all you need to do is to convince the judge that harm was done to you and it is likely to be the result of the dr's actions and is likely to be a result of some negligence in his ability.
Ie: He  should have known how to stemt he bleeding and not cut your baby!
He should have given you the option of natural ways to make the baby turn.
He should have not cut that artery in the first place.
If you can get any evidence to prove that what happened could have been avoided and was not the only course of treatment available to you then you have a very good chance of winning.
 
As Cas said - he has insurance for these things.  That is why he pays it.
 
It is entirely up to you but I know that having enough money to be able to access private midwives and to have full choice about your future care is very important if you want more children - I would think that it would be safer to have a VBAC,  if you have delivered before is a big advantage.  A first vaginal delivery after a c/s is probably likely to be higher risk as it may be a longer labour - anyone know if the studies done were on women who had previous vaginal deliveries or if they were VBAC and first vaginal delivery.  I think that fact would be relevant?
And were ruptures on women who had multiple vaginal deliveries and one c/s or what?  I think that the Doctors probably have very few real statistics to use to 'scar monger' you with and I would be asking for them to produce the studies to back them etc.  Ask for an evidence based assesment!
 
Good Luck
Rhonda
 
 
-------Original Message-------
 
Date: Wednesday, October 22, 2003 21:38:40
Subject: RE: [ozmidwifery] A few questions.
 
Hi Sonia,

I only just now read your birth story... This has been a tough week for
me birthwise because I've just seen the devastation on my neice's face
after her "coerced" c-section but somehow I've just got to press on.

What happened to you is horrible and I can understand that the doctors
would be scare-mongering more than usual but if I were you I'd take the
time to look at the research thoroughly then talk over your situation
with both midwives (homebirth midwives would be good) and medical
professionals. You might want to have a word with Ted Weaver at Salangor
in Nambour, Qld. Lynne, who's on this list works there and they take a
lot of women who have had previous c-sections and not just one.

Make sure you give your body time to adequately heal, that way if you
change your mind about VBAC (yes you can VBAC with a classical scar but
the risks are slightly higher) you will be giving yourself the best
chance at success (regardless of how you birth, you'll still need time
to heal).

On another note, and I don't want to seem callous cause I know you don't
feel like suing your doctor now but you may change your mind later on.
It was his fault (even if accidental) and he has insurance to help pay
for things like that, insurance money which could help you if you have
to find a specialist in another State to have your next baby. Just don't
rule it out is all I'm saying.

One of the main reasons why so many doctors prefer c-sections is because
they don't get sued but sometimes I think they need to be. They need a
wakeup call to tell them we've had enough of them saying c-sections are
safer than vaginal births, of cutting up women unnecessarily, of
stuffing up births... Sorry Sonia, I'm just so emotional about all this
today... Not meaning to imply any of the above should be directed at
you. I've had 2 c-sections myself and I know how hard it is to make
decisions about intervention.

Thank you for sharing your story....

Cheers,

Cas.

Cas McCullough
[EMAIL PROTECTED]
www.casmccullough.com



-----Original Message-----
From: [EMAIL PROTECTED]
[mailto:[EMAIL PROTECTED]] On Behalf Of *G and S*
Sent: Wednesday, 22 October 2003 12:40 PM
To: [EMAIL PROTECTED]
Subject: [ozmidwifery] A few questions.


Hello all,
I guess that most of you will now be aquainted with my
story so I was hoping that you could answer a couple of questions.

I have had two obstetricians tell me that I should not/must not have
anymore babes.


When I sought the second opinion ( which was just a few weeks ago) I
was told by the ob. that where the scars on my uterus meet ie at the
junction of the 'T', there is increased weakness and therein lies a
greater chance of UR in late pregnancy and/or labour.

He said that even if I made it safely to 36 weeks and had an elective
c.section there would still be the possibility of that whopping, big
venous sinus being in the way again. He suggested that history could
repeat itself.

He went on to say that if I were to get pregnant again he would
'ideally' like me to move to my closest capital city and live within 5
minutes of a major hospital. He said, " Sonia, why would you want to do
that to yourself? Is another pregnancy worth the risk?" I was so blown
away by the terror he was implanting that any research that I had done
regarding UR went sailing straight out of my head.

I know that I will never be able to VBAC.
I just can't accept that having another babe is not an option anymore
and that I'm not even a candidate for an elective c.section.

So, my questions are :

1. While disregarding the dramatics, do you think that the advice given
was sound or was it the mere product of an ob. covering himself?

2. If the later applies, does anyone know of an ob. or specialist
surgeon that is a little braver and would be willing to give me an
opinion which is not based on the number of children that I already have
and not one of fear?

I will travel interstate if I have to.
I'd appreciate any advice.

With love and many thanks,
Sonia. (SAS)











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