Hello I am a 32 year old G2P2002 both by C-Sections births. My son was born January 18, 2007. This is my 1st son's record report...

"Failed induction of labor with Pitocin and Foley bulb and underwent a low segment transverse C-Section of live born infant male. Apgars were 8 and 9."... "The patient had an induction with Foley, bulb, and Pitocin. She progressed to 7, 90, and 0 station, and after several hours of adequate contractions, the patient failed to progress.

Preoperative Diagnosis:
*Para 0 at 41-2/7
*Failed induction of labor
*Arrest of dilation

Postoperative Diagnosis:
*Uterine atony
*Cephalopelvic Disproportion

My daughter was born on her due date May 31, 2007. I attempted to have a VBAC with my daughter, but it failed due to placental abruption. My ROM showed blood clots, so my doctor rushed me back to the OR for a C-section.

My question is I would like to have another baby and try for a VBA2C. I know this is a controversial issue and according to ACOG it is safe to have a vaginal birth after 2 C-sections for some women.

On my daughters record it says C-Section due to placental abruption (likely chronic). I can't find anything on chronic placental abruption. Obviously I can't have a VBA2C if I have another placental abruption.

Does my past history of having a placental abruption keep me from having a trial of labor and hopefully VBA2C with my next child?

Sorry daughter was born 2008 not 2007 (that would be impossible, lol)

"Chronic" means, if it happened once (or more), it's likely to happen again because the situation will be the same.

We have a very sharp L&D nurse on site. I'll PM her to look at your question..

Thanks for the reply. I just don't understand how placental abruption could be chronic. I know it is premature detachment of the placenta and I am at a higher risk for getting it just because I have had a C-section in the past. But, how could it be chronic. I am starting to think my doctor wrote that because she isn't really an advocate for VBAC to begin with. I really appreciate you looking into this for me. :)

It sounded like she wasn't sure --"LIKELY chronic." Maybe she assumed that the situation would be the same in another pregnancy (based on the reports) -- and J_9, our nurse, would be able to interpret the numbers/information in the reports. One or more of them may indicate a chronic problem to watch out for in the future.

Thank you. Would this interfere with my ability to try for VBA2C?

Yes, this will interfere with another trial of labor. With your history of arrest of dilitation coupled with the placental abruption, I don't know of a doctor who will allow another attempt at a VBAC. You are also at higher risk of uterine rupture due to the scarring of the 2 c/s.

I'm sorry, I know this isn't what you wanted to hear.

Update: I am very excited just received this response from OB GYN Doc.

"Firstly, according to the latest ACOG guidelines , it is safe for women with two previous C sections to attempt VBAC."... "Hence, in your case, you can opt for VBAC in a well equipped center with rigorous monitoring for the earliest signs of complications. As long as you understand the risks and are willing to participate in the procedure, then yes, you can go for VBAC in your next pregnancy. ... "Regarding the indications mentioned by you, placental abruption has a recurrence of around 10 %. A previous placental abruption is no reason for you not to opt for VBAC."

This is great news to here. As a nurse I like to do my research. I am not an L&D nurse so OB GYN isn't not my area. Thank you for the replies. I will continue to weigh my options.

Good luck to you. Hopefully your facility is well equipped for an emergent delivery in the case of a uterine rupture.

My facility, nor any others in my area are not. You must have a surgical staff on site during the entire labor, as well as anesthesia and a NICU staff.

I've assisted in the delivery of an abruption as well as a uterine rupture. I'd do an abruption any day over a rupture.

Truth told, these are questions you need to be asking your personal OB/GYN. He/she is familiar with the policies and procedures acceptable to your delivering facility. The OB you "spoke to" online is not familiar with your facility and it's policies and procedures.