One of the (many) problems about becoming obsessed with the birth of babies is that the community tends to revolve around a limited number of participants.  I’m an Advisory Board member of ICAN and I scan the huge email list to see where I can make a difference when time allows.  The volume is far too large to read each post but sometimes you can see a trend or an item that jumps off the page.  A few years ago, after an ICAN conference, the women on that list were all abuzz about a presentation called “What Would Mammals Do?” by a speaker named Diane Wiesinger.  Diane is a lactation consultant who made the link between the way babies are born and all the difficulties that come with breastfeeding after traumatic birth.  Her talk to ICAN was then presented to the students at Conscious Woman and I was able to attend the class online.  You can audit the recording of the class on the internet and I highly recommend it.

From taking that class and looking for more inspired teaching by Diane, I found an incredible email list called Lactnet.  Lactnet is not only an ongoing and lively discussion by experts who are actively working hands on with new mothers and babies, but also it has an incredible archive feature.  I’ve gone to their archive many times in the past year when looking for information on how specific pharmacological drugs will affect a newborn and other queries—it is a goldmine of good information. 

Lactnet is another very busy, high volume list that is impossible to keep up with but, by scanning through the topics, I sometimes can interject some of my resources from the childbirth community.

Here’s an example from today:

Question: 

A Mum has been asking me what I know about ‘weak wombs’ and not being able to have more children as she’s ‘had to have 3 c-sections as she has a weak womb’. And ‘the hospital said I’d die, or the baby would if I get pregnant again as I can’t carry to term after three sections’.  Yet she’s had no investigations of her womb at all.  It’s just that she’s had 3 c-sections, the subsequent 2 as she’d had 1, and ‘everyone knows the womb will rupture on the scar site’.
 

Can anyone point me in the direction of appropriate research?  I know nothing of this, apart from what I read here when people discuss when others have been told they have to have repeat c-sections.  And I’d like to be able to pass on up to date and appropriate references for this mother. I’ve been up front with her and told her I’m not the person to ask, but as I said, I’d like to have some reliable evidence based research to present to her for her own reading.  I’m not seeking an ‘answer’, just reliable and sound factual evidence (in either direction). (end of question)

Response from Gloria:

First of all, it’s not that she has a ‘weak womb’, it’s that her womb has been weakened by surgical incision.  Uterine rupture is virtually unheard of in women who have an intact uterus.  We see and hear about uterine rupture  in the case of women who have had previous uterine surgery (e.g. cesarean section) or with the off label use of Cytotec and other prostaglandin induction agents (in some women, these chemicals have the effect of eating right through the posterior fornix with disastrous consequences).   The risk of rupture in women with scarred uteri is fairly low but it is an emergency when it happens.  The rate of rupture doubles if the woman attempting VBAC is induced.
 This is information provided by Henci Goer, author of “The Thinking Woman’s Guide to a Better Birth”:
The risk of uterine rupture is approximately 5.2 per 1,000 (this figure includes ruptures that are caused by labor inductions and other medical interventions).  Most of those ruptures are minor, and will remain undetected.  Among the women who do rupture, 1 in 18 babies will die.  That comes out to 2.9 per 10,000 by my calculations.
 Here’s the link to a slide show that I think is so inspiring about a woman who finally got a vaginal birth after 3 cesareans (Teresa’s Amazing VBA3C).As a previous poster has mentioned, your friend would be well advised to contact the good women at the International Cesarean Awareness Network (ICAN)   Gloria Lemay, Vancouver BC Canada