41 | Zara's experience of uterine rupture and emergency caesarean following a planned caesarean for breech; ECV, Birth Trauma, PND, Low iron levels, Prodromal Labour, Augmented Labour, Posterior baby, MGP

Today we meet Zara from central Queensland and talk to her about her two births. Zara's VBAC journey began with Darcy who was a planned caesarean due to his breech positioning. The caesarean itself wasn't traumatic, but it was what happened afterwards that left Zara feeling like she could not go through childbirth again. She experienced post natal depression following this birth.

Zara's heart eventually opened to the possibility of having another baby and when the time came she felt a deep desire to have a VBAC, doing everything in her power to give herself the best opportunity including securing continuity of care through her local hospital’s midwifery group practice (MGP). The end of Zara’s pregnancy presented some challenges which Zara admirably rose to, but once labour was underway Zara experienced what we all are aware of going into labour after caesarean, but feel hopeful won't happen to us- a uterine rupture.

A uterine rupture can occur in any labour but it is more common in women who have a scar on their uterus from a previous caesarean.

• We are told 1 in 200 or 0.5% of women labouring after one caesarean will have a uterine rupture, which means about 99.5% of women won’t.
• There have been other studies that have found the uterine rupture rate to be even lower, for example 0.2% and 0.1%
• An Australian study, Dekker et al 2010, went even further and found that the risk of uterine rupture during VBAC was 0.15% in spontaneous labour, increasing to 0.88% in an induced labour with prostaglandin and oxytocin, and 1.91% in an augmented labour.
• Of the women who do experience a uterine rupture, 6% of those are considered catastrophic, therefore 94% are considered asymptomatic, and this is what Zara experienced.

While Zara’s story doesn’t end with a vaginal delivery she speaks about how she is finding peace with this and the fact that she would do it all over again despite her experience. Her advice to believe in yourself, to educate ourselves about uterine rupture and to understand the risks is inspiring. We hope that her story is a valuable and informative resource for you all on your VBAC journey and a useful tool in understanding what can transpire during uterine rupture in labour.

~ Notes ~

You may connect with Zara on Instagram @zaramartin__

Studies quoted and associated links can be found in the following article by Dr Rachel Reed:

https://midwifethinking.com/2016/06/15/vbac-making-a-mountain-out-of-a-molehill/

Post Natal Depression/Anxiety and Birth Trauma support: If you or anyone you know is affected by PND symptoms particularly at this time of COVID-19 please don't hesitate to contact the following support networks.

The Gidget Foundation

https://gidgetfoundation.org.au/get-support/

PANDA

https://www.panda.org.au/info-support/pandas-national-perinatal-anxiety-depression-helpline

Beyond Blue

https://www.beyondblue.org.au/get-support/get-immediate-support

Cope

https://www.cope.org.au

**VBAC Birth Stories features women's lived experiences. It is not intended to replace medical advice. Should you have any concerns during your pregnancy please always consult your healthcare provider.

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