Posted by My OB said WHAT?!?.
Nov
12
Posted by My OB said WHAT?!?.
“…You Have A 5% Chance Of Dying!”
“You know you have a 5% chance of dying!” – OB during a prenatal to mother seeking a vaginal birth after 3 cesareans. This was said in front of the family’s children.
There are 29 comments to this post.
heart disease 1 in 6
cancer 1 in 7
stroke 1 in 28
motor vehicle accident 1 in 88
intentional self harm 1 in 112
and so on, I don’t see birth as being one of them
http://www.nsc.org/NSC%20Picture%20Library/News/web_graphics/Injury_Facts_37.pdf
man, you can die from ignorance and stupidity as well. More mistakes are made by doctors. I bet, most of the 5% die because of doctors making a mistake. Change your doctor hon.
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“So what’s the chance of me dying in an accident while driving to the hospital?”
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Eileen Reply:
November 12th, 2011 at 8:53 pm (Quote)
Far less than the chance of you dying from a VBAC.
I hate VBAC stats being blown out of proportion. It has risk. So does lots of things in life. It’s the woman’s right to choose what risks she is comfortable with.
However, statistics being mis-interpreted also annoys me.
Let’s assume your chance of dying in a car crash during a lifetime is greater than your chance of dying in a VBAC (I don’t have the stat, but I’ll assume that). However, you drive a car MANY more times in your lifetime than you have a VBAC. So your chance of dying in an accident WHILE DRIVING TO THE HOSPITAL is much much lower than your chance of dying during the VBAC, because that drive to the hospital is one in thousands you will take in your life and the odds on the VBAC are for that single occurrence.
Let’s say, for example, the above stat of a person’s risk of a motor vehicle accident of 1 in 88 was accurate for each time you got behind the wheel of a car. Then let’s assume you drive 10 times a week, going to and from one place each work day and going nowhere else. That means that every 9 weeks, on average, you would be in a car accident. Now this is clearly not true, and the reason is that the stats for liklihood over a year or a lifetime are not the same as stats for a single event! Car accident stats are for a period of time. VBAC stats are for the single occurence. Given how often we drive, that’s a big difference!
So argue against bullying and scare tactics, point out that the risk is likely not that high, point out that no matter what, this was not an appropriate comment in front of the OP’s children no matter what, point out there are other high-risk things doctors recommend in pregnancy (e.g. amnio). But please *don’t* make the “I’m more likely to die on the way to the hospital than from the VBAC!” argument, because it just shows you don’t understand statistics and discredits the whole VBAC movement.
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Tori Reply:
November 13th, 2011 at 5:53 am (Quote)
I was being a bit of smartass, but I can get serious for a moment.
The biggest factor is that every day we CHOOSE to drive, where by the frequency of which make this decision exposes to the risk of dying. Every day people makes decisions that expose them to various risks including the risk of dying.
Nobody gives anyone a ration of crap for deciding to drive every day, but perhaps the single occurrence aspect of VBAC that causes the uproar.
But realistically, in a VBAC situation where there is care provider paying attention and listening to the mother, what are the chances of the mother actually dying? Perhaps a rupture that results in the loss of the uterus. But actually dying? We don’t hear about that much death in the VBAC world.
I’ve never even had a section, so I don’t really have a bone in this fight other than I support the right for people to choose what path to take.
I was just being a flippant asshole, don’t assume I don’t know a thing about stats.
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I don’t know much about reading stats – but I really though that uterine rupture was more like 1/2 a percent – .5 – than 5%. Is it possible the doc doesn’t get the whole ‘decimal’ thing?
And then, even with the .5% *chance* of rupture, not all of those women die, or even lose their uterus.
So I’m pretty sure the 5% number is entirely misrepresented.
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Heidi had this to say,
Nov 13, 2011 @ 7:30 am (Quote)
Do the risks of a VBAC go up with each previous cesarean? I know a local OB who is very supportive of VBACs, but will not do a VBA2C because the risk of complications is higher. I don’t know if that’s true, so I thought I’d ask.
Regardless, I would be really mad at this being said in front of my children. My daughter is the type to hear these things and worry about them.
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CNicole Reply:
November 13th, 2011 at 10:42 am (Quote)
It is *slightly* higher after 2, then 3. But not up to 5%. Both ACOG and SOGC (Society of Obstetricians and Gynaecologists of Canada) “allow” (for lack of a better word at the moment) VBAC after 2 cesareans.
http://www.ncbi.nlm.nih.gov/pubmed/20374579
http://www.scfmresidency.com/SCFM_Curriculum/Journal_Club/10-19-06_Journal_Club/Uterine_Rupture_Article.pdf
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Mama Wrench Reply:
November 13th, 2011 at 1:12 pm (Quote)
Typically, the first two have about the same complication rate; after two it goes up. (According to the ACOG.) I haven’t seen any solid stats on the difference between risk, though.
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Rach had this to say,
Nov 13, 2011 @ 9:46 am (Quote)
Yes the risk of rupture is more with 2 sections, but that isn’t the only risk factor, there’s also increased risk of placenta accreta/percreta amongst others which I think they worry about too.
And one successful VBAC doesn’t mean you won’t go on to rupture the next time… (very recent experience of a woman in my care…)
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Mama Wrench Reply:
November 13th, 2011 at 1:14 pm (Quote)
No, but the risk does go down significantly with each VBAC… of course there IS a law of diminished returns and the more stress you put on an older uterus and an older scar, the higher the likelihood of rupture. I’d be interested to see the stats on induced mothers 35+ years who rupture without prior c-section, versus mothers 35- years with one prior c-section who are not induced or augmented.
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Rach had this to say,
Nov 13, 2011 @ 2:04 pm (Quote)
I do believe he made up this stat but you’re all assuming he’s talking about rupture alone with regards to the 5% when there are other risks which docs panic about (they always panic!). I’d be interested to know how the rest of the conversation went.
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Rach had this to say,
Nov 13, 2011 @ 2:13 pm (Quote)
Ah ha, found the RCOG guidelines on VBAC in my sweater drawer (where do you keep yours…?): no significant difference in rates of uterine rupture between single prev LSCS (68/10000) and 2 or more (92/10000), however significant increase in need for transfusion or hysterectomy etc…
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Rach had this to say,
Nov 13, 2011 @ 2:21 pm (Quote)
maternal death from rupture during VBAC: 1/100000, maternal death from other VBAC risks including rupture: 17/100000
HOWEVER risk from repeat section: 44/100000!! (but not statistically significant)
In conclusion you can tell the OB he’s talking #$^*….
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Details Reply:
November 14th, 2011 at 5:53 am (Quote)
For anybody who missed it HERE^ is the statistic. Repeat C-section 44 dead mothers. VBAC 17 dead mothers out of how many 100,000 each. That is One Hundred Thousand each. So which one is safer? VBAC very good!
Rach if you have a link so everybody can print it out and take it with them, that would be great!
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The Well-Rounded Mama had this to say,
Nov 14, 2011 @ 1:29 am (Quote)
He’s pulling statistics from where the sun don’t shine. I’ve not seen ANY studies to substantiate this claim, and I’m pretty darn familiar with the research on VBAMC.
For heaven’s sake, providers, please provide *accurate* stats to the women who are your clients. This pulling out of bullsh*t statistics really ticks women off and makes it so they distrust anything a care provider says to them in the future. And we NEED to be able to trust what our care providers tell us.
For those who want specific stats, I wrote about the research around rupture and VBAC after more than one cesarean here:
http://wellroundedmama.blogspot.com/2010/12/vbac-after-2-cesareans-distorted-risk.html
http://wellroundedmama.blogspot.com/2010/07/about-damn-time-good-news-for-vaginal.html
I encourage women to do their own reading and research on the topic as well.
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Rach had this to say,
Nov 14, 2011 @ 6:11 am (Quote)
http://www.rcog.org.uk/files/rcog-corp/GTG4511022011.pdf
Be aware that if you are in the US your OBs may point out that these are UK guidelines so be ready for that! They may also point out that the difference between 17 and 44 in 100,000 mothers is not statistically significant.
Good Luck!
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Details Reply:
November 14th, 2011 at 6:33 am (Quote)
Oh I’ve seen things that say that there is a 3 times greater risk with a scheduled c-section. So I wouldn’t let it worry you. The only thing I can think that would be significant is the some women who choose a repeat c-section over VBAC do so because they have significant health risks that would increase their risks no matter what. For a really good study you would want the repeat group to have been qualified to try for VBAC rather than just all repeats. Didn’t read this one yet. It might have done that.
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Add Your Comment.
I hate this! I just had a VBA2C and through my whole pregnancy I heard you can try… but your going to die…. And Oh you may end up with a hysterectomy! omg its the worst… But guess what, I am still here and oh look at that I still have a uterus too!
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