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VBAC After C-Section: Risks, Benefits & What to Expect


Question
Thank you for replying so quickly. Isn't there a possibility of me having another successful VBAC? shouldn't that be considered? and if not, why? My c-section scar is almost 6 years old, and wouldn't it have torn if it were to tear during my VBAC in 2001?  I carried both my pregnancies 40wks, is there a problem with going beyond 39 weeks if the twins are still growing and thriving inutero?  
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Followup To
Question -
I'm 35, I have 2 children, 1998 was induced at 42 weeks, stalled at 7 cm and then did a C-section (low bikini cut). 2001 had VBAC at 40 weeks. The date of my last mestrual period was Sept.16th 2003. I am having twins and am frustrated why the Dr.s want to do a C-section instead of inducing and at least trying for a VBAC.  I have only gained around 30 pounds, eat healthy, exercise, I have tried to take good care of this pregnancy so that I could have a VBAC, and now they tell me they want to do a Csection. Aren't there any other options? do you really think my uterus could rupture with induction? Isn't it a very small percent chance? wouldn't it be better to at least attempt a VBAC?  The presenting baby is Vertex, the second baby is vertex now but sometimes turns breech. Can you help me?
Answer -
There is always a 1% risk of uterine rupture at the site of the previous uterine incision, during labor. Any added complication (twins, hypertension, diabetes) increases the risk of rupture. With a twin gestation, if ANY of the babies is in the breech position, a cesarean section is indicated for the baby's well being and for yours. Certainly, with twins, a cesarean section is safer as a method of delivery. I would also choose to have a repeat cesarean section. The decision remains your unless one of the baby's is found to be breech, then a cesarean section will be done. Remember, there is a lot more pressure on the scar with two babies.

Answer
As long as there is no problem with the twins, there is no reason not to maintain the pregnancy until term. HOwever, there still is that risk of uterine rupture, even if you had a successful VBAC before. Twins put much more pressure on a scar. There is, of course, a good chance that all will go well with a VBAC, but I doubt that anyone wants to take the chance, unless you are willing to absolve all your doctors of any liability if anything goes wrong.