Re: VBAC question

[TinaPettigrew]

In a message dated 3/04/02 5:13:37 PM AUS Eastern Standard Time, [EMAIL PROTECTED] writes: Please excuse my inexperience on this issue, but I thought that putting a hand inside a uterus that has just given birth was dangerous (unless there was a life threatening situation) & increased the chance of rupturing the uterus.  I am sure some wise woman told me this during my mid. training (could be wrong though).  I have never heard of this being performed either. Tina H. Hi Tina, Mary and all, in carrying on from this (and yes right on Jennifairy),  I have worked with a woman who too was subjected to  a 'manual exploration' of her uterus following an EBAC. She described it as absolutely 'horrendous' and 'excruciating' and was not aware that the procedure would be performed til the event !! She perceived it as the OB's attempt to 'punish' her for her birth choice and  the reclaiming of ownership for her own birthing experience.... Perhaps the reason why some of you haven't heard of the procedure being performed before is that, the evidence doesn't support the routine 'manual exploration of the uterus....in search for uterine rupture or dehiscence without symptoms'  following vaginal births after previous CS. Enkin, Keirse et al (2000, pg 367) in 'A Guide for Effective Care in Pregnancy and Childbirth ' state on the issue that.... "Manual exploration of a scared uterus immediately after a vaginal birth is often inconclusive. It is difficult to be sure whether or not the thin, soft, lower segment is intact. In any case, in the absence of bleeding or systemic signs, a rupture without symptoms discovered postpartum does not require any treatment, so the question of diagnosis would be academic. In the absence of epidural or general anaesthesia, it is also very painful to the women......No studies have shown any benefit from routine manual exploration of the uterus in women who have had a previous CS. There is always a risk of introducing infection by the manual exploration, or of converting a dehiscence into a larger rupture." Yours in birth, Tina Pettigrew Birthworks Bachelor of Midwifery Student and Independent CBE Convenor, Aust B. Mid Student Collective. http://groups.yahoo.com/group/BMidStudentCollective [EMAIL PROTECTED] " As we trust the flowers to open to new life                - So we can trust birth" Harriette Hartigan. -------------------------------------------------------------------