Uterine rupture

[Cathmomof6]

I think I know the answer to this question but would like some advice on how to discuss this with my younger sister. We have a very close relationship and I know she will be talking to me soon. I have come to be somewhat of a “spiritual advisor” to her!!

She is 36 and husband is 35. They have an almost 11 year old daughter and 8 year old son. She works full time and has always been somewhat of an anxious, worrisome type - cant handle disorder or chaos and her house is always immaculate! Needless to say, my 7 kids and I don’t go to her house often!!! We live very close to each other but I watch her kids after school so she always comes to my house. She has really been hormonally crazy since her last baby - had IUD, depo, different pills, etc. to prevent pregnancy. Her husband does not really help very much and she has said she was done having kids. I have never preached to her about this. However, I guess with her biological clock ticking, they stopped this and tried for “one more baby”. Well, she got pregnant immediately. Her first baby was breech so had a c-section and was not really given option of vbac with 2nd. She was told she has a very thin uterus.

Anyways, at 38 weeks with this pregnancy she started having contractions and at hospital her water broke and she was in tremendous pain with something bulging from her abdomen. Turns out her uterus ruptured and that bulge was baby’s shoulder. They did an emergency c-section and all turned out well. Her baby boy and mine are 5 days apart. At the time the doctor told her they folded uterus over and if she would become pregnant again they would need to induce around 36 weeks to be safe.

Anyways, I know she has had a bit of a change of heart regarding family planning. She was considering tying her tubes, but I did kind of dissuade her from that. She has confessed contraception and seemed to be moving towards NFP. I even lent her the book Life giving Love by Kimberly Haughn but I know she has not red it yet. Well she had her first postpartum visit yesterday and doctor was pushing ABC on her. Telling her she has 3 kids to care for now and shouldn’t risk her life. Seems a little different than what she said in hospital?? !! I could tell my sister was upset about it.

So really her only morally correct options are continuous avoiding using NFP or complete abstinence, right? I can’t see her husband really being on board with either of these as he is very much “of this world” but I guess that would be between them. I know she will talk to me about this and don’t know what to tell her. I am pretty sure the doctor scared her enough that she will probably either get her tubes tied or go on her hormonal roller coaster again. Her husband has refused vasectomy in past!!

 

[The_Bucket]

So really her only morally correct options are continuous avoiding using NFP or complete abstinence, right?

Correct. Unless of course the complications are involving some kind of continuous bleeding problem that could be addressed with the Pill. In that case, however, they wouldn’t be contracepting. They’d be addressing a medical issue.

I can’t see her husband really being on board with either of these as he is very much “of this world” but I guess that would be between them. I know she will talk to me about this and don’t know what to tell her. I am pretty sure the doctor scared her enough that she will probably either get her tubes tied or go on her hormonal roller coaster again. Her husband has refused vasectomy in past!!

Well first off, if her husband is “of this world” I don’t see why she should have to compromise her morals. I don’t think that’s a fun conversation to have, but it might be necessary. Why should she have to go on a crazy hormonal roller coaster or sterilize in violation of her beliefs when he is the one that is fine with ABC.

What should you tell her? I don’t know. I know you need to stand up for the teachings of the Church, while also conceding that this is tricky territory and can really only be resolved between the two of them or the two of them and a priest. Because that’s the truth. You don’t want to be sowing marital discord.

As for the medical situation, I won’t give advice but I will relate my own experience. My wife had an emergency c-section at 25.5 weeks back in 2008. Got pregnant (not a great idea by the way) five months later and everything went fine. But she did have to have a planned c-section at 36+ weeks and was in constant contact with a high-risk doctor.

Some years later we talked to a regular OBGYN who was very severe and that told her she should definitely never have any more kids. My wife was obviously besides herself. I told her that she should not take that answer lying down and talk to a high-risk specialist. So she did. Doctor looked at the surgical reports and even with the two surgeries and scarring and an anatomical anomaly, said that additional pregnancies were not out of the question.

Armed with that information, we went to a high-risk guy closer to us who said that while the risk was no zero, he agreed that it was not a situation where she “can’t get pregnant again.” Once again, we had to have a planned c-section at 36+… but our daughter decided 35+ was good enough for her! Aside from 12 hours in the NICU to address some jaundice, she was fine and mom was fine too. Little lady is coming up on her first birthday in May.

We’ve been as careful post-three as we were post-two and thus far, everything’s cool. It would not be a good idea for my wife to get pregnant again for a little while longer… but again the doctors think that while the risk is not zero, it’s not unmanageable. It’s something to consider.

I’d only suggest not letting one particular doctor “scare” you into anything. Tell her to talk to a couple of doctors and give them full medical histories so they can give sober, rational advice. Inducing/planned c-section at 36 weeks is only to avoid a nasty labor, which can lead to rupture. And rupture is a big deal. But these precautions are usually successful.

 

[Xantippe]

The doctor may have wanted to soft pedal the medical situation when she was immediately postpartum. Or maybe the doctor has had a chance to review notes and literature and this is a more informed opinion than the first one given.

I’d suggest a second and maybe even a third opinion. Not doctor shopping, but just to get a solid answer.

She is 36–there are only so many more kids she’s even theoretically capable of having at this point. It’s not like she’s a 24-year-old with three kids.

 

[Xantippe]

Also, come to think of it, her OCD means that she would be an ideal NFP user. Maybe too careful, but not a risk-taker.

If anybody can pull off starting NFP at 36 with a life-threatening condition, she can.

 

[Cathmomof6]

Also, come to think of it, her OCD means that she would be an ideal NFP user. Maybe too careful, but not a risk-taker.

If anybody can pull off starting NFP at 36 with a life-threatening condition, she can.

Maybe but, knowing her, she has used ABC for 8 years with no surprises and would probably not be confident enough trying something different now!

 

[marymary1975]

I would also recommend her to have a second and third medical opinion. I know two people with uterine ruptures and they had immediate hysterectomies. So I guess the best thing just in case is to get more medical opinions.

 

[7armyrugrats]

I am very anti contraception and I honestly believe too many people over use NFP. Many others are very conservative in their method and become pregnant anyway. My husband and I have gone the abstinence route when I needed to health wise, but most husbands would never go for that. Is she a candidate for a hysterectomy? That is what I would opt for if I experienced a uterine rupture. Actually, the few women I know who experienced this were given hysterectomies immediately. I’m surprised that the dr didn’t do one after the C-section. I need to be here for the kids I have, not play games with my life. As much as I pray for another child, I would have a hysterectomy in this instance.

 

[savedbygrace71]

?.. Actually, the few women I know who experienced this were given hysterectomies immediately. I’m surprised that the dr didn’t do one after the C-section. I need to be here for the kids I have, not play games with my life. As much as I pray for another child, I would have a hysterectomy in this instance.

yes, totally agree. It’s life threatening if she were to get pregnant with a patched up uterus.