Mailbag 36: "What does the Fox say" - With Dr. Nathan Fox

Hey everyone, welcome to our mailbag podcast, number 36, What Does the Fox Say? Our first question is from Kim.

Hi, Dr.

Fox.

I continuously listen to your podcast after being featured as one of your high-risk birth stories on cord prolapse.

I just had my second baby via planned repeat C-section.

After the delivery, my OB told me I had a thin lower uterine segment with visible amniotic sac likely in the setting of uterine dehiscence.

I was wondering if you could speak a little about uterine dehiscence.

How common is it? Could it affect uterine healing after delivery? Is it risky to have another pregnancy after a prior uterine dehiscence? Thank you so much, and I look forward to hearing your thoughts on this topic.

All right, Kim, first of all, thank you for the question.

Second of all, thank you for listening.

Third, so nice to have you back on the podcast after telling your birth story.

Great to hear from you.

Thank you so much.

Okay.

In terms of your question, I'm going to answer it, but I'll start with a little preview first on uterine rupture, A, so I can explain how it's different from what you had, and B, because our next question is going to be about uterine rupture.

All right.

So I think as many of our listeners know, uterine rupture is a situation where the Usually in labor, in theory it could happen not in labor, but typically in labor, when the uterus is contracting, the uterus actually opens up on the inside of a woman's body.

And it can be very dangerous for her, for the baby, not necessarily if we catch it in time, but it could be.

And it's more common in women.

who've had an incision on their uterus prior, like surgery on their uterus prior, which is most commonly a prior C-section, though it could be other surgeries like myomectomy, removal of a fibroid or whatnot.

And because of this risk of uterine rupture, when someone is trying to decide, should I try for a VBAC, should I not try for a VBAC, meaning a vaginal birth after cesarean, Part of the conversation is, all right, if you try, there is a risk of when you're laboring of that scar from your C-section opening up inside.

We call it uterine rupture.

Again, they would say it could be dangerous for you, could be dangerous for the baby.

What is the chance it will happen? And, you know, typically it's about 1%.

But, you know, based on the circumstances, could be higher, could be lower.