Before you read ahead, please know that we discuss details of uterine rupture extensively, including direct quotes from moms who have experienced uterine rupture. If this is a topic that’s triggering for you in any way, please skip this article. Click back to our main blog page for lots of other helpful information! And remember… we think you’re amazing!
Uterine rupture. It’s usually the first thing our providers mention when we decide to pursue a VBAC. It’s also often what friends & family are worried about… even though they may not even know what it is or why it’s a risk. And uterine rupture is also the reason many women get talked into scheduling a repeat cesarean instead of choosing a VBAC.
We’re kind of conditioned to fear uterine rupture. Although the risk is relatively low, there is proof that they do happen. Rates vary from study to study and depend on the number of cesareans or length between pregnancies, but in general, uterine rupture rates in those who attempt a trial of labor after cesarean (TOLAC) are about 0.4 – 1% or just over 1%. Despite the numbers, it is important to feel as educated as possible on all things uterine rupture so that you can make informed choices.
I won’t be digging into the specifics of uterine rupture risks today (click here for more on that), but I do want to share something that isn’t talked about all that often… how would I know if I’m experiencing a uterine rupture?
Our goal here is to help you feel informed and less fearful. So, let’s dive into what you really need to know about the signs of uterine rupture.
Uterine Rupture and VBAC
Uterine rupture is the complete division of all three layers of the uterus. This means that there is a full separation from one side to the other. Specifically for pregnant mamas with a prior c-section, this is typically going to happen along the c-section scar. Again, we know the rates of uterine rupture during a TOLAC are low, but it can happen and is treated as an emergency situation when it does.
Signs of Uterine Rupture
We’ve compiled a list of uterine rupture signs from Cleveland Clinic, National Library of Medicine and stories shared in our community page. Thank you, to everyone who has bravely shared a possibly traumatic story so that others can be more informed.
- Sudden abdominal pain with a “ripping/burning sensation” that sticks around even after a contraction (this is often in the cesarean scar site)
- Very painful contractions after onset of abdominal pain
- Sharp pain in the upper abdominal area, possibly felt even with an epidural
- Fast heart rate for mom (this can be a shock symptom)
- Low blood pressure
- Abnormal amounts of vaginal bleeding
- Pain in shoulder or neck area
- Nausea and / or vomiting, usually accompanied with some of the symptoms above (NOTE: nausea and vomiting can be very normal symptoms of labor/transition)
- Continuous contractions that are painful and will not go away at all
- Slowed or stopped labor, or fetal station increased dramatically
- Nonreassuring fetal heart rate / fetal distress that is not recovering despite all efforts
It is also possible that you don’t feel or recognize any signs of a uterine rupture. Interestingly enough and from some of the stories shared in our community, a uterine rupture may not be discovered until after delivery.
It is also very important to trust your intuition and tell your provider about what you’re experiencing. Because many of these symptoms can be unrelated to uterine rupture but normal symptoms of labor, together you can assess everything that is happening. PLEASE, if you’re feeling like something just isn’t right, be adamant about getting it addressed.
Treating a Uterine Rupture
If a uterine rupture has occurred, your provider will deliver the baby immediately and repair your uterus. It is rare, but in some cases, a hysterectomy is necessary due to significant blood loss.
Where to Find More Info
Knowing the signs of uterine rupture is really important, so we wanted a space dedicated to just that. However, we know you may have more questions. Here are a few more suggestions for increasing your knowledge of uterine rupture…
Facts & Overall Risk
- The Risks of Uterine Rupture During VBAC or HBAC and How to Reduce Them
- How to Really Understand the Risk for Uterine Rupture
- Uterine Rupture Facts & Perspective with Julie and Meagan (podcast episode 47)
- Henci Goer + Let’s Talk Uterine Rupture (podcast episode 248)
- Dr. Nathan Fox + Scar Thickness, Uterine Rupture, Due Dates & More (podcast episode 261)
- Dr. Nathan Fox Returns Sharing Evidence on Uterine Rupture, Induction, Cervical Exams & More (podcast episode 271)
Birth Stories (listen to The VBAC Link Podcast on Apple Podcasts or Spotify)
- Episode 68 – Heather’s 2CBAC + Uterine Rupture
- Episode 105 – Briana’s CBAC + Uterine Rupture
- Search “uterine rupture” in The VBAC Link Facebook Community to find many vulnerable and inspiring stories
To those of you who have shared your uterine rupture stories with us on social media and / or the podcast, we know that may not have been easy. We are so grateful for your willingness to share, answer questions and be a light for other VBAC moms. You are truly women of strength!
Lastly, we would like to encourage you to consider taking a VBAC course. Our How to VBAC: The Ultimate Prep Course for Parents provides a ton of research, facts and support on all things VBAC, including uterine rupture. It’s a self-paced course full of six+ hours of video content, worksheets, checklists and so much more to help you feel informed and empowered. I think you’ll love it. And just for you, I would love to offer the code SAVE15VBAC to get an extra 15% off the enrollment.
As always, my strong friend, I will leave you with this affirmation and reminder…
We’re so grateful to be on this journey with you!
Don’t forget to join our Facebook community, follow-us on Instagram, check out our Parents VBAC and HBAC Education course and give our podcast a listen where lots of incredible women share their VBAC journeys.
Sources & Additional References
https://www.ncbi.nlm.nih.gov/books/NBK559209/
https://my.clevelandclinic.org/health/diseases/24480-uterine-rupture
https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/aogs.14211
https://reference.medscape.com/article/275854-overview?form=fpf
5 Products that *ACTUALLY* Make a Difference in Your VBAC Pregnancy
I attempted to VBAC for #2, found a doctor willing to let me try as long as I came to hospital during early labor.
I ruptured. When they opened me up baby’s head was in my abdominal cavity.
Mom and baby were fine thanks to being at a teaching facility, next door to an OR suite and on a closely observed monitor. Staff had her out in what seemed like seconds.
Hi Holly – Thank you for sharing this experience. So glad you and baby are healthy, but we know there is much to be processed even still. Sending you a big hug. 💙