Hello,

Thanks for your query at DoctorSpring.com.

Firstly, according to the latest ACOG guidelines , it is safe for women with two previous C sections to attempt VBAC.

Earlier guidelines were restrictive, and discouraged women with 2 previous sections from attempting the same.

As you have noted, it is a controversial issue - when you plan VBAC, you run the calculated risks of sudden scar rupture, haemorrhage, rupture of the uterus, fetal loss and hysterectomy or even death.

The percentages of these risks is low, hence ACOG recommends that a trial should be attempted in women who are adequately counselled and voluntarily opt to try for a VBAC.

Regarding the indications mentioned by you, placental abruption has a recurrence of around 10 %. The previous indication has me more worried. Cephalopelvic disproportion means that the baby's size was more than the size of your pelvis ( cephalos - head ). Hence, if the next time around, your growth scans show a large baby, then I would not recommend VBAC for obvious reasons ( high risk of failure and rupture of the uterus ).

Also, ACOG recommends VBAC for women with two prior Lower segment C sections.
In the operative details provided by you, this has not been mentioned, but I assume that the sections were lower segment ones, since upper segment ones are quite rare and for unique situations.

Hence, in your case, you can opt for VBAC in a well equipped centre with rigorous monitoring for the earliest signs of complications. As long as you understand the risks and are willing to participate in the procedure, then yes, you can go for VBAC in your next pregnancy. A previous placental abruption is no reason for you not to opt for VBAC.

Obviously, if next time around you have a breech baby, or twins, or some other reason that mandates a repeat C section, then VBAC is out of question.

I hope this answer helped you.
Please feel free to discuss further with me if you have any doubts.
All the best.

Regards

Thank you very much for your response. :)