In Canada, there are close to 390,000 births each year (Statistics Canada, 2017). Although many births may appear to be 'normal' and uneventful, data portray a different scenario. According to data from the Organisation for Economic Co-operation and Development (OECD), of the 21 reporting countries in 2015, Canada had the highest reported rate of obstetric trauma for both vaginal delivers with and without instruments (16.9 and 3.1 per cent, respectively) (OECD, 2015).
Obstetric trauma is among the most common adverse events in Canada. Obstetric trauma, including third degree and greater lacerations which may result in longer lengths of stay for mothers, as well as chronic complications such as fecal incontinence, dyspareunia, perineal pain and other pelvic floor disorders (Canadian Institute for Health Information, 2018). The immediate and long term psychological and physical impact of these complications on the mother and family are difficult to calculate. Many of the adverse events that occur are the result of system failures, rather than individual failures. It is now known that by creating a more reliable system of care we will be able to prevent, mitigate, and identify opportunities to prevent harm (IHI, 2012).
Uterine Rupture Survival Story (Allen, 2014)
Hi, my name is Jessica Allen …. I have three children, two boys who were delivered via C-section, and my daughter, who I tried unsuccessfully for a VBAC (vaginal birth after cesarean). She is who this story is about. Well, both her and me, I suppose. I decided on trying for a VBAC when I found out I was pregnant with her because there was a huge part of me that desired to have a 'normal' childbirth experience. I searched all over for a doctor who would let me attempt a VBA2C (vaginal birth after two caesarians), even debating home birth, because I so desperately wanted to have my last baby be how I wanted….
…I almost did it. I was probably an hour or so away from holding my baby girl. I was pushing and she was crowning! Then it got terrifying. I started having the most intense, sharp pains in my entire abdomen. I was crying and telling them that something was wrong because I should not be feeling pains like this with my epidural in place! Then my doctor saw blood in my catheter and told everyone that I needed to get into the OR right now. My uterus had ruptured.
We knew there was a chance of uterine rupture…The thought had crossed my mind, when discussing the risks of trying for a VBAC with my doctor, but it exited as quickly as it came… I never dreamed this would become my birth experience.