Induction after c-sec, anyone?

[gracej]

Hi everyone.
My first baby was delivered by emergency c-sec. I am hoping to have a natural divery this time. The doctor has decided to induce me a week early (big baby). He explained that the induction has to progress very slowly due to the c-sec scar.
I would really appreciate to hear from those of you who have had inductions after a c-sec. HOw did it go for you?
Thanks!

[DaisyMOO]

I would be rather wary of induction after a previous cesarean as there is some evidence which suggestes it actually increases the risk of uterine rupture. There's more information here

I'm surprised by him saying that labour needs to progress slowly as this is the complete opposite of what most doctors say and often give time limits for labour.

What was the reason for your previous cesarean? Was it related to your first baby's size? NICE guidelines actually state that there isn't enough evidence to support early induction because of a suspected large baby.

[uwila]

No way. I think scar abruption if you are not induced is a very real concern. Yes, it is rare, but if it happens it can have horrific consequences. And to be induced makes it more likely, so no way would I ever accept an induction. I thought this was not advised by any reputable consultant. Who advised this: the consultant or his/her junior registrar?

I suppose you should consider if the risks of scar abruption are worth having a VBAC, and worth having it a bit early. I would have thought waiting to go naturally and scheduleing a section if naturally doesn't happen for say 42 weeks was the way to go.

Personally, I'd be queueing up for a 39 week elective. But, that's obviously not what you want.

[uwila]

Yahoo Group for those who have experienced uterine rupture

And this site makes for some sad reading: a personal story

Again, I will say that scar rupture is very rare. But the consequences can be horrific.

If you are dead set on VBAC, you might prefer not to click on these links, as you probably won't find happy reading.

[NotQuiteCockney]

I'm pro-VBAC and anti-section (despite having had two, oh, the irony).

That being said, an induction is not recommended for a VBAC. I can see why the doctor would want to induce you slowly, so as to prevent uterine rupture, but it would be better not to induce you at all, imo.

[Laura032004]

I was induced with DS2 after an emergency c/s with DS1. They didn't use the pessaries due to the prior c/s, just a syntocinon drip. I really hadn't wanted an induction due the the scar rupture risks, but my waters had broken over 96 hours previously, and I had group b strep, so there was no other option really.

Personally, I would think that your body should only grow a baby which you are able to deliver. I wouldn't have been induced early because of it. Plus the sizing is unreliable - they told me DS1 would be 10 or 11lbs, he was 7lb 13oz. They said DS2 would be the same as DS1, he was 9lb 3oz.

[Cappuccino]

I had an induction for my second baby; my first was an elective section because the baby was breech

I had to really struggle to be offered induction but my consultant was really helpful and agreed to go against policy - due to family circumstances which meant I would have struggled to cope with being out of action after another c-section

but he would only give me one dose of the gel and if it hadn't worked it would have been a c-section again

one thing I did have to do was to get him to write everything down on my notes, including that continual foetal monitoring was not required. My friend had a VBAC and though her consultant had said it wouldn't be, he hadn't written it in her notes so the midwives had to do it anyway

[lulumama]

agree with what daisy has said

induction can pose more of a risk for scar rupture....

i would be inclined to wait until you are due to give your body a chance to go into labour spontaneously as that gives you a better chance of VBAC

i had spontaneous labour /VBAC , but had a growth scan at 34 weeks as measuring 37 weeks...baby was perfectly average..although there is room for error in growth scans, it was reassuring .....

[Marina]

I'm another veteran of an elective who hoped for a VBAC, but induction was considered out of the question.
The risk of scar rupture is significant, unfortunately.
I think capp must have been very lucky with her consultant, even the supportive ones IME are not happy to go with an induction post c-section.
I really sympathise with your wish for a VBAC though, I felt the same.

[lulumama]

induction policy varies widely, our hospital offers 2 doses of gel, synto , with constant monitoring..but a 6 hour limit on established labour

[Ellbell]

Just to repeat what others have said... I was very VERY pro-VBAC when I had dd2, but did a lot of research (as dh would have preferred me to have another section on safety grounds) and completely ruled out induction. It raises the risk of uterine rupture by far too large a percentage for comfort IMO (sorry, no statistics any more - this was 5 years ago now). I preferred another elective section to induction. Another factor is that everyone says that induced birth is much more painful than if you go into labour naturally, and I had also ruled out having an epidural, because I wanted to be aware of any unusual pain (e.g. between contractions, in the scar area, etc.) which might point towards uterine rupture. If I were in your position, I think I'd put off being induced until at least my due date. Either that, or opt for an elective, which can be a really positive experience. (I had an elective with dd1 and a VBAC with dd2 - both were equally fantastically wonderfully glorious experiences, one was not 'better' than the other). HTH and good luck.

[Ellbell]

Oh and totally agree with Capp about getting consultant to write everything in your notes. I had exactly the same thing with the continuous foetal monitoring. The midwives were all set to wire me up to the machine whether I liked it or not, till I pointed out that Mr XXXX (consultant) had written in my notes (and signed it!) that it was not necessary.

[Cappuccino]

I should explain a little bit more why I was allowed to have an induction as it was a special circumstance

I have a dd who was 4 at the time who is disabled so needed a lot of lifting etc. There was no option at all for me to not lift after having a c-section because that would have meant 24-hour childcare for dd1

I didn't feel that I would get a chance to heal after a c-section

[cryingatthediscoteque]

My consultant mentioned to me that they do occasionaly induce women who have previously had c-sections. He said they use very low doses of drugs and don't use the internal pessaries/gels as they can't control them as well.

He said too that using this method you would be very closely monitored and perhaps not given as long before they decided another section was necessary.

However, this was if the person was very overdue eg. 42weeks +, rather than because of size of baby.