VBAC-ers - what have you been told about induction?

[theborrower]

I've posted a lot about VBAC recently, sorry, but I've another question!

I'm aiming for VBAC with DC2 ( due in less than 5 weeks!). I'd previously agreed with a consultant that we'd aim for VBAC but if I went to 41 weeks it would be planned section.

Then, at my last meeting, the consultant (different from the one I had first time) brought up induction if I don't go into labour spontaneously, and we agreed that at 41 I'd try if I was able to have my waters broken, or go to a CS. I've subsequently posted about whether to wait for that because of childcare issues, but...

I've been doing a lot of googling / reading online (including online NHS leaflets about VBAC) this last week about inducing for VBAC and everything mentions avoiding this if possible, not only because of increased scar rupture but because it lowers your chance of successful VBAC.

The consultant did still say it was still a relatively low risk, they wouldn't use prostaglandins (which def increase risk more), so it would be breaking waters and a drip, and I'd still be continuously monitored.

What advice have you been given about VBAC and induction? Have you been told it's a good idea or not?

I initially thought that id rather not mess about and if spontaneous labour didn't happen i'd go to CS. I'm just a bit confused now. I'd like to VBAC if possible, but not at the expense of taking the riskier option for me and baby.

[Iamnotanugget]

I had the same concerns with dc2 and as the due date approached I was doing my own head in going round in circles deciding how to deliver. I finally opted for a vbac as although my emcs was fine the recovery takes a while and I wanted to be able to play with dc1 immediately.

I think you can get overloaded with too much information as the nhs have to tell you about all the risks. I was always told that if I was induced they wouldn't use the hormone drip because of the risk of rupture. If you are induced the chances of your scar rupturing are something like 4:2000 but even spontaneous delivery carries a risk of 1:1000. There are risks whichever way you get baby out. I just agreed to be monitored constantly and put faith that this would pick up any problems.

With dc2 I had my waters broken and then bounced on a birthing ball for an hour and labour started. I had a teeny bit of hormone drip to stabilise my contractions and dc2 was born without any problems.

With dc3 I had my waters broken and nothing happened. They put me on the drip and kept increasing it andd were talking about increasing it further but I told them to take it down. The drip is painful. You are more likely to request an epidural if you have the drip. Remember it's your labour. I felt much happier once the drip was turned down and dc3 arrived just under 4 hours after the drip was attached.

This isn't very well written as I'm on my phone but what I'm trying to say is all childbirth carries some risk. Whatever you decide you'll be closely monitored. All doctors have different views about the drip so although some say none, sone feel the risk is ok. The drip is painful but so is labour without it. A vbac gives great recovery time. I've had 2 and would recommend you try. If you have more questions I'll try to answer them.

[ReluctantCamper]

Hi borrower, I am in the same situation as you, but I have 14 weeks to go, not 5. First time around I had a pretty rubbish induction that ended in a CS, so have decided just like you that if labour happens I'll go with it, but am booked in for an ELCS at 41 weeks as I have said I will not be induced.

Because of my experiences I am pretty anti the drip, but I know there are lots of people who had successful labours using it. I will just say though - it does make contractions hurt a lot, and most people end up having an epidural when using it, so bear that in mind.

Also bear in mind that nothing can be done to you without your permission - i.e. if you don't want the drip or your waters broken, don't consent and then it can't be done. This was how I finally got my drip removed first time round following a couple of hours of uselessness from midwife and regsistrar, I said very loudly and clearly (twice!), 'I withdraw my permission for this drip', and things moved quickly after that!

Good luck, I'm sure all will be fine what ever you choose.

[AllBoxedUp]

I was hoping to have a VBAC and like you had planned to have a c section of I went to 41 weeks. When I said this I was told that was fine as they didn't recommend inductions for VBACs anyway.

My hind waters ended up breaking at 39w5d and after 48 hours I had to go into hospital because of the risk of infection. At that point I was asked if I wanted to try for an induction. As I had only heard pretty negative stories about inductions I decided to not have one but am still unsure if I made the right decision. I've read some more positive cases on here since then.

My c section was fine though. I felt pretty good after 5 days and was only on hospital 1 night. DD was 8lbs 8oz as well and big with it so maybe it was for the best!

[insanityscatching]

I've had 3 VBACs and was induced for two of them.
So first VBAC dd was 9 days overdue, (consultant wanted CS because I have a small pelvis but ds1 was a vaginal birth and the CS was due to breech) I had half dose of prostoglandin and then waters broken. Dd was born 9 hours after prostoglandin and a back to back labour all totally painless as I had an epidural in place from the off should I need CS.
Second VBAC I went into labour myself at 39 weeks and had waters broken to speed things up another epidural because that was consultants preference.
Third VBAC and a different consultant I had polyhydraminos and waters went day after due date. Offered clary sage bath requested a drip and an epidural. 48 hours after waters had gone I was given the syntocin drip, no epidural this time and dd was born 6 hours later.

[ThatBloodyWoman]

I told I wouldn't be induced and that if I went overdue by more than a few days, I would have a cs.

My best advice with vbac is to do your own research.

I didn't till after.....

[SignoraStronza]

I wanted to go for vbac but was very specific about not having the syntocinon drip as am terrified of the bloody stuff after having eight hours of it ramped up to the max with no pain relief (not in UK, don't worry).

Didn't want induction either and they were reluctant to do it anyway. Was also told I wouldn't be able to use pool and would have to have continuous monitoring (again, something I'd had before, which made it nigh on impossible to move around).

In the end I decided on an elcs - if I were to be unable to do it my way, at least I could make it as passion free as possible.

I do sometimes wonder 'what if?' but dc2, like dc1, was showing no signs of wanting to make an appearance anyway (and was also rather large) so am fairly sure I did the right thing.

Just make sure you ask as many questions as possible and find out what hospital protocol is. It really did help that I was armed with all the info this time round.

[foragoodfriend]

I tried for a VBAC after 1 EMCS. Went into labour at 42 weeks, laboured for 3 days only getting to 7cms, was asked if I wanted an epidural but that there was an increased risk of instrumental delivery so went for a CS again.

I personally wanted to avoid induction after reading about the increased risk of uterine rupture. I did all I could to have a more "natural" birth than the 1st one that was overdue/waters artificially broken at less than 2cms/syntocinon/epidural/EMCS. Hopefully you will go into labour before 41/42 weeks and you will be fine - so many people are. I hated the pressure on me to have a CS booked in at bang on 41 weeks. I agreed to more regular checks and held them off and was lucky enough to go into labour myself at bang on 42 weeks.

Good luck. Try not to stress (easier said than done).

[Flickstar]

I'm 37+4 here and hoping for a VBAC after induction and subsequent EMCS last time. I was told I could be induced but they would not use hormonal stimulants (pessary or drip) as they increase scar rupture, instead they would insert a ballon and blow it up which would manually dilate the cervix until waters were able to be broken. Doesn't sound pleasant so I will be having an ELCS around my due date (can't go over due to late onset PET last time and BP medication)unless I go into spontaneous labour before then.

[MrsWombat]

Thanks for the thread. I'm marking my place as I'm currently 17 weeks and have an appointment with the VBAC midwife soon so would like to be prepared with questions.

I don't want to be induced in any way other than a sweep, if I am overdue would rather just go straight in for the ELCS at 41 weeks ideally. DS was two weeks overdue and I ended up with an EMCS at 42 weeks after a "failed" induction. If it didn't work last time, it's probably not going to work this time.

[Iamnotanugget]

wombat I had an induction that ended with an emcs and went on to have 2 successful vbacs.

I'd forgotten about the balloon. They break your waters if you're looking close to labour. The balloon is if your cervix isn't ready but can take a couple of days.

[omama]

Watching with interest. Currently 13 weeks with dc2. Ds was born by elcs as breech. Am hoping for vbac this time as want a quicker recovery. Consultant didnt seem to keen on induction if I go overdue, which is fine with me as not keen either!

He wants me to have a stretch & sweep at 39 weeks & again at 40weeks in a bid to get things going naturally without going overdue. If I get to 41 weeks I have to see him again to discuss options, but it will likely be elcs.

[theborrower]

Thanks for the replies. Gosh, it's hard to know what to do, isn't it?? Yep, I'm doing my head in a bit thinking about what to do

I think I'm away to do some more reading online, and about 'normal' induction too, to see what they say about that. I'm also going to chase up my midwife tomorrow about this supposed 'VBAC clinic' at the hospital, she said she was trying to find out more about it and book me in (think it's a one to one visit with a midwife to see labour suite, ask Qs etc), but I feel as if we're running out of time!

I wonder at one point they say "stop changing your mind and decide"

[littlesausages]

Had 2 induced vbacs and both were the best decision. My midwife also assured me that if things didn't move along quickly that they will give me a cs. I was monitored the entire time and didn't go 1 minute without a midwife being in the room with me. When my daughter was born and placed on my chest was the greatest feeling also that I could do stuff for her not having just had major surgery. If you have a cs you will not be able to drive for weeks afterwards which is something you might need to consider if you live rural.

[Pinkie2103]

I'm 19 weeks and planning a VBAC (possibly at home) and really want to avoid induction, especially with the drip as it made contractions pretty horrendous with my first birth (which ended with an epidural and cs)

I have hired a doula and joined a great VBAC group on Facebook (VBAC Support Group UK) which has loads of great advice and information. I have my first appointment with my consultant in two weeks so we'll see how that goes

Good luck OP. I recommend the FB group for further advice and tips on keeping calm and trying to bring labour on naturally

[martha15]

At the risk of starting a fight.....there is no WAY I would let them induce me for a VBAC, and there is no WAY I would even contemplate a VBAC at home.
After much thought and research I am planning an ELCS rather than a VBAC for DC2. If I had gone down the VBAC route - which I seriously considered - I would have always planned to have a section if I hadn't gone into labour naturally by 41 weeks.
The problem with uterine rupture is that whilst the likelihood of it happening is indeed low, if it does happen the consequences are utterly catastrophic, and there is often little to warn the medics that it is about to happen. C sections carry risks, particular when you have more than one, but complications like bleeding, thrombosis and infection can generally be managed and treated in hospital.

[MrsItsNoworNotatAll]

I was induced 2 days before my due date as my blood pressure was rocketing. I really didn't want another c-section and they (medics) were fantastic. Nearly had to have a cs as Dd2 had turned herself round, her head was facing my snatch and she was in distress and had to be delivered quickly. I was prepared for a cs but thanks to their speed she was delivered naturally.

I think you can get a bit overloaded with information. Me personally, I didn't. I hope you do get to give birth naturally if that's what you wish. I much preferred it to a section and I recovered more quickly.

Good Luck xx

[theborrower]

Hi again, I thought I'd update.

I met with the consultant for a final time and we've agreed that if I get to 41 weeks I'll go to hospital on that date. If they can break my waters they will (which would be followed by a drip - if required? Can't quite remember if that's a certainty) but if there's not any/enough progress made within 6 hours they will do a section. If they can't break my waters because my busy is not ready, it will be a CS on that date.

He reassured me that it's a small risk (rupture) and I'll be continuously monitored. I'm sure he also said that I can refuse the drip if I want. And that if I get there on the day and decide I've changed my mind about breaking waters that's ok too and they'll just do the CS.

For those of you who saw my childcare thread too (about whether to delay induction/CS for few more days), I'm not going to go further than 41 because I need to go to hospital once labour starts, and I just don't want to risk any delay waiting for my MIL to get here, or my DH missing birth because he's waiting for them and I've gone in on my own.

Good luck everyone!

Oh, and thank you for the Facebook group recommendation - I've just joined so will check it out.

[43percentburnt]

Hi I had a vbac last year. I hypnobirthed and water birthed after doing research, I was monitored with a hand held Doppler, they got me to hold it.

At 40 weeks pregnant the hospital said we will talk when I get to 42 weeks about how to move forward. I gave birth at 41 weeks.

I did vast quantities of research and refused my two local hospitals after meeting with a consultant. I travelled out of county in the end, but the hospital were great I trusted them not to pressurise me whilst I was vulnerable.

Research is key, every pregnancy carries risk. I read everything as I wanted to be fully informed as to what could happen. I personally felt that induction would increase my chance of drips, epidural, forceps, ventreouse and c-section. Therefore I may as well just have a c-section.

[elliejjtiny]

I'm wondering about this too. I've been offered induction with the drip but declined that so far. I'm only 36+3 but my waters broke last week.