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Induction for 2nd birth having previously had emergency section for first

(18 Posts)
Pagan Mon 10-Jan-05 17:18:31

Was just wondering what was the norm and would welcome any experiences.

At first I was told that if I went 10 days overdue I'd automatically be given another section which I'm fine about. Then today at my 38 week antenatal appointment they said that induction was an option. Now I'm confused. I tried pressing the consultant but English wasn't his first language and we were getting nowhere fast.

tunise Mon 10-Jan-05 17:21:41

I don't know if it varies from hospital to hospital but i was told they didn't do inductions after c sections anymore. Maybe check with your midwife?

Pagan Mon 10-Jan-05 17:26:23

That's the impression I was under. Shall keep bumping this until Mears appears - she is a godess and an oracle!!!

mears Mon 10-Jan-05 17:26:33

Induction is possible but best avoided IMO. VBAC is most successful in labour starts spontaneouly next time round. There are individual reasons why induction might be tried though.

Pagan Mon 10-Jan-05 17:28:14

Now that's what I call spooky - Mears you are telepathic too!

Thanks for the advice - it's helped clear my befuddled brain. I came home from the hospital annoyed and upset and more than a little stressed about it all. Now I feel better!

mears Mon 10-Jan-05 17:31:18

Very spooky . Need to go just now but if you have specific queries let me know.

pupuce Mon 10-Jan-05 17:41:45

I find many hospitals are happy to let women go 2 weeks past their due date for a VBAC (whilst they might recommend an induction at 10 days pas for a "normal" client!).
I think it would partrly depend on the reason for your 1st section too..... as the induction for a VBAC might just be breaking waters...

lailag Mon 10-Jan-05 18:40:39

Had emergency section first time, needed to be induced second time ("medical reason"), with drip and the whole lot, they were keen to proceed to section as things were very slow in progressing and had had broken membranes for so and so many hours, risk of infection and bla bla.Wasn't very keen so just about managed VBAC with forceps in time...
Anyway, just to say that consultant wasn't in principle against induction after section (but had I wanted elective cs that would have been an option as well I think)

Amanda3266 Mon 10-Jan-05 19:12:48

Yep! I used to be a midwife (3 years ago now) but agree with Mears totally. Induction best avoided following a c-section. You're much more likely to get a successful vbac if labour starts spontaneously.

Mandy

Gwenick Mon 10-Jan-05 19:14:52

Had CS first time round, 2nd time round was induced as my membranes had gone several days before. Pain relief failed, was the labour from hell and was born with ventouse in theatre.

Can happen

Gomez Mon 10-Jan-05 19:24:34

I was in a similar situtation with DD2. My consultant said no induction straight to c-section. But at ten days over my waters went and I was about 3cms dilated but no labour. The consultant on call 'allowed' me to a have syntocin drip for 4 hours to see what happened but only because my cervix was favourable.

I progressed very slowly, got another 4 hours out of him as bubba was fine and had made it to 9cm but then stuck... for another 2 hours and eventually the inevitable c-section beckoned. However DD2 was OP and big (10lb 10oz) so I doubt if I would have managed to deliver her anyway. I was very keen to avoid another section and I was happy that I had given it a go this time. (DD1 was an elective c-section at 39 weeks due to breech presentation.)

So I suppose what I am trying to say is it depends on your individual circumstance when the time comes. I would also say that if my waters hadn't gone I wouldn't have allowed them to do anything automatically at 14 days over and would have asked for daily monitoring for a while. But as I said I was very keen to not have another c-section. And maybe I should add the section was fine and I am not sure what all my fuss was about TBH!

Good Luck

lailag Mon 10-Jan-05 19:45:45

at the time did a bit of "research" ;the royal college of obs&gynae didn't seem to advise against induction (with oxytocin) after cs; there didn't seem to be enough evidence availble regarding the increased risk of rupture.
dd now nearly 2 years old though and guidlines may have been updated???

pupuce Mon 10-Jan-05 19:48:46

guidelines are AGAINST induction with prostin gel for a previous section.

Gwenick Mon 10-Jan-05 20:37:53

I was induced with gel - was going to be with the drip until they discovered that my cervix was still too far back for it to work properly/

Pagan Mon 10-Jan-05 20:50:28

Thank you all for your comments (I love Mumsnet)

My own circumstances the first time round ...

Waters broke naturally at 7 days over term with contractions starting a couple of hours later. Was finally admitted to hospital 24 hours after waters breaking with a degree of to-ing and fro-ing in between because I wasn't dilating.

Given epidural and put on some drip and all was well, even managed to dose for a bit but the tracer showed DD's heart going down. I still wasn't dilating much. Managed to get to 5cm then they left it no longer as tracer was 'alarming' judging by the look on the midwife's face. (They turned the sound off and the screen away from me so I couldn't see - for my own benefit I think as I too was becoming alarmed).

I'm happy to go for a trial of labour for a VBAC this time round but don't mind a section if it doesn't go according to plan and especially don't want to be induced. Thanks again for the advice

lailag Mon 10-Jan-05 23:39:38

"from the review of observational data and extrapolation of the data relating to induction of labour of women in other subgroupes, vaginal prostaglandin appears to be safe. If and when oxytocin is used, the dose shedules employed should be carefully considered."
RCOG guidelines 2001.
BTW my sequence was prostaglandines, rupture of membranes, oxytocin, forceps delivery in theatres ready for cs...
All in all recovery from CS first time round went much smoother...

eidsvold Tue 11-Jan-05 02:26:32

I know with me - my desire for a vbac was taken into account but the consultant was very reluctant to induce me - he preferred I went into labour spontaneously. I went ten days over and ended up with a second section.

ghosty Tue 11-Jan-05 06:44:20

I guess it depends on where you are. I wasn't 'allowed' to go into spontaneous labour at all. I wanted to but there was no one who would even contemplate it on account of my previous c-s, no doctor I spoke to, nor my lovely but very conservative Midwife. I was induced with 2 lots of gel (8 hours apart) 3 days overdue. By the time the second lot hadn't worked (apart from mild contractions) I happily agreed to have a second c-s as I was bored out of my poor little brain .
It has never been suggested to me that induction is dangerous after a c-s.

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