VBAC - rules for induction

[wog]

Hi everyone have not been on mumsnet for about a year. dd now 21/2 and dh and I decided a couple of weeks ago its time for a brother or sister. So a couple of questions: it took us 8 months to fall pregnant first time, will it it be quicker or longer this time?

But my main concern in the delivery, I was 10 days overdue 1st time therefor I was induced, I went into labour about 3 hours after the gel was inserted and was in labour for about 18 hours but I only dilated to just over 9cm dont get me wrong I did get to the pushing stage but only for about 45mins before they decided to section me. So my concern is that if I go over my due date they wont induce me just put me in for an elective section - but I want the chance of labour again. I watched a programme once about a girl who had an emergency c-section the first time and was induced the second time and had a vaginal birth. Can someone please give me some advise because if or when the time comes and I walk into that consultants room I dont want to know nothing and just go along with whatever he tells me.

Sorry for the big long story but I have been trying to find some medical websites for info but cannot find any.

[Gwenick]

I had CS first time round - no labour - it was an 'elective emergency CS' - long story LOL.

2nd time round I went for a VBAC. Waters broke (as with DS1) and nothing else happened - 4 days later they induced me - and I was induced using the 'least recommened' way - with the gel. They initially told me that I could only have an 8hr 'trial of labour' - but I inisisted that I would have as long a labour as nessecary (this was before knowing I was going to be induced) and would only be given a CS if 110% nessecary for me or baby.

[mears]

wog - there are no hard and fast rules about this really. The recommendation is that induction is best avoided with previous C/S, however the consultants at my hospital make decisions for individual cases.
It depends the reason for your C/S last time. You nearly got to fully dilated. Was your C/S because you did not dilate any more or was it because the baby showed signs of distress? You said you were at the pushing stage. Do you mean you felt like pushing or you did actually start pushing as asked by the doctor/midwife. If you were asked to push, you must have been fully dilated.
Anyway, what I am trying to say it that your consultant may not necessarily rule out induction of labour depending on what happened last time. Need to go just now but will post a link when I come back.

[wog]

Gwenick did your consultant discuss this with you when you first fell pregnant - did he recommend that you have an elective section or was he quite happy to induce you

[Gwenick]

I told him in no uncertain terms I was NOT going to have an Elective CS. He wasn't completely happy (but I only saw him 2 times during my entire pg) but knew he couldn't refuse me.

We didn't actually discuss induction, but I did hint that I wanted to be induced if labour didn't start on it's own. When my waters broke, and I went up to the hospital - they didn't even mention having a CS and just booked me in for an induction 3 days later if nothing happened on its own.

[wog]

Mears, they did an internal at midnight and said I was 9cm and I only had an hour to go, they cam back and said that it still wasnt 10cm so they gave me another hour then another hour and by 3am I had the urge to push (I thought I needed a poo) and they encouraged me to push, the doctor said he would give me 45 minutes and then he was going to section me. As far as I can remember the said that my cervix was hanging down slightly and my dd's head could not get past it - does that sound like a reasonable explination.

[wog]

Gwenick I am only worried because when my sister had her firs ds she was induced and started having contractions within a couple of hours but she did not dilate mast a couple of cm and the baby went into distress and they sectioned her and at her first appointment at with her second ds she was told that if she went into labour herself then she could probably have a vaginal birth but if she went over her due date then she would be booked in for an elective as they would not induce her again and this is what happened so she never had a labour with both her ds's and I know she was desperate to experience labour never mind child birth.

[wog]

Gwenick I am only worried because when my sister had her firs ds she was induced and started having contractions within a couple of hours but she did not dilate mast a couple of cm and the baby went into distress and they sectioned her and at her first appointment at with her second ds she was told that if she went into labour herself then she could probably have a vaginal birth but if she went over her due date then she would be booked in for an elective as they would not induce her again and this is what happened so she never had a labour with both her ds's and I know she was desperate to experience labour never mind child birth.

[Gwenick]

They can't FORCE you to be induced - although they'll press very hard.

Know what you want and TELL the consultant that's what you want. They may not like it, but it's YOUR choice - not theirs.

[wog]

Thanks Gwenick

[mears]

Sounds as though the signs were you were fully dilated hence getting you to push, but infact you weren't because the lip of cervix was still there. Can you remember if you had a drip sytarted to make the contractions stronger? Did you have an epidural? You might have felt the need to push because baby was possibly OP (back to back).
I think there is no reason why you shouldn't be offered VBAC. The best thing would be if you went into labour on your own, therefore you should be left till 42 weeks if need be ( and all is well).
If you don't go into labour, then there is no reason why induction cannot be attemped unless the baby's head is very high (not a good sign for success)

There is a link here

By the way, took me 8 months to get pregnant with first 2 babies. Got caught out with third 'cause I thought the same thing might happen. DS2 was 7 months old when I fell pregnant with DS3. Was still breastfeeding at the time too. You just never can tell what will happen

[wog]

Yes Means they gave me my gel at 8.30am Sun Morn I was having bad pains by lunchtime, they gave me co-codomol at 2pm, did my internal at 3.30 said I was dilated already and put me on a monitor, took me down to delivery room at 5.30 put my drip in about 6.00/6.30 and broke my waters then turned my drip up about 8pm and I got my epidural at 8.30 but it never blocked my back passage at all then at about 11.30 it all wore off and that is when the did my internal at midght and told me I was 9cm therefor they did not give me anymore epidural and then you know the rest - they finally took me to theatre at about 5am and dd was born at 5.35am Mon Morn - So what do you think happened?

[wog]

Mears where are you, I neeeeeeed you lol

[zippy539]

On the first point - took me three years to get pg with ds and three minutes (precisely ) to get pg with dd, I think a lot of it is just pot luck.

On the second point, I had a crash section with ds and was told when I got pg with dd (just over a year later) that I wouldn't be induced if I went over. But I think it does depend on the individual consultant, reason for previous c/s, time gap etc. In the end I had to have an elective anyway as I got GD and dd had to come early.

Good luck with the TTC !

[mears]

Sorry Wog - had to ferry children to various places and then get something for dinner Sounds very much like you were OP - baby lying back to back which makes you feel as though you want to poo\push in labour. Epidural doesn't always get rid of that pressure. When baby is OP the head does not fit well against the cervix and also head does not come down as well into pelvis. Sounds as though that is what happened really. Doesn't mean that will happen next time round though.

[karen01]

WOG-sorry long BHIH. I had an elective section 36weeks ( no labour) in 1996, then in June 04 I had a VBAC> The consultsant wanted me to have another section but i said I wanted to labour. She informed me that I could not be induced using gel and drip etc as contractions could come to rapidly. I asked her to do a sweep and this she did on my Due date. I wasn't dilated or soft so it was painful but it worked. I started contracting the next morning at 8am but all day they were really mild. Went to hospital at 6pm as they were close together but still not that strong. It was once I got to hospital they informed me that DS was op. The registrar came round and wanted to dsection me then but Isaid no let me try. They agreed to let me go for a while but not too long (can't remember the time frame.) But when waters broke about 9 they had meconium in them but I still refused the section. At 2pm I was only 3cm dilated and baby still very high and op so it was painful so I said I would have an epidural, they gave me it thinking I would need it foir theatre also. This administered the first dose then broke!! so I had no more stayed on gas and air, at 3.45am I wanted to push midwife said she would check me as shed didn't think I was ready but knew something had happened as I had a slight bleed and started to shake/shiver even thoughI I was not cold. I was 10cm, then three pushes later DS made his appearance he didn't even stop to let midwife guide him out he shot out like a bullet and I am so glad that I stook by my guns and had him naturally.

[wog]

Thanks everyone for your stories they have made me feel better - mears where can I get info on my labour, would my gp have these notes and should they give a clear indication for my c-section?

[mears]

The hospital you delivered in last time will have your caserecords. If you are planning to deliver there again your consultant can discuss what happened with you. Just ask.