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can you be induced if you've previously had a csection

(25 Posts)
Autumn2014 Fri 24-Jul-15 09:54:08

when my first child was born I had to have an emergency C-section at 31 weeks as I developed severe pre eclampsia.
I'm not pregnant at the moment (unfortunately I had a mmc this year) but thinking ahead. If I did need to deliver early again (hopefully not as early as before) would I automatically get a section again? or would I be induced? can you be induced or does it affect your scar, other risks etc?
I was due to see the high risk consultant when I was pregnant earlier this year and was going to ask this question, but then I miscarried. It's been playing on my mind since.

Itscurtainsforyou Fri 24-Jul-15 09:59:28

I think you can (I know people who have) but it depends on the doctor/hospital policy.
There are risks, but I think they can weigh things up on an individual basis.

Autumn2014 Fri 24-Jul-15 10:16:32

thanks for your reply

LionWings Fri 24-Jul-15 10:27:35

I was told no way, you can go into labour obviously but they won't do anything to start or progress labour. The midwife told me they would do a mild drip but the hospital wouldn't. The risk is higher if you have a small gap between pregnancies.

Autumn2014 Fri 24-Jul-15 10:37:20

that's what I thought LW. I hope I'll go to term next time and in natural labour so I can have a vbac. But if my hypertension isn't under control then I was wondering what my options were if I was pre term again. or even if I reach term but don't go into labour.
I wont have a small age gap 7+ years so I suppose that is one less risk.

theaveragebear1983 Fri 24-Jul-15 17:26:21

I've been told I can be induced with pessary but would need constant monitoring due to risk of rupture, but that's because statistically I am lower risk as I've had a natural delivery and a subsequent c-section. Not sure how it would be if I'd had 2 sections? I'm opting for elcs anyway.

ThinkAboutItTomorrow Fri 24-Jul-15 17:33:53

I've been told they wouldn't want to induce but that if I really wanted to they would try a mild drip. Not the peasant, I think because of monitoring or something.

Basically my hospital won't let you labour for too long or hard because of scar rupture fears

irregularegular Fri 24-Jul-15 17:41:25

I was induced during a vbac with no problems. They would only use drop not pessary and there was quite a lot of monitoring.

OhahIlostmybra Fri 24-Jul-15 17:45:43

Yes you absolutely can be induced for a VBAC and I have been offered this option by my consultant. For anxiety related reasons I don't want to go past 40 weeks and they have offered me a date on 40 weeks to come in and either be induced or have a ELCS.

I understand the way in which they induce is different for a VBAC due to the risk of a scar rupture. I have been told they would first break my waters if my cervix looked ripe and if that didn't progress matters within 3 hours I would be placed on the drip, with constant monitoring.

I honestly don't know which option to take!

SauvignonPlonker Fri 24-Jul-15 18:01:25

Autumn, I think a decision can only be made after discussion with your consultant.

I had severe PE & an EMCS at 29 weeks in my 1st pregnancy. Then 2 m/c.

I had thoughts of a normal delivery 2nd time round, and the registrars were almost trying to encourage me to have one.

When I discussed it with my consultant, she said "you'll never see your term date & it will probably end in another EMCS. You might not get PE again (30% chance, but averages 2 weeks later in pregnancy if you do) but you will get "something"

I was a bit shocked, but I guessed you don't go from severe PE to nothing.

From 32ish weeks, the liquor volume (fluid) around DD, was on the low side & at 35+6 I needed an EMCS. Mainly as DD was breech, but also as my cervix would not have been favourable for induction at that early stage.
I would have declined it anyway, as I am risk-averse & felt it would have ended in EMCS anyway.

bugoven Fri 24-Jul-15 19:57:42

I had an EMCS due to fetal distress August 2014 at 36 weeks after being induced 39 hours earlier.

My VBAC consultation was a few weeks ago and I was advised that there is 75% chance of VBAC and induction would be a balloon catheter and ARM only as the pessary, gel and drip all carry higher risk of uterine rupture. May be due to the small gap between pregnancies and individual hospital practice.

Duckdeamon Fri 24-Jul-15 20:00:38

I was induced with syntocin after waters went but nothing else happened (after C section with DC1): it significantly reduces the chances of a successful VBaC which I was not informed of, grrr.

SirVixofVixHall Fri 24-Jul-15 20:05:09

Induction has a fairly high risk of ending in a c-sec anyway. So personally, given the risk of rupture, I would not be induced. If labour isn't progressing properly then the chances are extremely high that you would end up with another c-section, so choosing to have one at that point is to me the safest option, and it is also the advice I was given by a very senior midwife when I was looking at birth options for dd2.

lots33 Fri 24-Jul-15 20:06:33

I had an EMCS with DS and then planned for a VBAC. DD was 2 weeks late and I was induced, again ending in a EMCS. Wish I'd gone for ELCS!

Duckdeamon Fri 24-Jul-15 20:07:25

Sirvix, that's the decision I would've made had I been given the info and stats. It turned out Ok (ish) but it still makes me angry that because I was down for a VBAC that is the plan they went forward with without discussion or reflection, even when circumstances changed.

SirVixofVixHall Fri 24-Jul-15 20:41:14

Duck, I think it is perfectly reasonable for you to feel angry. I did try for a vbac in the birthing unit, as planned, but after things failed to progress and worrying pain in my scar, i was given another c-section, which was the right call as it turned out my scar wall was very thin. I had been clearly warned that if I got shipped over to Labour ward from the birthing unit, that I would almost certainly be looking at another section, as it would be a sign that all wasn't going well. I was told that I could ask for one at that point, but I didn't need to, the consultant insisted on it because of concerns about my scar and the general way things were (or rather weren't) going.

LostMySocks Fri 24-Jul-15 20:51:40

I'm hoping for a VBAC but am recommended not to go over 40 weeks due to my age. MW told me that they only use the more gentle types of induction

Autumn2014 Sat 25-Jul-15 10:46:58

Thanks everyone. Sp thanks for your detailed post. I suppose it makes sense that the,earlier the delivery the more likely that induction would be less likely to work, and of course if it was a situation where baby was distressed or my condition worsening that they couldn't wait for induction to work then a section would be the best option. I'm not averse to another section, but just aware that I have child already to look after that would need to be taken to school etc once husband back at work and no family locally to help me out after a section. If course best laid plans could change and i end up with a pre term section and a poorly baby in scbu again...and trying to juggle everything

ovumahead Sat 25-Jul-15 11:03:57

Thanks for starting this thread. I'm facing possibility of an induced vbac due to gestational diabetes
I had been wondering about the increased risk of rupture especially with induction. Is there a good source of information or statistics about this online? Or NICE guidelines that have specific recommendations? I want to go fully informed to my consultant appointment at 36 weeks

Ekkwhine Sat 25-Jul-15 11:06:32

I was told I could have the peas arise but not the drip

Ekkwhine Sat 25-Jul-15 11:06:47

Pessaries even lol

SauvignonPlonker Sat 25-Jul-15 11:22:01

Ovum; yes, there are NICE guidelines "Diabetes in Pregnancy".

I work in a diabetes obstetric service; our section rate is about 50%. I guess it will vary between different services, but we don't generally induce at 38 weeks if there has been a precious c-section; steroids are also given before 39 weeks.

GraceGrape Sat 25-Jul-15 11:27:29

When I was preparing for a VBAC, I researched the increased risk of rupture and decided that I wasn't happy with the level of risk involved. I told the midwife this in my "VBAC" consultation. They weren't happy but I was very firm about it. Luckily it didn't become an issue as I went into labour at 40+5, but I think you have the right to make your own decision. There seems to be a lack of clear guidelines, and different hospitals have different policies which I think adds to the confusion and my own sense of unease.

Duckdeamon Sat 25-Jul-15 11:32:51

Think there is good royal college of obstetricians and gynaecologists VBAC guidance online.

OhahIlostmybra Sun 26-Jul-15 09:47:11

Duck, that guidance is really helpful, thanks. I didn't realise that my chances of success of a vbac were greatly reduced as detailed in that note. Food for thought!

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