URGENT! Advice needed - VBAC Induction

[BigMommaOfAlmost4]

Induction set for tomorrow (not ideal but need it for various reasons and am very relieved). It's been 8 years since previous ELCS for twins. Two previous VBs prior to ELCS.

Hospital have told me that they will try ONE pessary, leave me for 6 hours and then break waters if necessary. Apparently if that does not work, they will try syntocin (I am assuming at a low level ) which has never been mentioned before by consultant. Midwife mentioned it today for the 1st time.

Now I had read before that syntocin is risky in a VBAC as chemically induced contractions can increase the risk of scar rupture. Now I have also just read on here that the PESSARY is risky as that can also bring on too strong contractions (I always thought it just 'ripened' the cervix?).

My consultant has previously said that I should just need my waters breaking as I am already 3cms (have been for over a week), cervix effacing and long and head 3/5's engaged (which is apparently as low as it can go before full on labour starts).

Now I am confused. Midwife was the one who mentioned all this after I had seen the consultant today and I was just so happy that they were going to start me off that I did not think about it til afterwards .

Ideally I would like them to break my waters first and see what happens without any chemical interference. Can I ask them to do that?? What is the safest way to actually do it?? HELP!

I wonder if they are covering the 'what-ifs' like if you aren't dilated enough to ARM they'd be happy to use a pessary. Then - once you've had your waters broken they'd be happy to start some synto.

any sort of induction with previous caesarean is slightly more risky because, like you said, hte risk of strong contractions and scar rupture - but i'm thinking they are going to monitor you very very closely.

I imagine the first thing they will do is examine you to see if you need a pessary to start dilating the cervix. if not then they'd go for rupturing membranes, then waiting a bit to see if labour starts, then if it doesn't then starting the synto.

Make sure they know you want to discuss every step with you in advance.

and Massive amounts of Good luck!!!

At my hospital there is one consultant who will induce after a cs... and the others won't!

My consultant said it is too risky to be induced and said that if I had gone over then I would have a c-section. (I'm having an ELCS anyway).

If you are closely monitored then hopefully you should be OK. I mean they must know what they're doing ?!

I suppose you need to make sure you are happy with everything and ask lots of questions tomorrow.

Good Luck !

UPDATE: DS3 born on Saturday night!!

Cervix was not thin enough for ARM so had one pessary and within 3 hours was in full blown labour. Waters broke naturally 30 mins before delivery! Labour 5 hours in total and 9lb 7oz DS born with just G&A, and no stitches.

The hospital were excellent, never mentioned me having a cannula in and although I did have CFM when contractions started coming 2 mins apart, I was encouraged to stand and walk around the bed or lean over a chair. The midwife also said she would not do a VE (even when I begged her!) as she did not want me to be disappointed if I was not as dilated as I hoped! So all in all, VBAC induction is possible and in my case, very positive. Best birth experience so far (and very, very last ).

fantastic. congratulations