Methods of induction for a VBAC?

[PussinJimmyChoos]

Am 38 weeks and really hoping to have a VBAC

When I saw the consultant the other week, they seemed happy for me to try for this as baby isn't breech etc and booked an appt to see me at 41 weeks if haven't delivered by then and I'm sure she said there are methods of induction that they use for women with a history of c section

Saw midwife today and she said if I'm overdue, they won't induce, it will be straight for a c section and I'm like huh as this seems at odds with what I've been told

Surely there are methods of induction for v-bac'ers that reduce risk of rupture etc - am sure she said something about a drip rather than pessary

Hi, I have been told the same as you, it is to do with what is in the peserie (sp?) that they use for an induction.

Hiya

I got to 41 weeks with my attempted vbac. the plan was for a maximum of 2 gels, but because I was already in latent labour and contracting regularly they decided it was too risky. So instead I had my waters broken and the syntoxin drip.

Got from 4-10cm in 4 hours, but DS2 was huge and ended up getting stuck and an emcs

my consultant said there was no reason not to induce if monitored correctly - but a maximum of 2 gels/pessaries and a maximum of 6 hours on syntoxin from memory.

Ahh thanks everyone - not sure what midwife was twatting on about then...she annoyed me as she said oh if you go overdue, it will be a c section. She saw my freaked out look and said 'well, how else do you think they will get it out?!' so I explained and she said well, that's new to me....hence my self doubt and legging it to mnet for advice

Bloody hell, some midwives are twats!

Pussin, some midwives do leave a lot to be desired.

My consultant said there was no reason if I went for a third not to try for a vba2c. The midwife on community straight away said it would be a straight c-section. They do seem a bit more behind the times.

My wonder now is if I fall pregnant again, it will be by a different father - so how will that affect it all? God knows, its all such a minefield.

My consultant said the same as Pussin's midwife, i.e. No induction. He said it increased the risk of rupture. As a result I had about 4 sweeps (horrible, horrible) and made DH have sex with me every night post 40 weeks. I also took lots of long walks in the evening!

I did end up going into labour naturally at about 41.5 weeks.

It must depend on the PCT that you are in. I suppose if you went pirvate you could demand what you wanted more?

The risk of uterine rupture is increased with induction, that's why a lot of trusts don't do it.

Having had the pleasure of being hooked up to the synto drip once, I personally wouldn't fancy it anyway.

Seems to be two schools of thought about this then and I guess it depends on the consultant?

I thought it was ok to be induced if v'bacing as long as very carefully monitored - which you are anyway...this is confusing

Just told DH he may have to have sex with me if I go overdue and he said bloody hell, how will we manage that?!

He has a point

Hey,

This is an interesting thread-thanks!

My IM said that the gel pessary induction method is the most dangerous for VBACers. For no other resaon than the fact that once it's in, it can't be stopped or turned down, like you can with the drip.

There are mixed studies about the use of the drip for VBACs, so not a complete no-no in terms of scar rupture, though obviously there are associated interventions that can lead you quickly down the path to another c-section.

If you get into some sort of irregular labour pattern and progress a reasonable amount ARM may also be among the safer options to hurry you up!

Hope this is of some help and good luck!

@pussyjimmychoos- doggy style. Tis the only way at that stage.

Throughout my pgI have been told categorically that I couldn't have Prostin Gel for a VBAC as my CS scar is less than 2 years old. In fact I was told that they don't like to induce AT ALL and book you for a CS which is cancelled if you labour naturally!!!

This week at my mw appointment I was told that my consultant is one of the very few who WOULD be happy to use Prostin as opposed to the drip . Surely there has to be a more structured way of delivering the information in any given hospital so that it is at least consistent???

Working for the NHS myself I am aware that this isnt always possible, but when dealing with giving birth I think I'd appreciate a little more sound advice !!

I've been told recently that I can't deliver naturally due to massive varicosities and am now wondering if that information is indeed correct!!!

The lovely Lulumama gave me some advice on induction of labour and I was surprised to learn from her of something called the Bishops score - will link to this below

She said whether VBAC or not, induction of labour (IOL) with a bishops score of less than 6 -7 is likely to be a long drawn out process and more likely to end in c.section again. the body has to be ready

www.amazingpregnancy.com/pregnancy-articles/173.html

I had never even heard of Bishops before - the didn't even mention it when breaking my waters/giving me a drip for DS - and that labour ended in emcs

Will definately be mentioning it at next midwife appt - unless I go into labour spontaneously before then (please God!)

You could also ask about a Foley catgeter induction. A client of mine had this as she needed to be induced as diabetic and a VBAC.
They inflate a balloon filled with saline inside the cervix until you dilate to 3cmm's and it falls out. This usually starts labour. It didn't for my client but its worth a go and less likely to cause rupture than other methods-
clinicaltrials.gov/ct2/show/NCT00451308