Induction for VBAC

[NickiAndAlex]

I'm hoping for a VBAC (previous CS was because baby wasn't coming out, despite being fully dilated and pushing for 2 1/2 hours).

I'm currently 40+6 with no sign of anything happening yet.

The hospital I'm based at will do inductions for VBACs, but I'm nervous about it, since I have been told in the past they stress the scar too much.

Does anyone have any experience of an induction for a VBAC, and any advice - I have a consultant's appointment lined up to discuss it on Thursday, and want to know as much as possible before then. Hopefully I'll have the baby before then, but no indications yet!

I'm surprised they'll induce (other than a membrane sweep) as research evidence indicates an unacceptable level of risk. You might find that they'll use one Prostin in the hope that this will bring on labour but won't use Syntocinon as this is what increases the risk.

There's no need to rush into an induction or CS. I know the waiting is frustrating but lots of people give birth at or after 42 weeks.

I had an induced VBAC with DS3 8 months ago. They gave me one Prostin at 6pm and by 8pm I was in full blown labour with DS born at 10.11pm at 9lb 7oz! I was at 40+2 and obviously ready. If the Prostin had not worked, they would have tried to break my waters IF my cervix had ripened, it not they would have left me.

Wonderful birth with very little interference (midwives did not examine me and let me walk around the bed with the monitor on and no cannula!!) and only gas and air.

Wishing you a similar outcome if you have to go down that route .

Oh and I had 4 membrane sweeps from 38 weeks which did nada!

nocake, my consultant said they are willing to induce with both pessary and drip if necessary. I don't know what the relative risks are, but I know other hospitals won't do it.

As for the waiting, I am an older mum (40), and I gather there's an increased risk of placenta failure due to age, too, some places don't let you go overdue at all at my age!

BattyBetty thanks for sharing your experience. I have no idea how ready I am now, I will ask the midwife when I see her tomorrow, maybe see if I can have a sweep.

The RCOG guidelines on VBAC vs ELCS are available here:

www.rcog.org.uk/files/rcog-corp/GTG4511022011.pdf

If you look at page 10 onwards it talks about induction for VBAC. It increases the risk of rupture by 2-3x, although doesn't say women should not be induced, just that they should be very carefully monitored etc. Hope it goes well at your appointment.

at "don't let you go overdue", it is not up to them to "let" you.

If you are concerned about the health of your placenta, you can ask for expectant monitoring. There is no need to induce "just in case" the placenta fails if you don't want to, they can monitor the function of the placenta for you, and avoid unnecessary intervention.

I had an EMCS, after intervention with syntocinon, there is no way I would accept it again, even if the consultant was happy about it, due to a combination of the evidence of risk, and my previous experience with it (neither I nor my baby tolerated it well)

If you wish to go the induction route (remember-it is always your call not theirs) be comforted that the evidence against induction for VBAC is not as clear cut as you may at first think.

Read a few studies and make your own mind up. There's certainly a mixture out there. A report that states X times the risk may also be including small and a-symptomatic issues that are only discovered after a woman has been opened up for a c-section because of F.Distress (for instance). Dig around.

Personally I wouldn't be at all suprised that even with an increased risk of rupture you are still looking a stat that is more palitable that the known risks carried by a c-section.

In terms of "safety", a drip is safer than the gels for the reason that a midwife can control the drip with instant affect, should they have reason to.

I would never accept induction again personally. But if this is what you want, then inform yourself and go into it fully prepared.

All the very best. Remember! Information is power!

Thanks for all your advice! Fortunately in the end, it wasn't needed, my baby came of her own accord on Tuesday (7 days overdue). Unlike last time, I had no advance warning, I just woke up at 3am with contractions around 4 minutes apart!

I also got my VBAC, too!