VBAC with induction. Will I split at old scar?

[Jhas]

Hi all, I have just come back from a consultant appointment about the date of my induction, and she has frightened the crap out of me by saying that if i try for a vaginal birth following a c-section then there is a 1/500 chance that the scar will open internally. She said that if i go for a vbac with induction then this can rise to as much as 1/100. Has anyone else had an induced Vbac? If so what were your experiences and would you do it again if you had your time over. I am so stressed out about this now that i am tempted to just book in for an elective.

I have to be induced by the way as i have Obstetric Cholestasis

Afaik many places do not induve VBACs at all because of the risk of rupture increasing so much. Are they offering you a CS?

yes, I can have a CS if i want one.

I was told some consultants will induce and some wont. My understanding is that it's not done more than it is done.

It's a tricky decisi

Oh I'm sorry posted prematurely.

A tricky decsion, as I half said. And a personal decision.

They will monitor you very carefully and there are, I'm led to understand a number of signs they look for and in any uncertainty would rush you into emcs.

I was also told by midwife that all "ruptures" are not equal but are included in statistics. A tiny gap counts just as a major one, but major ones are less rare.

They wouldn't know which it was until after the event but don't assume all are massive holes etc.

That said, a very personal decision. And you need to be confident and relaxed about it to be able to labour well and wiyh

Oh for goodness sake I'm being useless sorry!!

You need to be relaxed and confident with your decision. Are you hapy with the immobility that continuous monitoring would need?

I was induced for a vbac, unfortunately I ended up with a crash section, but that was due to a cord prolapse, my scar didn't rupture and I had decided it was worth the risk (obviously a personal decision). Had the cord not prolapsed at the last minute there would have been no problems

I was induced for DS (12 years ago!) for a vbac. I wasn't keen on induction because of the risks of rupture, but I was 14 days overdue and going crazy. The midwives kept the drip turned low so the contractions didn't increase suddenly and helped me to stay mobile for as long as possible. The birth went well and I had no rupture and no further intervention.

I have had 3DCs, one CS under spinal block, one crash CS and one normal delivery. Normal delivery was the easiest to recover from, but a cs with a spinal block was a very positive experience for me so don't worry if you decide to have a planned cs.

I think it's definitely something that is worth you researching a little more, especially if things like statistics are important to you.

How many weeks are you? You might find it helpful to chat through with your midwife.

My consultant at the Portland was very pro vbac but would under no circumstances use induction drugs. It was go into natural labour or ELCS so I am surprised that it is being offered.

www.rcog.org.uk/womens-health/clinical-guidance/birth-after-previous-caesarean-birth-green-top-45

RCOG guidelines for birth after a previous CS here. I found these very interesting and useful when I was looking at my VBAC options.

I'm in a similar position so looked into this. There's a fair bit of info in this document: www.rcog.org.uk/files/rcog-corp/GTG4511022011.pdf
on the royal college of obs and gynae website if you want more research stuff.
From what I can make out the risk of rupture varies according to how they do the induction. I think a lot of units don't use the prostaglandin pessaries to induce a vbac, but will use the syntocin drip as it can be turned down or off if needed.
Personally I find the risk of conversion to emergency cs of more concern for me as I'd be really disappointed to go through the same experience of a long and painful labour and end up in theatre in the early hours when I know I could opt for a less stressful elcs and go home the next day. I think that just shows its a personal descion, not that you should worry about this too!

The risk of UR with a spontaneous labour is very small. IMHO the increased risk of UR with induction makes it unacceptable (to me). I would certainly discuss it further with your doctor/midwife. Are they recommending VBAC or CS for you? And do you have a preference?

thanks all.
Doodle alley, Re: immobility: I have been told they have some new kit which should allow me to be monitored and still have a water birth which would be brilliant if i decide to go ahead with VBAC, but after doing a bit of research i am leaning towards an elective. Will do more research, talk to DH, and then discuss with consultant. At the end of the day if i am really worried from the word go, then natural labour will not be an easy ride anyway. Thank you everyone for advice so far.

I've also looked into all of this, and for me, personally, I'm OK about trying for VBAC with no induction, but I would ELCS rather than be induced.

However, it's a close run thing because as someone who's only had an EMCS, and never given birth vaginally at all it's less likely that I'll succeed with VBAC than someone who has had one normally. I think that if I was going to be continually monitored, immobilised in bed then I would actually opt for the ELCS as I remember that the first time the only way I managed was being able to fidget (I had mobile monitors when being induced for my first one)

Oh that kit sounds good. Unfortunately no such kit in my hospital.

Very jealous!

Whatever you do, make sure you make the decision that's right for you and that you feel comfortable with.

I'm on the home straight for this pregnancy and have spent a lot of it trying to convince myself to go down one route because i thought it would disappoint everyone else!