To induce or not? VBAC.

[TransatlanticCityGirl]

Just got back from visit to consultant regarding induction planning and could really use some advice.

I'm 40+10 according to hospital scan dates, but only 40+3 according to my ovulation date which I am quite sure about as I was using CB Fertility Monitor + Opk + temperature charting. (it was a VERY planned pregnancy)

This is my 2nd child. DD was born at 40+16 by EMCS after failure to progress at 6cm following 3 days of attempted induction (Gel, ARM, Drip). She was 9 lb 10 oz. Late babies run in our family - on average born 10 days after due date.

Consultant advises that waiting to induce won't increase my chances of a successful VBAC, it will only decrease. However he agrees that spontaneous labour (which we cannot predict will happen anytime soon) would give the best chance.

He did a sweep today and says cervix is "very favourable" - 3cm dilated, soft but not yet thin enough. He has booked me in for a scan & monitoring for Friday at which point I could decide to be induced that same day or delay until next week.

I can't decide what to do… a part of me is saying hold out for spontaneous labour as long as possible (best chances for VBAC, less painful labour) and the other part of me is saying I'm being stupid for not inducing before Monday (risk to baby).

My main motivation for avoiding a CS is my 3 yr old toddler at home who is an absolute terror at the moment, and I cannot see myself being able to look after her if I cannot lift her etc. Otherwise I wouldn't mind a CS so much as I had a super quick and easy recovery last time.

The other factor on my mind is that I'm not convinced baby is in the best possible position. He is certainly head down but possibly partially back to back. I might be making this too hard on myself….

Experiences / thoughts appreciated!

It's such a tough choice. I'm in a slightly different situation in that I was induced due to pre eclampsia in my last pregnancy at 38+5 and DS born by EMCS at 39+1 after being stuck at 8cm. Currently 35 weeks and plan is ELCS if no spontaneous labour. I was told that they would not induce with the pessary as it can increase the risk of scar rupture due to over stimulation and would instead use a balloon to manually dilate the cervix which I don't like the sound of! Although recovery will be difficult with my 23 month old I've made this decision as I don't want to spend a potential three days away from him whilst being induced on top of any recovery days in hospital. In your situation I would consider the size of the baby too as I got more and more overdue. Probably not helpful to you at all but just wanted to share my thoughts re. induction.

Thanks Flickstar. Interesting how we're coming from different perspectives on this one. Do you have family to help you? I have pretty much no one as my family all live overseas… I've hired a post natal doula just in case.

The good news is that I've had a show this morning so I hope this means I'm on my way to a natural delivery. Still no contractions however….

My experience was similar to yours - late first baby who got himself stuck, so I had a CS at 40+16, although he was only 8lb 4.

Dc2 born at 40+19 VBAC at 9lb 2.5 which was ok - longer than expected at 10 hours (though shorter than the 3 bloody days with DS!), and I got a 3rd degree year as well. I recovered much better second time around, despite the tear, so if I were to go through it again, I'd do the same. Having said that, of course, only you can decide what you're prepared to risk, so if you're unsure then I'd speak to your consultant when you next go in for monitoring, and see how you feel then.

Exciting! How are you getting on transatlantic?! Really hope things are well under way now.
I don't have family nearby but my mum is going to come and stay for a week or so and my husband finishes work for 8 weeks 10 days after EDD (he's a teacher) so I hope to muddle on with my mum and possibly inlaws until he finishes so I do have more support than you, even though they're not on my doorstep. That has probably shaped my decision.

Unfortunately no contractions yet - it seemed like we were heading in the right direction yesterday but everything stopped after I took a nap. I now feel like it could be days before anything happens again.

I've been to see the consultant today and they've done a scan. They are predicting a 9lb 8oz baby - however I know these things are notoriously inaccurate. That said, this has ruled out the syntocin drip from the hospital's perspective as there are increased risks using it with large VBAC babies apparently.

As I expected would happen they have scared the living daylights out of me. VBAC + big baby + overdue = increased risk of stillbirth, uterine rupture, shoulder dystocia, etc… plus having to push a baby of that estimated size out doesn't sound fun.

So I'm going in this evening for induction - basically they will only break my waters and give me 24hrs. After that it's straight to CS. I'm hating this situation as I really wanted to go into spontaneous labour, but without my crystal ball telling me when that will be, the longer I leave it, the less my chances will be.

Not sure if I'm doing the right thing or not but I've effectively decided that I'd rather suffer for the next 2 months looking after a toddler following a CS than end up with a stillborn/poorly baby and/or uterine rupture/hysterectomy.

:(

I think it sounds like you've made the right decision for all of your family. Come back and let us know how it works out for you!

If it helps they predicted my second was over 10lbs the week before she was born so they were well over! Good luck.

Thanks both :)

Well I went in for induction last Friday evening shortly after my last post, but they didn't get to break my waters until Sunday afternoon due to other emergencies. Once they did, I made absolutely zero progress in 24hrs, just some mild contractions that ceased the moment I rested.

So EMCS it was and happy to say that my little Felix was born on Monday late afternoon weighing 9 lbs 11 oz, healthy and perfect, and I'm recovering well. I am a little bit sad that I will never experience natural childbirth, but as my DH reminds me, I have also never experienced the pain and that's not such a bad thing!

Congratulations! Felix is a lovely name

Thanks for sharing your experience, I'm aiming for VBAC too and have just had a discussion this week with my consultant about induction and how it will differ from a regular induction. Interesting to hear your experience. Glad baby arrived safe and well, hope you are recovering well too.