Induction via breaking waters for VBAC

[EveMoneypenny]

I'm 36+6 and would ideally like a VBAC this time around, but I cannot go over my due date because of a blood complication. DS1 was emcs because he was very large (over 11lbs at 42 weeks) and deflexed OP position. This baby has been consistently measuring 50th centile on my growth scans. Although I'm aiming for VBAC, elcs is booked for 39+6, and consultant has offered induction by breaking waters plus a low dose of drip if necessary as an alternative. I think I would refuse the drip completely - terrible experience with that last time as soon as it was started. However, is it likely that waters being broken as the only intervention would actually work? Has anyone got experience of this, particularly for a first vaginal birth?

Are you sure your consultant didn't mean the waters breaking and the drip as a package deal? I wouldn't be certain that only part of the intervention is on offer - you could clarify this with them to help your decision. I can see why they would dislike breaking your waters without any possible tools to deploy for follow-up intervention if required. The longer the waters are gone, the greater the risk of infection, including very serious infection. Simply breaking them and doing nothing else but hope nature kicks in is a risky plan.

I'd also ask about your prior history and its impact. Your previous baby at 42 weeks really is quite overdue and suggests your body may not go into labour easily. That combined with your blood condition, plus previously very large baby... For me, that number and complexity of risk factors would be too much to risk VBAC but I appreciate not everyone feels the same.

Thanks for the reply. It was suggested as a package deal and initially I enquired about doing without the drip. She said that would be a shame as if labour had progressed to the point where it was felt only a low dose of the drip was needed, it would be like doing most of the hard work and then bailing out near the end. However, as with any intervention i know i would be able to decline the use of the drip at the time, but I wouldn't want to mislead them about my intentions. I wouldn't have waters broken and be left - I think there would be a very short time interval, just a few hours, allowed to go into labour before proceeding to cs the same day if not.

Anyway, I think I will decline this course of action because the thought of all this intervention is reminding me too much of my last interventions laden experience! If it goes to cs so be it, but I will hope for a VBAC before the cs date.

I can see why I sound totally bonkers wanting a VBAC, but on the flip side the blood complication is anti-c antibodies, which pose no risk to me and the level at which they start to get worried for baby is 7.5. Mine have been 0.2 all pregnancy. So the mere presence of them is enough that clinical guidelines indicate delivery before 40 weeks, but the risk is thought to be tiny. I did go to 42 weeks last time, but one pessary put me into labour straight away and I got to 9cm before further intervention was needed. Finally, it would definitely be cs if this baby was the same size, but 3 growth scans, the last yesterday, have put him on the 50th centile. If it is a cs in the end that is OK, but I am worried about the possibility of future pregnancies if I end up going down the road of repeated cs. I had a brush with placenta previa this pregnancy too just to add to all my other issues (now completely cleared up and a very safe distance away from cervix) which has cautioned me about the risk of c sections - I'd previously been very gung ho about them because mine had gone very smoothly the first time.

Hi,
Maybe chat it through with your midwife/consultant. From what I know. (anecdotal of course) waters broken too early can result in quite a painful labour, whereas when done later on, can help speed it up.
With my first birth, my waters went but then I never went into labour on my own and had the synto drip which wasn't pleasant - however some people do have positive experiences of this way of induction.
I've had 1 vaginal and 2 elective sections due to breech presentation. If this one is head down then I'll try for VBAC which my consultant supports, however she will not induce due to the increased risk of rupture and to be perfectly honest, I would prefer section over induction. I'm keeping an open mind!

That is a good point regarding waters being broken early. Since I posted I have really gone off the idea of any sort of induction. If it's the section so be it, although I'd still prefer a shot at VBAC. Good luck with your own situation.