VBAC - can I refuse an induction on 31 August?

[CaitlinsYellowSocks]

I'm pregnant with my second DS and the due date, based on the 12 week scan, is 24 August. (By my dates it's more like 28/29 August). I will be 39 at the time of delivery.

I have been given the choice of an ELCS at c.39 weeks or a VBAC. I was hoping to at least try and go for a VBAC.

However, my midwife has told me that the VBAC will be very medicalised (constant monitoring, lying on a bed and being hooked up to a drip etc.), rather than the more active birth I was hoping for. And if I don't go into labour spontaneously by 41 weeks the hospital policy is to induce me via ARM on that day, which would be Friday 31 August.

I'm really reluctant to have an induction and would rather go straight to a C-section if I go over 41 weeks.

• I had a failed induction at 40+10 last time, which ended in an EMCS at 42 weeks. I'd previously had a couple of very uncomfortable sweeps which hadn't done anything (I was reluctant to have these but felt pressured into it by the midwife). It was a really horrible experience and the idea of having to go through another induction terrifies me. The C-section was comparatively pleasant.

• If I'm going to have to have any form of intervention, I'd rather it wasn't on 31 August unless there's a specific medical reason. I know this is trivial, but if there's any chance of him being the oldest rather than the youngest in his year, then I would rather wait a couple of days.

• Obviously having a healthy baby is more important than having a pleasant birth experience or a child with an optimal birth month, so I don't want to do anything that would put him at risk. But the risks to the baby of waiting a couple of days over 41 weeks don't seem significantly greater than the risks of induction (especially if the scan dates were out).

I have a meeting with the VBAC midwife at 30 weeks and I'm not sure if I can request that I be allowed to wait until e.g. 41+3 without any kind of intervention (other than monitoring to ensure the baby is healthy) and then have an ELCS if nothing has happened before then. Does anyone have any advice or experience of this?

Sorry for the essay.

You can refuse an induction at any time. I had a VBAC and would have refused any induction because I felt the risk of rupture was higher.

FWIW I was able to have a fairly active birth. Stayed at home for most of the labour. I did get hooked up to the monitor when I was in but could still move pretty freely, get into different positions, on my hands and knees etc.

Your body your choice.
Also I had a vbac and other than the initial monitor when I got to hospital to check I WAS in labour I was free to move walk and do what I liked. The midwife listening with a portable doppler a few times but I only lay down when I wanted to!

I had a quick labour though... baby out in 2 hrs.

You don’t have to consent to anything, hospital policy or not. I had a VBAC after EMCS for breech and had a totally intervention free labour until I requested help, so the idea that they can just strap you down is rubbish. They might want to, but you don’t have to!

My trust will not induce for VBAC because of risk of scar rupture, so I wouldn’t be booking in for induction full stop. I’d just be saying, either section after 31st August or they can wait and see when baby decides to put in an appearance themselves. I’m not sure what risks there are to babies after 41 weeks though.

I think they would much rather women did as they were told and booked in meekly to make their lives easier. You may just need to be very firm and say either VBAC or elective CS after 41 weeks.

Thanks very much everyone, that's reassuring.

The way she phrased it made it sound like "this is our policy so this is what's going to happen, and you don't have any choice in the matter" - but as @NotAnotherJaffaCake says, they would probably I just followed policy and did what I was told.

I think I need to read up on the risks of induction (possibly followed by EMCS) vs waiting for spontaneous labour until 41+ weeks (possibly followed by ELCS) vs ELCS at 39 weeks, so I am able to weigh up the options, and make my case when I go in.

Sorry not really relevant to your question at all but.... I would much prefer my children to be the oldest in a class rather than the youngest! For a lot of reasons but I think you shouldn't refuse intervention for this reason! All the other reasons yes but not this one!

In your situation I would decline induction. Suggest to the midwife that you book an ELCS for 1 September. If you go into labour naturally before then then you will try for the VBAC. Obviously it is completely up to you and you could decline any intervention past 41 or even 42 weeks, although this would elevate the risk to the baby. I understand why you ideally wouldn’t want a very late August baby, and think 1 Sept should be an acceptable compromise (disclaimer - I am not an obstetrician!). Good luck

Thank you - @noimaginationatall, I know it's not a medical reason, but I'm worried about him struggling at school as the youngest in the class, especially since he is a boy. I don't think I will be able to refuse intervention on these grounds alone though.

@sandsnake - That would be my ideal, if they're OK with it. Annoyingly 1 September is a Saturday so I might have to wait until the Monday or get pushed towards the Friday - I don't think my hospital does electives at the weekend, only emergencies.

Hi op, in almost identical position to you. They can’t make you do anything at all, I’ve declined induction and am going for VBAC with no cefm, cannula etc plus eating (they told me I couldn’t eat), I’m also refusing all sweeps prior to labour. If I go over to 42 weeks I’ve agreed to go for elc. It is totally your choice and I have made very informed and well researched choices. They advise based on their policy but it is just their policy.

Thanks @LadyPug - I think I will go down the same route as you. Happy to book in for an ELCS after 41 weeks (which will be just under 41 weeks by my dates) but I can't face the thought of going through another induction. I'm hoping that the baby decides to put in an appearance before then, August birthday and all.

I had an induction with my first and it was not a good experience. It is absolutely your right to refuse one, or insist you go longer. Likewise they can’t force you to have a medicalised birth rather than an active one. Some insist on you having an epidural put in ‘just in case’ to keep you on the bed, but again you can refuse this.

If you go in to labour naturally then maybe don’t go in too early. I was suppose to have a very medicalised induction & labour for my second child. Fortunately I went into labour naturally and stayed at home until I couldn’t handle the pain anymore. Got to the hospital just in time - no drugs, no intervention... I kind of wished I hadn’t bothered and stayed at home for all of it 😂

Could you hire a doula to help you know and articulate your rights?

I had an induced VBAC. Obviously every birth is different but my induction took 30hrs before anything even started to get going. Do the induction process may start but that doesn’t mean labour starts at that point! First pessary was given 24hrs to work (which it didn’t). The second pessary got things going. There was no need for the drip and all but the last 30mins I was on my feet/birthing ball. Granted once things got going I was only in labour for 4 hours but I’m sure being active helped. Good luck. You never know, baby may surprise you and arrive earlier!

I had an induction with my first, it was the worst birth I had out of five (not horrendous, but the other four were brilliant). I wouldn’t have done it again, and in fact, refused induction with my fourth.

As far at the school thing goes, what local authority are you in? My youngest is 29th August and won’t be starting school this September when she’s four. We have agreement to delay until 2019 when she’s Compulsory School Age and will start in reception. Some LAs are very good at agreeing and in three year’s time when you need to look at this, it shouldn’t be a problem.

I agree that an early September birthday is much better than late August, my daughter was due on 31/8 but came 10 days late on the auspicious date 09/09/09! She is a girl, and bright, even so it's done her no harm to be one of the eldest in the year . So I am very glad she was overdue!! It's not a trivial reason. Xxx

Can you book an elcs in for 41+3?

Why 39 weeks? Sorry if I've missed something. This is what I'm doing except I'm decided to elcs at almost 41 weeks due to experienced my last pregnancy where I went to 42 and baby wasn't v well.

but if there's any chance of him being the oldest rather than the youngest in his year, then I would rather wait a couple of days.

You'd be able to delay the school year if born in August.

I'm avoiding induction; it doesn't seem to be an easy choice if vbac. Vbacs are mostly more successful if they start naturally and you've laboured before.

Sorry multi tasking!

I had confused messages from my mw till I did a birth reflections session with a mw about my last birth (emcs) but the mw also happens to run appts on vbacs too so it was more like that.

She'd originally said I could book a elcs in the 40th week but in the end the dr / consultant would have let me go over 41, despite me being aged 41, as everything is great. I'm hypothyroid too but that's all great.

It might be who you get on the day (she went off and booked it) but I do think you could do this.

I think they tend to book you in for an elcs at 39 weeks so you don't accidentally go into labour if you definitely want an elcs.

In England the law has changed for summer born babies starting school and you can defer for a year and then start in reception still!

I wouldn't rely on the change in the law which allows children to delay start as LEA's and schools are not guaranteed to accept these requests in the absence of sufficient evidence that this is required in the case of the individual child. There is also some lack of clarity whether all secondary schools will be required to accept children in their adopted year rather than the year they should have been in.

Speak to a different midwife, or perhaps speak to a doula, to understand your rights during pregnancy and birth.

Your body, your birth, your choice. Be informed, do your research and make evidence based decisions. I am having a home vbac based on my own research. If it comes to it, i am electing for a C section over induction (including ARM), again based on my research. You can chose to decline anything you like.

Intrigued by this! DH and I are both secondary school teachers and PFB is due in July, we both have summer birthdays and until recently hadn’t really thought much of it.

However realising that DHs step sisters child (born in November) and our baby will both start school together has totally blown our minds! She’s already weaning and our child hasn’t even been born yet, I know the age thing matters less as they get older, but when they are starting school our niece will be almost a year older than our child! Madness, it’s actually the teachers I feel sorry for having to cope with kiddies of such development gulfs! If I were you I’d be angling for a September birth! 😂 I don’t think we can keep baby in for an extra month and a bit though! Teachers! You’d have thought we would’ve planned better!

Apparently it's very common for teachers to have sept birthdays, not least as they get the 6 weeks before they start their maternity leave!

I'm a teacher btw; it's sort of worked like that accidentally due to Easter holidays actually.