VBAC after c-section (specifically if section was for failed induction/failure to progress)

[TTCmay]

Hi. After your experience please, ladies. Briefly:

DC1 was born 5 years ago by c section after failed induction. I was induced at 40+10 and DC was born 40+15. I had contractions/labour pains without any progress - by the end (40+15) I was only 2cm dialated. I had loads of gels but the cervix was high and closed and they could not break my waters/hook me to drip. I was in pain for 5 days, no sleep for 5 days, then major op at the end and a newborn to look after - not great!

I am now pregnant with DC2. I have my VBAC clinic appointment this week at the hospital. My thoughts this time are:

• Categorically I do not want to be induced (mentally scarred after last time!), even the limited induction they offer VBAC patients.
• I do not like the thought of being cut open, but I honestly would be willing to have another section (particuarly as I would not have the pain/lack of sleep for 5 days prior).
• I would be happy to wait until my due date to see if I spontaneously go into labour - I am VERY pessimistic this will ever happen! (my mum had all 3 of us 2 weeks later and was induced will all, my only sister had 2, one which was induction and one which was planned section due to placenta previa).

My understanding is that VBAC success rates are much higher where the orginal section was for breech/high blood pressure etc, rather than failure to progress.

Does anyone have any experience ? Particularly has anyone had a successful VBAC after a section for failure to progress when induced when overdue (i.e. does it ever work!?).

Thanks x

Afraid I have no advice but am interested in others responses as I am in a similar position. I am pg with DC2. I had DC1 last year (there will be 18 month gap) by emergency section after I failed to fully dilate. I got to 9 1/2 cm but the last 1/2cm just would not budge. I would rather have vbac but can't deal with another emergency section after hours of labour.

I had emergency section for failure to progress (failed induction at 40 + 10)which went on and on and on until ds1's heartbeat dropped like a stone (as did mine).

One year later I had a vbac with ds2. To be perfectly honest I think they let me labour on because they were understaffed and the theatre was busy!

Going into labour naturally is a million miles away from being induced. Can you agree with the consultant that you'll try a vbac if you aren't overdue? Do you know what the consultant's views on elective sections are?

I would try for a vbac up to due date. But I am keen to have that date as the end date ie I think I want section booked then (or next day). Not sure they will agree that or make me go to usual induction date (40+10 at my hospital).

Not sure what the consultant's views are - will find out thurs! The midwife seemed surprised i even wanted to book the vbac appointment, think she expected me to go straight for elective in circumstances.

Tippi when did you go into labour with dc2? Presume spontaneously? Good to hear it can happen, especially as you were quite overdue with dc1 too.

Hi - sorry for short post but crying baby calls! Just to say I had a very similar experience and ended up with VBAC. My old links may help - they are here.

My VBAC wasn't without incident but what I would say made the difference was that DS was nowhere near ready to leave but DD was! Having known what I know now about Bishop's scores etc (see another of my threads as I don't have time to find links again ) I would have opted for elective csection rather than induction with him as we were being set up to fail.

Will try to come back to post properly!

I had a c section at 40+4, due to induction and failure to progress, I was monitored through my 3nd pregnancy last year, to see if I was viable for a VBAC and was told I was a good candidate. As I came to the end of my 2nd pregnancy I was in terrible pain with PGP and I begged for an elective c section but they made me wait. I'm so glad they did, my DD was born bang on her due date after 7 hours of labour, I progressed very quickly and managed to go without pain relief. It was miles away from my first labour which I can only describe as horrific. It was a wonderful experience that I would happily repeat a hundred times . Just do what feels right for you, as long as baby is delivered safely that's all that matters.

Similar experience to you first time round.

Second time was meant to be a vbac but ended up being planned section at 42wks as my hospital's policy is to not induce vbacs because of significantly raised chance of rupture (I think 1 in 100 instead of 1 in 200 for natural labour). Was strongly advised not to go past 42wks so backup option of elcs happened and it was a great experience. Very relaxed, knew what to expect and great recovery - so much easier than the emcs. Probably greatly helped by having had full night's sleep beforehand - instead of two days and nights of literally zero sleep the first time. Would highly recommend elcs. Would also mention induction risks to your consultant - I always find it odd when one hospital does something that another says is too dangerous.

Hi OP, your story is nearly the exact same as mine. I'm currently 19 weeks pregnant with DC2.

I have point blank told my consultant I will not be induced, he was fine with that and has agreed that if I haven't given birth naturally by 42 weeks then it's a CS.
The consultant has also said that I will have all the medical people required for a CS with me if things go wrong again, and if things look like they are not progressing as they should they won't hesitate giving me a CS.

The idea of going through my first labour again terrifies me, but I do feel reassured that this new consultant and the staff will react far quicker this time around. I'm also listening to hypnobirthing CDs to help relax me.

Good luck x

very interesting. I'm 16 weeks with dc2 and have vbac clinic coming up. same story as many, 9cm but couldn't get her out - head was in the wrong position we think. spontaneous labour but my waters were broken and I had the drip for a bit too. I'm very keen for a vbac - I didn't think I was until I read all this and read about most hospitals saying no to a drip. hmmmm.

hi - i had a emergency c section w DS in similar circs to many of you - went into labour spontaneously but very slow to progress due to DS position, was dilated fully by the end of 48 hrs active labour (after a drip, which did nothing) but by then me and DS were too worn out to go on (I had not slept properly for two nights prior to the active labour as well) and Drs advised c section. It was horrible and the recovery took ages.

I really want a VBAC this time and have read that 70% of women even who had slow or incomplete dilation are able to do this successfully. If you dilated fully it is up to 90%. Also, the term 'rupture' is used far to readily, even of the less than .5% of VBAC women who have a 'rupture' the vast majority only have a tiny separation that makes little difference - 'rupture' makes me think of splitting open like a watermelon, which is not it at all! The risks of having a problem with the cord or placental abruption, which are common to all women, are much higher than uterine 'rupture'.

But if I don't go into labour spontaneously by a certain point I will opt for an elective caesarean rather than induction.

NCT has some informative evidence based factsheets on VBAC which you may find helpful. I will try to find a link.

Yes, I went into labour spontaneously with ds2 but he was prem (I had a bladder infection which I ignored which then aggravated my womb lining etc etc..) so not ideal but the contractions were so much more bearable and I wasn't so bloody terrified as I had been with ds1.

Hi have been to vbac clinic. Options are -

1. Elcs at 39 weeks
2. Try vbac with section booked at 41 weeks if nothing happened.

I made it clear that I would not be induced and they were fine with that. They said they would always recommend natural birth but that it was entirely my choice.

They said Defintely not on midwife led unit. Definitely not water birth. Need to be constantly hooked up to monitors.

I can have a sweep at 40 weeks (no earlier) and at 40+3. but categorically sweeps have to be done by a consultant as midwife not allowed.

Any way it was really just a chat as I have to go back at 36 weeks (currenly 25 weeks) to make a final decision.

One thing that annoyed me is that they had my old notes there which said that the reason for my section last time was not failure to progress (which I has been told, as had been induced for 4.5 days) but because dc was having decelerations. this was NEVER mentioned to me. Decelerations were recorded from 7pm and dc not born until 1.30am (my section kept getting pushed back as there were a number of emergencies). All was fine with dc in the end but feel very uncomfortable- feel trust breached ... Am I overreacting?