41 years old, VBAC and induction

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Hello,

I'm looking for your thoughts on my situation.

I am 41, I had my first child at 39 by c section due to placenta previa. This time I am advised to have and want VBAC. The thing is my consultant wants to induce me at 40 weeks on the nose.

Now I've done a bit of reading and it seems that wanting and getting a natural delivery is going to be a challenge.

Firstly, the induction at 40 weeks is an issue I will deal with the next time I see my consultant and insist that she can't do this until 41 weeks unless she has a medical reason. It just seems odd as a hospital policy.

Secondly, hospital policy seems to be that my baby is constantly monitored, either by the sensors that go around the bump or the clip. After asking about this, it isn't a clip but a probe that goes into the skin on my baby's head while she is in the womb. Has anyone had something that felt like a national birth with one of these in place? It all seems like an overkill when the risk of uterus rupture is very low.

I've told my midwife that I want minimal intervention and she doesn't seem concerned that induction and consistent monitoring is intervention.

Has anybody else been in this situation?

I'm planning on going for vbac and have done a lot of research into it. I'm in my 30s so no pressure to induce. I think they only want to do that as you are over 40 and there are increased risks after your due date. I don't know how significant the risks are. I think they are still very low.

Based on what I've found out I'm surprised they would encourage vbac if they are going to induce. It reduces the chances of vbac success and if they use the drip it will put u at higher risk of uterine rupture so most doctors won't allow that. Maybe they plan to just use pessaries and break your waters but then the induction would have a much lower chance of success. I think I'd be asking what method of induction they want to use and what the chances of vbac success are in these circumstances (they should be able to give u a ballpark figure) as you may go through a long induction process and end up with a cs anyway if it doesn't work. I wouldn't be too quick to rule out a planned cs in these circumstances.

You could also decline the induction and request increased monitoring instead if your happy that the risks are low. But obviously you would have to get more info on what those risks are

I had the monitor on my belly with DC1 when we realised there was something wrong. I found it really uncomfortable. I kept getting told off for knocking it off and I hated it
Touching my belly when I had a contraction. They needed a more accurate reading later so used the clip. I much preferred this. I didn't even notice it. I doubt u would be able to get off the bed with the clip. I wasn't trying to walk around anyway tho as I couldn't walk unaided by this stage (long labour). The bed back moved so I could sit or lie however I wanted. I mostly sat upright slightly leant forwards.

My midwife said I could have intermittent monitoring during vbac if I go to the alongside birth centre rather the hospital. You could maybe ask about that in case you go into labour naturally.

Good luck. Hope it all works out for you!

Hey Bananas.

The consultant said that they would use the baloon method overnight and then break my waters I'm guessing in the morning, so no hormone pessary or drip. I do worry that it reduces the chance of vbac being successful as I have two factors against me (bmi over 30 at time of booking and not ever having had a vaginal birth).

I would prefer a vaginal birth. Partly due to having a boisterous 2 year old at home and I don't much fancy the regular being jumped on with an unhealed wound.

Interesting what you say about the monitor. I was told that the clip would allow me to be mobile. Thanks for that.

Hi
I'm in my forties and they want to induce at 39 weeks - the risk of placenta deteriorating and stillbirth is the reason. This doubles for someone in their forties, but that in fact means a risk of 2 in 1000 as opposed to 1 stillbirth in 1000.

Everything Bananas said. I'm now thinking planned c sec because inducing so often seems to end in c sec anyway from what I've read here ( though I don't know the stats).

In terms of the clip. I said I couldn't imagining walking around as its on the baby's head so I thought there was wire going from my vagina to the machine monitoring it. I was however very out of it by this stage and not looking to wander around anywhere anyway so possible I've got that wrong. Maybe they have wireless ones. The other thing with the clip is I can't imagine they could use it in the early stages as how would they get to the baby's head? Surely you would need to be a bit dilated and waters gone? I was fully dilated and waters gone before we needed the monitors on so I'm not sure of the answers. i forgot to also say that I know loads of people who've had continuous monitoring and still had a successful vaginal birth. You can still move around within certain constraints, some
Places have wireless or even waterproof (for birth pool) monitors and the bed backs move up and down to help you find comfortable positions. Personally I didn't feel it inhibited my ability to birth naturally but the one on my belly was annoying and I was glad to get rid!

Did they not discuss how your chances of a successful vbac would change in the various scenarios (with induction, with spontaneous labour?)? If not that's pretty bad. They should be open and honest about the pros and cons of all the options so that you can make an informed decision.

I was induced with my first at 37 because my waters had gone but labour didn't start. It was horribly painful and didn't work so I had a section. This meant I was exhausted after a long labour from the syntocin plus had all the side effects of a section. With my second it was suggested that I be induced 8 days after my due date. I decided there was no way I was going through that again. I opted for a section if I went overdue. It was so much better having a section when I wasn't exhausted and I recovered much faster.

Induction is probably for your age. You can decline however and have a bit extra monitoring.

The clip on baby's head is either a fetal,scalp electrode for good contact or for ST analysis in labour of,baby's heart (Ie. much better monitoring than just listening to a heart beat, but not many units use that). With the clip you can be mobile a lot easier, although obviously with in the range of the monitor

Once they break your waters they will put the drip on if you haven't started contracting after a certain amount of time. They will definitely want to do continuous CTG or fetal scalp probe if you have the drip. Both will mean you will be restricted to the bed unless they have wireless CTG. I ended up with the head clip during my induction.