Inducement not allowed if trying for a VBAC???

I was talking to a friend today (who has a friend going to try for a VBAC), and she tells me (according to her friends doctor), if you've had a C-section before you're not allowed to be induced subsequent births? Is that right - anyone else heard / been told this? What's the reason for it?

My first had to be induced and resulted in an emergency c-section after 10hrs labour & no progression and baby in distress.......anyway, we're TTC #2 at the moment and I was all for trying a VBAC but the no inducement thing got me a bit worried. If you don't go into natural labour, there's nothing else they can do to try for natural birth?? Seems so unfair.

The reason they won't induce with a VBAC is because artificially stimulating labour increases the risk of a uterine rupture.
However, they also get very antsy about vbac mums going past 40 weeks as well, which is very frustrating because some babies are just not ready to come at that point.
If you're wanting a vbac it really is best to go into labour on your own, because induction in itself is more likely to lead to an emergency caesarean. So if you're trying to avoid another ceasar, avoiding induction is a wise idea.

If you get to your due date and nothing is happening, cervix not looking favourable or whatever that's when the natterings about booking for a c/section will start (if they haven't already). At this point it is up to mum to remember everything she knows about vbac, going post dates etc and stand her ground. She can ask for daily monitoring etc and ultimately no one can make her have a caesarean. This is easy to say but mums are emotionally very vulnerable at the end of pregnancy and are all to often trampled and bullied and guilted into things they don't want. The trick is to be prepared for all this before it happens - do the research so you know you can't be guilted, make sure you have good support around you etc.

Oh also with a second baby you're more likely to be a bit dilated at the end of pregnancy, so they can break your waters. This could be enough to send you into labour on your own but the drawback is that if it doesn't, you'd probably be straight off to theatre since they can't put you on the drip. So it's a bit of a catch 22 that option. But if you're staring down the barrel of a scheduled c/s anyway to me it would be worth the risk but that's a decision only you can make.

As Flea said, the risk of uterine rupture is higher in women having a VBAC labour chemically induced. What worries you about not being induced? Personally, I would have thought having that pressure off would be a good thing ;-) The thing is, babies come when they are ready. Term is anywhere from 37-42 weeks so that is a huge timeframe. The biggest issue you will find with an ob as your caregiver will be the pressure to have a c-section if you go past your estimated due date, which is just that, an estimate :-)
Do your research beforehand so you are a little more prepared for some of the pressures you will face. Or better yet, choose the path of least resistance and choose a care provider who believes that birth is normal and babies come when they are good and ready ;-)

So what would happen if you tried to be adament with the MW or Obs that you didnt want to book a c section that you wanted to wait till bubs started labour on it own???
Would they look to turn you away or something drastic like that or would you still be treated but have to sign a waiver of sorts????
I am 3 weeks of my very sought after VBAC and I had never considered these things... SILLY ME! :(

Flea.... are you a practising Doula as yet????

Thanks for your replies.

It doesn't worry me not being induced...it was more because I went to 41 weeks with the first pregnancy, what if it happens again and I get to 42 weeks (which i'd be prepared to do) and haven't gone into natural labour by then. It just struck me that your choices are reduced if you can't try and 'help' it along. I know there are natural alternatives etc, but just really wondered if you've tried all those why you couldn't be induced with drugs etc. I'd never heard of it before and just wondered.

What you've said makes sense. Cheers

My first was born at 42 + 4 days induced resulting in c/s. With my second I did heaps of research & had a doula prepared for going overdue. I was told at 40 weeks that I needed to be booked in to be induced, but I had to be monitored the entire time. I refused. As the others have said, it took a lot of hard work on my part to stand up to the OB's at the hospital & make sure it was my choice. I was told my baby would die because of me being stubborn, but they had no evidence that was the case. I asked for a scan to stall time & it worked, I had the scan on Tuesday & on Wednesday night I went into spontaneous labour.

Be strong & have support around you prepared to help you through the battle if you need too. You can still have a VBAC, my VBAC baby was born at 41 + 3 days.

Yup... as said it's because with inducement it's usually quite full on straight away so it isn't recommended with a prior c/s.

I had a successful VBAC... loved it by the way. I went 4 days over and there was NO mention at all of a possible c/s at that stage so I was EXTREMELY happy about that. The midwife was like ... and why would you need to... when I asked her about going past EDD and c/s etc. So, it was great! Which hossy would you be going to? Oh and I was a spontaneous labour (didn't go into labour with number one as he was a c/s due to breech).

Hey Kirstie :)

They can't turn you away from a public hospital if you refuse to have a caesar. They may ask you to sign an indemnity but they would try other means first.
What they will do instead (and this is by no means always the case, but if they're hell bent on coercing you this is the usual tactic) is tell you that your putting your baby at risk by going too far post dates. Let's book a caesar and get baby out... and who knows maybe you'll go into labour before then anyway...think about your baby....dadada....

This sort of talk is very, very difficult for a pregnant person who is close to meeting her baby and who is totally hormonally geared towards doing everything possible to protect her baby, to process rationally. And they know that.

To a mum who either doesn't know that she has options (ie monitoring), or doesn't know that EDD's are just guesses about when a baby might come, and who doesn't have support from anyone around her (ie. hubby siding with the hospital so she's out on a limb) it's very easy for them to basically guilt trip you or frighten you into agreeing to a caesar. So they don't really have to pull out the "big guns" and say find another hospital, they just manipulate you emotionally.

It's pretty disgraceful yet it happens so often :( Blatant abuse of trust and power IMO, especially when they not only coerce women with emotional blackmail, but they present the c/section as being a practically risk free procedure in comparison to simply going post dates with a healthy pregnancy. So not the case!

Anyway I'm rambling lol...yep I'm a doula now Kristie.

Tobily - aka Flea :) Thanks for that.... I was speaking with DH about it and told him what they could possibly say to me if I go over... We discussed the possibility of a ceaser again.... But now that I am armed with a little bit more info I will talk to him again.... He wants me to have the labour I want but the moment they get to him emotionally then its gonna be out the door! If they say to him that baby IS distressed he will be on my case big time to have the ceaser... But if they say baby COULD be distressed he will tell them to pee off until baby comes on her own (within reason of course)
I have a list of questions that I am going in with at my 38.5 week visit so see what they say and I may PM you for some advice if that would be ok!

Sorry I was rambling there but at least if I have him filled in on thier "tactics" then we will be ok.
Thank you Fi!

Amygirl... Sorry to have pinched your topic there and run away with it.... You definately hit a nerve for me with your question and not a moment too soon!!! THANKS :)
xo

No worries Kristie :)

If DH is going to be the person who will be sticking up for you in labour it's really important that you talk together beforehand about the sorts of things that might be thrown at you and how you might handle them. I don't mean it to sound like an "us" against "them" thing in terms of the hospital - but the reality is that if you're having a vbac in hospital and your labour in any way varies from what they "like" to see - ie takes longer, stops and starts a bit, etc (all very normal in labour but doesn't fit with their get-the-baby-born-in-12-hours-or-less mindset) then you'll probably encounter pressure so having a strategy to deal with it is always a good thing ;)

Kirstie... with Oskar he was in distress (very dark meconium coloured water) and his heartrate was dropping to around 40 bpm at the end of every contraction. I still had a natural VBAC (no drugs) with vacuum assist as doc suggested very strongly we needed to get him out asap... having said that his apgar was 9 I think from memory... so he was fine once he got out!! ]

I see you are at Caboolture.. I'm not far from there. Are you having bubs at Caboolture hossy?? That's where I had Oskar and they were fabulous.

Tobily - Thanks so much, its good just to be armed with information and knowing that you do have choice ... it seems in the public hospitals you just have to be firm with them.

Cass - Yep am having bubs at Caboolture :)... They seem ok so far in relation to appiontments and stuff... not much to go on as I am normal every day pregnancy so they are quiet quick with me.. Its nice I have to say as I have not heard 1 bad thing about Caboolture at all!! I had my little man at Redcliffe and sadly there are nothing but bad or semi bad experiences re that hospital, including mine.

Thanks guys :D
xo

I hope you have a wonderful experience at Caboolture.

Hey everyone I am new to this site , and this is the most helpful information I have heard about VBAC's coming from real women and not some written literature of a professional saying all the awful things that may happen. It's nice to know there is possibility in natural birth even after a c section. My 1st was a c section because she was 10 pound 2 and I went overdue with her and her head would not engage. I really am hoping to try VBAC, but am worried I may be hoping a little too much given the size of my last baby, because I have heard they are meant to get bigger with each one too. I am having a scan at 34 weeks to check the size of him and then at 36 weeks my obstetrician wants me to decide which way I am going to go. It only makes sense to go to full term and then decide I feel he is jumping the gun a litttle, with making a decision, maybe its because of my previous c section, I dont know. But I will have to wait and see how big he is I suppose I so badly want to give birth naturally. I had a horrible time recovering after my 1st, it was 6 months and I had blood clotting and all sorts after, I dont want to go through that for that long again. No matter what some may say about C sections being the easy way I out, I fully disagree with that, because of the recovery time involved. Babies are meant to come out naturally though but sometimes in certain cases they cant, I just hope this doesnt happen to me again.

Just thought Id say hi, and thanks for all the information on VBAC's.

Danielle.

Danielle it is scary, have you access to any books about natural birth for the other side of the story? A very good one is Silent Knife and another is A Thinking Woman's Guide to Better Birth. You can look on the main site for ordering online :) Good luck, it is possible & you can do it!

Hi Girls,

I had my first bub in Sept last year by caesarean because I had pre-eclampsia and her head wasn't engaged so an induction would not have worked. Unfortunately the anaesthetist couldn't get the epidural in so I had to go under a general anaesthetic. I found the whole experience very traumatic and I'm really hoping for a VBAC next time. Initially I was told by hospital staff that if I wanted to have a VBAC with #2 I couldn't have it at that hospital (Pindara on the Gold Coast), but I have since found out, that my OB is one of only 2 OBs from Pindara that DO allow VBAC'S there, the rest insist on another caesar. My OB is open to the idea of me having a VBAC but has warned me that I'll probably need another caesar because #1 bub's head wasn't engaged which indicates my pelvis won't fit a baby through - so I know that my OB probably already has the pre-conceived idea that I'll be having another caesar. However, what I've read in this discussion has given me the strength to make sure that I allow my body the time needed to see if I go into spontaneous labour.

One other thing, does anyone know if there is a minimum length of time you should wait to fall preg after a caesarean if you want to have a VBAC????

Charli'smumma - have you read the article on pelvis size here? Not sure what it's called....but it's very interesting. The long and short of it is that there's only a teeny tiny % of women with pelvis' too small to birth through (trivia: did you know that squatting during labour can open your pelvis up 30% more than lying on your back?!!!!). Whilst you might be in that teeny tiny %, well, you also might not be.

Not sure if that's right about second babies being bigger either....