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thread: Would you induce for VBAC?

  1. #1
    Registered User

    Jan 2008
    Just Coasting
    1,794

    Question Would you induce for VBAC?

    So, imagine this is the scenario. I really want a VBAC, I am either 14 days over, or for a medical reason, it's time for bub to come out.

    I know prostaglandin gel is a big no no, but if I still really want to give VBAC my best shot I think I'd be willing to press for the hospital to try me on a low dose of oxytocin to see if it would get things happening (just a low dose and with monitoring of course).

    Would anyone else do this? Or would you go straight for a CS?

  2. #2
    Registered User

    Dec 2005
    In Bankworld with Barbara
    14,222

    Having synctocinon/oxytocin really wouldn't be a good idea, even at a low dose. You would probably be better to have a balloon method induction where they gently open your cervix with a balloon inserted into it. Alternatively if you are slightly dilated at all, which being your second bub you could well be a bit dilated by term, they could do ARM.

  3. #3
    ♥ BellyBelly's Creator ♥
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    Feb 2003
    Melbourne, Victoria, Australia, Australia
    8,982

    Induction with anything other than a foley's catheter (balloon induction) can increase the rupture risk - alot. From memory without is 0.7% up to the 2-5%+ depending on what's used.

    Use EPO, before bed, put on a pad and insert them right up to your cervix. They have an ingredient that imitates prostaglandins.
    Kelly xx

    Creator of BellyBelly.com.au, doula, writer and mother of three amazing children
    Author of Want To Be A Doula? Everything You Need To Know
    In 2015 I went Around The World + Kids!
    Forever grateful to my incredible Mod Team

  4. #4
    ♥ BellyBelly's Creator ♥
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    Feb 2003
    Melbourne, Victoria, Australia, Australia
    8,982

    Kelly xx

    Creator of BellyBelly.com.au, doula, writer and mother of three amazing children
    Author of Want To Be A Doula? Everything You Need To Know
    In 2015 I went Around The World + Kids!
    Forever grateful to my incredible Mod Team

  5. #5
    Registered User

    Dec 2007
    Sunny Qld
    14,682

    Mate that was sorta the scenario with DD1 - 14 days over, she had to come out - induce or not.

    We chose not to (even though it was only the balloon method because my OB doesn't induce any other way with a VBAC, far too risky) and go straight to the c-section.

    But I only got to 12 days over with DD2 and went into labour by myself (woot!) and I was inserting EPO from 36 weeks, and having a homeopathic remedy from 37 weeks.

    So even though you went over with your first, you may not get that far with the second

  6. #6
    Registered User

    Sep 2006
    the mulberry bush
    895

    i'm in the same boat, if i go over i have asked what will be the next step and it will be the balloon catheter.... if the cervix is not ripe or open at all, then i think i will go for the caesar...
    good luck.

  7. #7
    Registered User

    Oct 2006
    Perth
    3,299

    My ob wasn't keen on any induction because the risk of rupture is too high. He was willing to allow me to go 10 days post dates before starting to discuss c/s. We never got that far any way - DD was born at 38+5. If we got to that point though I probably would have chosen another c/s.

    Like Arimeh, I used EPO from 36 weeks as well. The day I went into labour, I researched a bit into reflexology points for inducing labour and poked my feet and thumbs myself for a little bit - went into labour that night so I don't know if that had anything to do with it.

  8. #8
    2013 BellyBelly RAK Recipient.

    Apr 2009
    3,750

    The hospital I work at induces women wanting a VBAC. As we are a larger hospital we also get women coming to us from the smaller birthing hospitals who choose a VBAC as the smaller places do not offer this as an option. Obviously it depends on the circumstances as to who is offered or accepted for an induced labour when they have had a c-section in the past.

    The Drs where I work are not fond of the foleys catheter in comparison to other places who use it much more religiously although it is used. Personally I haven't seen it used for that purpose where I work at but it could be and their is a policy for that.
    Policies might sound ridiculous as they don't neccessarily protect the natural philosophy of labour and its progression but as a midwife for legal reasons we obviously have to follow these.The usually way of induction for a VBAC where I work is an ARM if able and its definately preferred that way or syntocinon on a low dose until the cervix is softer and a little opened to allow for an ARM. This is not the practice at alot of other places but it is where I work. It would really depend on the hospital's policy where you intend on birthing at as to what their normal practice is. Synto where I work is used with VBACS although we do not increase it at the same rate or have the same starting dose we would if the women it was used on had a previous c/s. I would enquire at the hospital you intend to birth at as to what they normally do if in that situation you needed to decide between a c/s and an induction.
    But like the other girls said there is no reason you will need to be induced or go overdue based on your first birth. I am also not advocating any type of induction just mearly stating what we do where I work which is different to places close to us who do not use synto.
    A friend of mine is in the same situation as you. She wants a VBAC but her hospital said she has to go into labour spontaneously and she also has to be not overdue. She has had one vaginal birth then a c/s. She has gone 2weeks over with both so she is not feeling confident. Her local hospital also only accepts VBACS when the woman has had a vaginal birth as well as a c/s (only 1) so all places are different.
    Thought I better add that I work in a medicalised maternity unit that does not follow the midwifery model of care unfortunately.

  9. #9
    Registered User

    Sep 2006
    the mulberry bush
    895

    i've got a booking for reflexology on wednesday, so am excited to hear that maybe it might work!

  10. #10
    Registered User

    Jan 2008
    Just Coasting
    1,794

    Thankyou for your replies everyone! I'll definately be keeping EPO and reflexology in mind when the time gets closer

  11. #11
    BellyBelly Life Subscriber

    Feb 2006
    South Eastern Suburbs, Vic
    6,054

    Wishing you all the best with the birth Emma1979 and with your planning MamaSpice!

    I have a friend whose waters broke after a massage to get things moving, and another who swears by acupuncture. And if you want to press your luck (which I would), maybe claim to your partner that you've heard facials, manicures, haircuts and coffees can move things along too.

  12. #12
    Registered User

    Jan 2008
    Just Coasting
    1,794

    I have a friend whose waters broke after a massage to get things moving, and another who swears by acupuncture. And if you want to press your luck (which I would), maybe claim to your partner that you've heard facials, manicures, haircuts and coffees can move things along too.
    LOL, love it nelle!

  13. #13
    Registered User

    Apr 2009
    in the garden
    3,767

    Nelle... love it

    The only option I was offered was ARM - I asked about Foley Catheter but GCH don't do it. However they were willing to let me go to 14 days - I only went to 10.
    I used EPO internally, RLT, acupuncture, walking, pineapple, curries....

  14. #14
    Registered User

    Dec 2006
    Gippsland Vic
    1,686

    I would be trying other things beforehand, trying to not go overdue, eg: homoepathic remedies, stretch and sweep, accupunture worked for me. If it still had'nt happened i would go with the CS.

  15. #15
    Registered User

    Sep 2007
    Adelaide
    220

    My doctor has said that he is comfortable breaking my waters (if possible) and using the synto drip to induce me. He has told me of the risks of using the drip, but he believes it is acceptable. I'm not sure how I feel about accepting a higher level of risk.....

    I'm kind of assuming that AROM will be enough for me. With my previous birth my Dr broke my waters and within 30 min I was having strong contractions less than 5 min apart. I ended up with a c/s because DD got stuck due to being posterior and then went into distress.

    But this time I'm going to do EVERYTHING I can to get things started. I kind of gave up last time because I was too uncomfortable and it was hot. So I'm hoping I won't get to the stage of seriously considering induction.

    I'm finding it a bit hard to find a balance between preparing for a VBAC and accepting a possible c/s. I don't want to get too excited about a VBAC just in case it doesn't work out, but I still want to be prepared. I'm not really sure how I can manage both.

  16. #16
    Registered User

    Dec 2007
    Sunny Qld
    14,682

    Holly - I can definitely understand how you are feeling, I was devastated when I didn't get my VBAC. Absolutely devastated.

    This time round however, I made my peace early with however this baby was going to come out - it was the right way for it to be born. Be it VBA2C or c-section. I firmly believe that our babies choose their own birth - so I just relaxed and went with whatever she was destined to.

    Try to let go of the decision making - cos after all - it may not be your decision to make


  17. #17
    Registered User

    Nov 2008
    Gippsland
    18

    I would try natural induction methods at 7 days past due date: Nipple stimulation, castor oil and orange juice, birth ball rotation, sex and more sex. Where I work as a midwife breaking of the waters is the best method of induction for a VBAC, sometimes the balloon catheters are used and we have used syntocinon infusions on a very low rate with very close continuous monitoring watched by an experienced obstetrician and midwife (With operating theatre close by). No GP's and grad year midwives!

  18. #18
    Registered User

    Feb 2008
    Gloucester nsw
    120

    Hi,
    I am also going for a Vbac , so just reading thread for information on risk/induction. Not sure however what EPO means and ARM
    they could do ARM.
    HollyC: im totally understanding "I'm finding it a bit hard to find a balance between preparing for a VBAC and accepting a possible c/s. I don't want to get too excited about a VBAC just in case it doesn't work out, but I still want to be prepared.' i so want to be able to GIVE BIRTH but at the same time realise i may not ever get to....

    Thanks
    Krissy

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