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Thread: Inducement not allowed if trying for a VBAC???

  1. #19

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    Charli'smumma, just wanted to let you know that my step-sister's first bub was almost 10lbs, and her second was only 7.5lbs. They were both boys too.


  2. #20

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    Silent Knife is in stock at the moment, The Thinking Woman's Guide should be in very soon - it's in transit!
    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
    Follow me in 2015 as I go Around The World + Kids!
    Forever grateful to my incredible Mod Team and many wonderful members who have been so supportive since 2003.

  3. #21

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    Thanks for your replies girls. My first bub wasn't overly big - 7lb 8oz so it wasn't her size preventing her from engaging (well I don't think anyway). The OB didn't really tell me too much. I'll have to read the article about pelvises. Maybe bub was just in a funny position I don't know. I'm not exactly a tiny person myself so I really hope that my next bub does engage. Apparently I won't go into spontaneous labour if it doesn't???

  4. #22

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    many babies don't engage until labour starts or even for a few hours after labour starts especially for second and subsequent births. Dont be fooled by the myths propogated by those all to willing to surgically remove your precious baby. It's just more scaremongering, they just need to wait !

  5. #23

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    Thanks Smilie10P, For some reason I thought that I wouldn't go into spontaneous labour unless my baby's head was actually engaged. I'll definately be trying to hold out as long as I can next time before going down the caesarean road again!

  6. #24
    paradise lost Guest

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    My (first and only) baby's head engaged fully about 3 hours after my labour began. I was 2/5ths engaged a few times before then but she was still bobbing up and down. It wasn't until my contractions were going well that she moved right down. She was born at 41+4 so it's not like she was pre-term. I'm 181cm tall and one of my midwives said she doesn't pay much attention to engagement in taller women as the baby often has a lot more up-and-down space to muck about in.

    If bubs is more than 14 days overdue and still not at all engaged or labour has been strong for many hours and the head is not descending, then you MIGHT have a baby too big (far more likely to just be in a funny position) to fit through...maybe.

    Many second babies are a little bigger than 1st babies, (and many aren't) but then many first babies are born surgucally when they could have been born vaginally. Obviously your bub had to be born due to your PE and inducing when the head is very high increases the risk of cord prolapse (when the cord is washed down past the head and through the cervix, putting it at risk of complete compression) which is a dire emergency. It's likely that without the PE Charli would have engaged and been born just fine.

    Bx

  7. #25

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    Thanks Hoobley, I hope you are right Fingers crossed I don't have PE next time. I have heard that it's less common in subsequent pregnancies??? I don't think Charli's head was at all engaged (well that's what my OB indicated) but she could have just been in a funny position. She was born with a pointy head though and I expected a really round head being a caesar so that does make me wonder whether she was actually partially engaged. . . My elective caesar under a general robbed me of a birth experience and that precious bonding time. I never want it to happen again so I'll be trying my hardest for a VBAC all the way . . .

    Sorry guys, I got this thread a bit off track but back to inducement for VBAC. I did read somewhere that besides being able to rupture the membranes apparently they can insert a catheter to just inside the uterus and blow the balloon up to try to put pressure on the cervix to start dialating and to try and stimulate the natural labour hormones. Not sure how often this kind of thing is done but if you go way overdue and you are staring down the barrel of another caesar maybe it is an option?

  8. #26

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    Yes some hospitals use a foley catheter to induce VBAC women, but ideally all goes well/healthy and you don't get induced in the first place Because at the end of the day, an induction can fail, especially if the body/baby isn't ready, then you only have one option left.
    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
    Follow me in 2015 as I go Around The World + Kids!
    Forever grateful to my incredible Mod Team and many wonderful members who have been so supportive since 2003.

  9. #27
    mushka Guest

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    hi guys, glad to hear of the discussion about VBAC I am a junior midwife at a maternity tertiary referral centre in WA. VBAC is no big deal for us. Those of you who have experienced negativity in response to wanting a VBAC should pursue other care providers. In my experience, public hospitals are more advanced in these areas and have 24 hour care so if a VBAC is unsuccessful and you need a NELUSCS (non elective) it's no big woop di do. In bigger hospitals the fewer women electing a c/section straight off the better. That's not to say the care is unsafe, just more individualised. Doctors are not on a time schedule, theatre staff work 24/7 along with the rest of us.

    Charli's mumma: the recommended time frame after c/section to allowthe scar to heal is 18 months.

    Babies do not necessarily get bigger as you have more. the size is really dependant on many things, your health at the time (blood pressure etc), the placental health and how the placenta is implanted into the wall of the uterus.

    The best school of thought is every woman is entitled to a trial of labour, not all of your babies will engage into the pelvis in the same way, so the second time round after a c/section your baby may engage into the pelvis in a way that is accessible for it to birth in comaprison to your previous. Labour is usually shorter the more babies you have and you are most likely to be overdue for your first one. Although it can still happen.

    60-74% women can go on and have a successful VBAC (with lower uterine scar). Induction does increase your risk of an emergency c/section slightly in comparison to going into spontaneous labour but induction is still considered a reasonable thing to do as long as there isn't other risk factors. Women who had c/sections previously for breech, pre-eclampsia are in the most favourable category for VBAC, along with women who had a vaginal birth prior to the c/section.

    A c/section for failed progress in second stage is also favourable, because it indicates the cervix can dilate. However it may indicate problem with the descent of the baby's head. So it has trouble making it's way down the passage. Descent can be aided by upright labour, mobilisation and active labour, no epidural till in established labour. Failure in first stage (cervix stops dilating) indicate a problem with size proportion (baby vs pelvis) however every labour is different and the engagement may be slightly different. Sometimes if the head isn't applied well to the cervix it doesn't have the pressure on it to make it dilate. However it can come down to the angle of the baby's head when engaged which may have held it up last time....not the size. Different parts of the head are bigger than others in diameter.

    There are many variables and that is why even if you didn't succeed (sorry wish I had a better term) in first stage or second stage doesn't mean the variables will be different next time. A cervix which has dilated to 6cm will dilate better the next time than one that has never had to do anything.

    There is an organisation you can access called Birthrites, it's in WA (i think maybe national as well), lots of info there about VBAC.

    When someone tells you that you can't go past certain dates for a VBAC, ask yourself if that's logical. Did you have a previous c/section for size last time, or was it another reason, breech, c/section. If so was size even an issue. Most women will have a baby that's the right size for them, unless you are a diabetic, than early induction is recommended.

    So, induction of labour is done with VBAC in some hospitals, so do some research. Look around for a practitioner who isn't scared of VBAC and normal birth, somewhere midwives practice along side doctors is a good place to start.

    Good luck, you have a right to a trial of labour, trying for a vaginal birth after c/section can prevent many complications for future pregnancies such as placenta praevia, placenta acrete and repeat c/sections. Cheers mushka

  10. #28

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    I have had 2 successful vbacs after my first breech baby was born by c section. My second pregnancy was induced by breaking my waters to see if labour would start as my amniotic fluid was on the low to normal level and I was told if I didn't deliver that night I would be up for another c section. After having my waters broken (I was luckily 2 cm at 39 weeks) and a cervical sweep( ouch) my contractions came on FAST!! You can ask for a stretch and sweep at your 40 week appointment to see if it gets things going. Then try every natural method and wives tale known to man. I also used raspberry leaf tea towards the end of my pregnancy ( 36 weeks) and I swear it helped my uterus contract. All my babies came under 2 hours. Have you also considered having someone else present at the birth, along with your husband. I think it's really important to have someone with you that will be a strong advocate for you.

  11. #29

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    hey,

    I just noticed mushka's reply to this thread, it was full of information I didn't know yet, I am learning very fast about VBAC'S . I was just wondering, it was mentioned that women who have had a c section in the past for breech bubs or medical conditions like pre-eclampsia are more favourable for VBAC.

    Is this why my doctor didnt like the idea of me attempting VBAC, because my baby was posterior, a big baby of 10lbs 2 oz, and her head was more like sitting on my pelvis instead of going under, does that mean that it may lower my chances of VBAC this time, because of the baby to pelvis ratio, that it may be more likely to occur again? Also my body has experienced no labour what so ever - could that also have an impact on weather it would be successful?

  12. #30
    SamanthaP Guest

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    Can I ask why you didn't labour last time? How did your dr/midwife know the baby wasn't going to fit without labour? Lots of babies are posterior and to be honest, that's a shocking sole reason to have a section.

    Forget the term 'trial of labour/scar', it just spells out failure. It's horrible yuk medico speak. It's just a birth. Not a VBAC birth - just a birth. Your best option is to hire a care provider who will treat it as such - not a rupture waiting to happen.
    Last edited by SamanthaP; February 18th, 2008 at 07:55 PM.

  13. #31

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    Wow Mushka, thanks for all your input, there's a lot of great info in there!

    Jo+3, I think with my next pregnancy I'll be asking for the stretch and sweep if I get to 40 weeks and nothing has happened. It can't hurt to try it hey . . .

    Danielle, I didn't have any labour with DD either and I am dearly hoping for a VBAC next time. I've read on this site that there is a lot of evidence out there to suggest that this so called "pelvis too small or baby too big to fit" problem doesn't exist in most cases. Lets hope that the so called experts who tell us that our baby wont fit are wrong and that we will have a great VBAC for our next births!

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