VBAC

True or false? Can't get induced if going for a vbac?

I heard you could not get induced if doing a vac!  Any truth to this? 

Re: True or false? Can't get induced if going for a vbac?

  • Depends on your care provider- some do, some don't.
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  • I was induced on tues at 4cm minus 2 station.  I was really nervous about it, but it was awesome!  A small amount of pitocin was started an hour before they broke my water. I was in labor within 30 mins of water being broken, and delivered an 8lb 3oz baby boy after an hour of pushing.  Whole ordeal took 3 hrs and 15 mins. Only one OB in my practice induces.  I was really nervous about the pit but they only ended needing a very small amount.  It was a great experience!
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  • It depends on your provider. My past OB said they will not induce labor but will augment it, meaning you need to have improvement yourself for them to help push it forward. The other OB I talked to said they would try a soft induction.

     

    http://vbacfacts.com/2012/05/27/myth-vbacs-should-never-be-induced/ 

     

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  • The hospital I was at didn't allow inducing a VBAC because it is really small. The surgical team is not always available. If I needed to be induced, I would have had to go to a larger city 5 hours away. 

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  • Many providers will not induce a VBAC.  However, studies show there are a few different methods that are safe for VBAC.  A lot of doctors are overly cautious when it comes to VBAC, either in spite of the evidence or because they are not familiar with it.  We have had a lot of people on this board be induced and have a VBAC.  If you look at our birth stories list (go to vbacbumpies.blogspot.com), you will see some induction birth stories.  And there have been more that I have not added yet.
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  • I went to 41 weeks and was given a choice of pit induction (after a failed foley induction) or a RCS.  I chose the induction and had a VBAC.

    Many providers won't do it, but it's not a safety issue (though they present it that way).  They just don't want to do it.  But there are providers that will.

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  • For me: My doctor said when I hit 40 weeks and nothing has happened they will schedule a c/s. They will not induce at all from "ground zero" if I'm closed up tight.

    Now if things start on their own & I need a little boost they will give a small amount of pit to get things moving.

    So yes & no for my doc's practice.

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  • I was told by my doc that induction was the one thing off the table, but she said I was a good candidate for VBAC, if I wanted to try it. She's also acted like I healed well from the c-section. Like you, I've heard of people getting induced, so I can only assume it's her/the practice's preference as a provider to rule it out so readily.
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  • Mine said no. Apparently some will but only using certain methods. 
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  • It depends on your care provider and whether you've progressed at all on your own. My OB said that cervadil and other agents used to ripen the cervix are absolutely contraindicated. But I was already 4 cm dilated on my own when she scheduled my induction because pitocin is not contraindicated for VBAC and my body showed signs it would be conducive to induction.

    She had originally told me (early on the in pregnancy) that she would not induce but the story changed because I was progressing well on my own.

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  • There are some studies that show an increased risk of uterine rupture during a vbac when induced, which is why docs shy away from it. I can see how it would probably be less risky if they were augmenting already ongoing labor versus starting from scratch. They tried to induce me with pitocin for ds and after 10 hours I dilated to 1/2 cm, so I know at least for me, if labor hasn't begun on its own, a RCS it is.
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  • Like everyone else said, it depends on your provider and your body.

    If I would have been favorable, my MWs would have used a foley bulb to induce.  

    Their policy on pitocin was that they would use it to augment, but not induce.  So when I was having trouble getting my contractions regular enough to have effective pushing, they did end up using pitocin, especially because both the baby and I were doing well.

     

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  • My OB won't but she told me that upfront and at the beginning of the pregnancy.
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  • As everyone else said it depends on the provider. I think the biggest reason is the risk of uterine rupture. There is a risk of it for all preggo moms, but is far riskier with c section mamas due to the scar. From what I read, even if you have had a CS, the risk is still not that big. The consequence is obviously, painfully enormous, but the chance of it happening, not very likely.
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  • It depends on the comfort level of your provider.  Mine won't do it.  I am ok with their decision.  They feel the risk is too high.  Pitocin encourages contractions that are typically stronger than regular labor contractions, and the drug label actually doesn't recommend it's use in women who have had c-sections (or other uterine surgeries) due to the increase of rupture. 

    But, I have read on the bump and elsewhere of women who have had it for successful inductions & VBACs as well as to augment labor that seemed to be slowing/stalling. 

    However - there are alternative, non-chemical induction methods that could be used to help such as a foley bulb, membrane sweep, etc.

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  • I was induced at 4cm, -1 station & 39 weeks.  It was my 4th baby, 3rd vaginal birth, 1st VBAC 17mo after my c/s.  I labored w/ epi for 5 hours.  Pushed for less than 8 minutes.  Baby was 7lbs 5.5oz.  My OB was required to be in house for the entirety of my labor, but there were no regulations against an induction at my hospital.  There were no problems during the induction & she said my scar felt fine (from the inside) after delivery.
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  • Depends on your practice. 

    We went over all of the TOLAC paperwork at my appointment on Monday and I had a whole list of questions because I don't want any surprises and want to make sure we're all on the same page.  I asked about what would happen if I would end up needing to be induced for any reason and my MW said that depending on the circumstances, and if I had a favorable Bishop's score, they would still move forward with a TOLAC.  If I need to be induced and did not have a favorable Bishop's score they would recommend a RCS instead, which is understandable considering it's likely you'll end up with a C/S anyway and the risks are higher if you're inducing, especially in a situation where you're not favorable for that induction.  Now, I'm also with a super supportive MW practice.  I won't be induced just because I pass my EDD or anything like that.  They won't even start talking induction unless I reach 42 weeks or there is a true medical necessity.

    In general it's obviously a better situation for you NOT to be induced period, especially for a VBAC though because inductions up your risk of uterine rupture for anyone.  

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