How long past due date before induction for VBAC?

CopperT0p

At my appointment today with my midwife, she mentioned she is going to get a letter consult from an OB as to how far past due they recommend allowing my pregnancy to go for a VBAC.  She mentioned typically it is recommended to look at induction at 41 weeks for a VBAC, and that's what she thought would be recommended in my case.  

My history is that DS was a C/S due to breech presentation, meconium and an OB on call that wasn't experienced enough in breech delivery to be willing to try it (even though I was willing to try). I had no other medical issues with that pregnancy and have had none with this pregnancy.  Baby is head down this time.

I'm just wondering how long past your due date you were allowed to go if you were trying for a VBAC? Any particular reason why? 

iris427

The hospital I'm delivering at has a 41 week deadline. My doctor said they try to avoid inducing VBACs but they will consider it for me because I've had a prior vaginal delivery.

cecilyandgautam

The practice that has the highest VBAC success rate in my region (90+%) has patients go to 42 weeks. They say that allowing labor to start on its own yields the best vaginal birth outcomes, so they just wait. 

CopperT0p

cecilyandgautam, I was hoping they would let me go to 42 weeks, because as you said I have read going into labour on your own will yield a better success rate. 

We are a smaller city with a level 1 L&D department, and the OR can take up to half an hour to get prep'd if it is the middle of the night.  I believe they are trying to minimize the risk of uterine rupture because of a large baby/long labour, but that is trading for a risk that can be created by medicated induction.

DS was born by emergency c-section at 40w 6d and was 8lb 3oz, so I doubt I will have a much larger baby this time even if I had to go later than 41 weeks.

Mama-Bear

My OB would let me go to 41w and wouldn't induce a VBAC so I ended up with a RCS at 41w2d (because OB had my EDD 2 days off - was an IVF pg so I was sure of my EDD).  Even at 41w I wasn't even 1 cm dilated, I'd made minimal progress from 37w even with sex, nipple stimulation with a breast pump, walking, walking, more walking, bouncing on an exercise ball.

SweetMelissa5

My OB was willing to let me go to almost 42 weeks but wouldn't induce for a VBAC, so I had a c-section scheduled for 41w6d in case I went that long; I went into labor on my own, and DD1 was born vaginally at 41w4d. For DD2, I switched OBs; they also refused to induce and had a 42 week limit. She was born on her due date (another VBAC), so it didn't matter anyway.

holly321

My hospital doesn't let anyone go past 41 weeks,vbac or not.

holly321

I was allowed to be induced, and was at 38 weeks for prom.

DaisyTortilla

My OB is allowing me to go up to 41 weeks. However, he will not induce but, I am comfortable with that. We already had in mind not waiting too far after, so this was perfect for us. But, I know lots of ladies have told me they are allowed to go up to 42 weeks and some even more. I think that is awesome, I wish I had what it takes to go that long.  

CopperT0p

I would be willing to go past 41 weeks and let this baby come on his own time (but preferably before 42 weeks).  

I'm mentally and physically preparing for all options. My ideal is to have a home birth VBAC, second best would be a hospital VBAC, and obviously if it comes down to needing another C/S, I will if it's in the best interest of babe or myself.  I'm lucky in that my midwives aren't being pushy about the C/S, they just wanted me aware that if he's late, it may come to that as our only safe option. 

fsumom

My OB (not sure about hospital rules) stated that 41 weeks was probably what he was most safe with but he will not induce!  Therefore, if I don't go into labor on my own by 41 weeks, I'll have a RCS.

Amores0121

My OB said 41 weeks. She said if I was having an RCS they would schedule me for 39 weeks (not sure why..) but since I want my VBAC they will let me go into labor on my own. She said if the cervix was "ripe" they would do a foley bulb.  I pray LO comes before 41 weeks and I get my VBAC, otherwise they may push for a RCS.

rowanthefrog

41 weeks. But no induction, if I hit 41 weeks then it was a C-section. My practice will not induce a VBAC.

A

megs68

With DD, my moderately friendly VBAC practice "let me" go to 42 weeks. I wasn't comfortable with any medicated induction and wasn't favorable enough for any non mediated induction so ended up with a RCS at 41 weeks 6 days. When I was looking for a doctor for that pregnancy, some required delivery by 39 weeks or a. RCS so I rejected those since I knew that wasn't likely for me. I am currently 30 weeks pregnant and this doctor is very VBAC friendly and said at 42 weeks we'd have to discuss options for my VBA2C. I also fibbed on conception date to buy myself 4 extra days although I don't think I needed to with him. I know there's no way I won't be late, my babies are all textbook pregnancies and just need extra time so I wouldn't be comfortable with being pushed for a delivery before 42 weeks if everything else was fine.

CopperT0p

Thanks for all the replies.  

It turns out I didn't go past due after all.  DS2 was born at 39+2.  I had the VBAC, but required a low dose of induction meds to get my contractions going since they weren't strong after 24 hours of labour.