Inductions for VBAC

Aloe0l

I just had my 12wk appointment today, and I asked about what induction methods they would consider if I go past my due date.  They told me they do not induce with VBAC patients at all.  I inquired about pitocin, as I've read that is typically safe for VBAC but the MW said ANY induction methods (and I didn't clarify if she specifically was talking medicinal inductions vs say, a foley catheter or membrane sweep, etc) increase the chance for uterine rupture.  I thought only something like cervadil was a big No-No, and didn't think pitocin was.

Anyone have any information?

JG362009

I don't have any articles or anything but my OB would induce with anything except cervadil/cytotec.  She'll do a membrane sweep, foley bulb, and pitocin induction.  She did say that inducing with an unfavorable cervix is less likely to be successful but didn't say it increased uterine rupture. 

akbride25

There are some places that will induce a VBAC patient, and some that won't. My hospital here is really small, and VBAC is pushing the limits of what they are allowed to do. They won't do any sort of induction because of the extra risk, but I could go to a larger city several hours away if I needed to be induced.

ldbryan

My OB has talked to me about doing a "light induction" using Pitocin.  She said they just use a smaller amount than those that aren't VBACing.  From what I've read, it seems to be fairly new (in the past few years) that OBs started chemically inducing VBACs.

Squirrel29

My doctor won't routinely induce for VBAC's, but he doesn't routinely induce for anyone and is very comfortable with being post dates.  From what I have read, and from my discussions with him, low doses of pit are considered safest after you have already started labor on your own and have dilated to around 5.  I have heard of lots of docs using foley bulbs and membrane sweeping prior to that level of dilation but I do think that chemical prostaloglandis (SP?) are generally considered to be dangerous.

bobbs420

My practice starts doing "gentle" inductions after 41 weeks for VBAC patients. Laminaria, foley bulb, low doses of pit if necessary, etc. I know Cervidil and other chemical cervical-ripening agents are considered a no-go for potential VBAC patients though.

MAprincess

I was induced with pit for my VBAC.  In theory, there might be a very, VERY slight increase in the rupture rate for it, but not enough to even register in a scientific study, so your doctor is misinformed or lying.  It is Cervadil that has the increase rupture rate (even in those who did not have a previous c/s).  For me, the induction question is a great way to see how VBAC friendly a doctor is.  To say they'll let you go on your own before 39 weeks or you get a c/s, is not VBAC friendly (this is what the first "VBAC friendly" doctor I interviewed said).

cchill01

bobbs420:

My practice starts doing "gentle" inductions after 41 weeks for VBAC patients. Laminaria, foley bulb, low doses of pit if necessary, etc. I know Cervidil and other chemical cervical-ripening agents are considered a no-go for potential VBAC patients though.

This for me too.  We just discussed my potential induction today.  Since I went over 42 weeks with no progress with DD, she's thinking there's a chance I may need some help with #2.

She'll sweep my membranes - if there's room to get in there.  She'll have me drink castor oil.  She's supportive of accupuncture.  So, there are definitely some options for me before I get to the point of pitocin.  

Aloe0l

bobbs420:

My practice starts doing "gentle" inductions after 41 weeks for VBAC patients. Laminaria, foley bulb, low doses of pit if necessary, etc. I know Cervidil and other chemical cervical-ripening agents are considered a no-go for potential VBAC patients though.

That is awesome you can go PAST 41 weeks!  Already today the MW I saw was saying that they'll talk c-section a few DAYS after my due date.  I asked about going up to 41 weeks and she was just like, "Well, if that's what you are comfortable with, you can do that...but we'd still schedule you for a section at 41 weeks" - so...I'm not sure how I'm feeling about this particular midwife.

Also, she said they'd only give me 12 hours if my water broke and I wasn't in labor, and it sounds like they wouldn't even use pitocin in that case.

I've had other women refer to this MW in particular as a "med-wife" and so I'm not sure what my thoughts are with sticking with this practice for my VBAC.  Then again, she's one person in an office of 3 OBs and 3 MWs....so I might see how my next visit goes, where I'm seeing a different MW.

Amitchell0626

I don't have any info either but my hospital also wont use any kind of induction meds.

RunSchwartzRun

I don't have any scientific info, but I had my VBAC at a very well respected university hospital and they gave me pitocin.  My water broke at 2am and I had virtually no contractions by 7am, so pitocin it was.  I had no issues, but of course that doesn't mean it is 100% safe.

vanillacourage

I was induced as a VBAC hopeful - they broke my water, started pitocin, and I dilated enough on my own that I didn't need the foley bulb. 

ZooCrewMom

MY OB said basically the same thing. The only thing standing in my way if I want to VBAC is being induced. Since I went into labor at 41 1/2 weeks with LO #1 I wasn't concerned.

 

 

bobbs420

Aloe0l:

bobbs420:

My practice starts doing "gentle" inductions after 41 weeks for VBAC patients. Laminaria, foley bulb, low doses of pit if necessary, etc. I know Cervidil and other chemical cervical-ripening agents are considered a no-go for potential VBAC patients though.

That is awesome you can go PAST 41 weeks!  Already today the MW I saw was saying that they'll talk c-section a few DAYS after my due date.  I asked about going up to 41 weeks and she was just like, "Well, if that's what you are comfortable with, you can do that...but we'd still schedule you for a section at 41 weeks" - so...I'm not sure how I'm feeling about this particular midwife.

Also, she said they'd only give me 12 hours if my water broke and I wasn't in labor, and it sounds like they wouldn't even use pitocin in that case.

I've had other women refer to this MW in particular as a "med-wife" and so I'm not sure what my thoughts are with sticking with this practice for my VBAC.  Then again, she's one person in an office of 3 OBs and 3 MWs....so I might see how my next visit goes, where I'm seeing a different MW.

Yeah, I am happy they will let me go until 41! I'm just hoping I go on my own before I have to be induced. My due date changed, so I am only 40 weeks, 2 days now instead of 40 weeks 5 days. I'm grateful for the extra time that I didn't think that I had! I am only 1 cm and 20% effaced though, and my midwife said yesterday that she wouldn't be able to get the laminaria in my cervix the way it is now. She said the next option would be low dose pit. Pit was hell on earth with my first, so I am praying that I go before my induction date! I would get the other doc's and midwives opinions in the practice. I hope they will consider a gentle induction for you instead of scheduling a section.

Luvmy2sons

With my DS2 I had my labor augmented with a low dose of Pit because I stalled.

This time I was going in for a full induction (AROM then Pit), but my m/w swept my membranes before and threw me into full blown labor. She did rupture my membranes when I got into the hospital still though (which made my labor go super duper fast).