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induction questions

Lisa and MickeyLisa and Mickey
in VBAC

Hi everyone! I am part of the google VBAC group and am so happy to see this board! My DS is almost 10 months, and while we aren't ready to TTC yet, I want to have a game plan in mind for when we do get pregnant again.

With DS, I was induced at 42 weeks exactly according to sonogram dating. By my count, based on charting, 41 weeks and 4 days. They asked to induce me sooner, but when I explained that it was impossible for my EDD to be that early, they did let me hold out til "42". I fought hard because I knew, in the back of my mind, if I was induced it would end in a c/s. I was right. About 36 hours after my induction started, I was still at 3 cm and had not changed in about 12 hours.

I have read several times on this board people say if you were induced, the baby wasn't ready, which I agree with. Was there an alternative to induction as late in the game as I got? I was under the impression that 42 weeks was pretty much it. 

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Re: induction questions

  • ryemoryemo member
    I don't think induction is an option with a VBAC because of the increased risk of uterine rupture. I think that you need to know up front how far a provider will let you go overdue and what your options are for negotiating that (if the baby looks good on a stress test and fluid is good, for example, you get to keep waiting). Finding a midwife or provider who is supportive of VBAC and willing to work with an overdue mom would help.
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  • papagenapapagena member

    41 1/2 - 42 is the longest I've really heard of doctors being comfortable waiting, generally, but if you were dealing with somewhere like The Farm, they might encourage you to go longer, and perhaps you could find someone who would be willing to do that with pretty regular testing. I would say you'll be hard pressed to do that, though, especially in a VBAC situation.

    There are some induction options, though.  It varies with what the doctor is willing to do (my OB wouldn't talk induction for a VBAC) but my FP doctor is open to using pitocin, which increases risks slightly but not too much, and I have brought up the possibility of inducing with Foley Catheter Bulb to avoid chemical induction all together. 

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  • DonnaMartinGraduatesDonnaMartinGraduates member

    I personally have never heard of anyone going past 42 weeks. Most of the people I know who were overdue were not allowed to go past 41 weeks at the very latest. I talked to my doctor today and she said I cannot be induced, I have to show that I am in labor to attempt a VBAC, but that they will give me pitocin if needed. No cervical ripening drugs are allowed.

    I am not a firm believer that your body will do what it's supposed to, when it's supposed to. Actually, I think sometimes your body has no clue what to do :) 

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  • cchill01cchill01 member

    Hey.  You and I had the same labor.  After 60 hours of induction and 3 hours of pushing, I finally ended up with a C/S.  I did dilate, but I was never really having my own contractions.  The second they turned the pitocin off, they stopped.  The would not let me go any further than 42 weeks.  Although, I agree with you that DD just wasn't ready.  I wonder what would have happened if we refused induction.  My problem was that I was scared because you just don't know what's going on in there.

    I will be trying for a VBAC, but like you, I don't know how I'm going to convince my next LO to come sooner.  Most providers seem to only let you go to 41 weeks if you've had a c/s prior.  And they won't help you with an induction - not that it was any help last time. 

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  • iris427iris427 member

    Most providers are not comfortable with you going past 42 weeks, so your only other option was probably refusing the induction and creating a conflict with your doctor.  I know that occasionally, a provider will be OK with someone going past 42 if they agree to very careful monitoring and induction or cesarean if anything starts to look off.  My OB told me I can go past 42 but I'm praying that won't even be an issue.

    There is a poster on NB who went past 43 I think.  She had a homebirth with midwives and they monitored her and she went into labor on her own after 43 weeks and had a healthy baby at home.  

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  • iris427iris427 member

    imageryemo:
    I don't think induction is an option with a VBAC because of the increased risk of uterine rupture. I think that you need to know up front how far a provider will let you go overdue and what your options are for negotiating that (if the baby looks good on a stress test and fluid is good, for example, you get to keep waiting). Finding a midwife or provider who is supportive of VBAC and willing to work with an overdue mom would help.

    There are some induction options with VBAC, but not all providers will do one.  You can try manual induction techniques like using a foley bulb.  Pit does increase the risk of UR but it is still only between 1-2% and there are some studies suggesting the Pit can safely be used to induce VBACs. 

    But again, it can be hard to find a hospital or doctor that will agree to induce a VBAC, despite studies showing it can be done. 

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