VBAC
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VBAC question....
Hi all!
So i'm very early pregnant with a singelton after having twins in 2010. They were c-section babies because I got pre-eclampsia. at 36 weeks, 5 days.
Yesterday my OB said I was a good candidate for a VBAC (Which I desperately want)...however...he used to be in a practice of only two doctors, and now he is in one with five...I REALLY want him to deliver me - but the only way to really ensure that is to schedule a c-section (please...no) or to schedule an induction.
But he said that with a VBAC you really dont want to use a lot of pitocin. Any idea why? Any of you successful VBAC ladies have a scheduled induction??
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Re: VBAC question....
The use of pitocin during a VBAC, while considered safe by many, does elevate the risk of UR slightly. It's a very minimal increase though, compared to the elevated risk with prostaglandins.
I had a pitocin induced VBAC and they set a couple of restrictions. They would only give me about 1/2 of the pitocin that they would give a non-VBAC. They also would only allow me to be on pitocin for about 10 hours. When they hooked me up at 9am, they said if you're not showing some decent progress by dinner time, the attending will probably call for a c-section.
Since you can't guarantee what doctor will be on call, can you make sure they are all on board with an induced VBAC? Try to meet each one during your regular visits Also, I would recommend getting a doula in case you don't get your doctor of choice.
Olivia and Matilda, 09/10/201 - Graham, 10/01/2013
I successfully vbaced by induction. My water broke and I didn't go into labor quick enough for the on call doctor. They put me on the lowest dose possible, for 6 hours, I was having decent, well timed contractions. But they checked me, and I had no progress. They were going to up my dose. The doctor was making me nervous, in the sense I felt I was about to get an unwanted rcs, so I got an epi to e safe ( my spinal didn't work with dd, so I had to put under). I dilated to 10 before they had a chance to up my dose. But thy were willing to up it, which is good.
My regular Ob has no issue with vbac induction, as long as you have some progress of your own.
I used the same provider as cchill. I was an induced VBAC at 41 weeks. I was put on pit at 8 am and didn't deliver until 2 am (so 18 hours total) and the pit was going the entire time- so I didn't get that 10 hour restriction. But they did limit the amount of pit to half, etc. It did the trip and DD was a successful VBAC!
Do the other 4 doctors in the practice not share the same views as your doctor on VBACs?
I'm not sure about the other four doctors...I haven't...and (yes I know this is wrong) don't want to. I LOVE LOVE LOVE my OB. I am very attached to him - I guess because he delivered my twins. I just cannot imagine anyone else delivering my baby - but I think I'm going to have to get over that.
ETA: I think part of the reason I'm so attached is that with multiples, I had at least monthly dr's visits, if not more often because they were high risk....so it wasn't like I only saw him once or twice. So I really got to know him as my doctor.
Olivia and Matilda, 09/10/201 - Graham, 10/01/2013
My VBAC was induced and I'm being induced again this Friday (delivering early due to pregnancy induced hypertension/start of pre-eclampsia). My doctor wouldn't commit to an induction unless I had made some progress on my own because they can't use cervadil, but I'm 3 cm now, so they can break my water and use a low dose of pitocin. I was warned that it does slightly increase the risk of uterine rupture to about 1%, but my doctor feels that the risks of surgery greatly outweigh the risks of using pitocin in a VBAC.
I understand having a preference for your doctor but I would be open minded and meet all the doctors in your practice before trying a scheduled induction for a VBAC unless there are medical indications that you should induce.
Good luck!
Yeah, the timing restriction on me might have had less to do with the pitocin and more to do with the climate in the hospital between the midwives and the OBs at that time.
Olivia and Matilda, 09/10/201 - Graham, 10/01/2013
i had a successful VBAC three weeks ago with an "augmented" labor with a low dose of pitocin. it can be done but few drs really feel comfortable with it because it seems to up the risk of rupture.
regardless, i had a successful VBAC and that should give you some confidence in helping you attempt your own