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VBAC induction UPDATED with birth story!!!


Forum: VBAC: Vaginal Birth After a Caesarean

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  #1  
July 16th, 2011, 09:11 PM
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Location: Ottumwa, Iowa
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Hi all,

I am having a VBAC (God willing) but my Dr. says he is very uncomfortable letting me go past 41 weeks. I am now 40w1d and am not dilated at all, but baby is -3 station.

Next Friday I have to have an ultrasound and nst test to determine if everything is okay. Because my husband is a DJ and has to work, we talked him into letting me at least wait to get induced until July 24th and he said he would not used Cervidil or Cytotec but just a very small dose of pitocin. It still scares me and I am not 100% sure I am comfortable with it.

Anybody manage a VBAC under induction at around 41 weeks? I am kind of scared my body is broken since I am not dilating. (I never labored with my DS due to a previa.)


~*~*~*~UPDATE~*~*~*~
I DID IT!! WOOT WOOT!!


On July 22nd my Dr. made the decision to induce me for postdates. He wanted to induce me that night after an ultrasound showed that I was on the lower side of amniotic fluid but my DH had a gig and I really wanted him to be able to be there for the whole labor/delivery, so he agreed to wait until Sunday night. At that appointment I was still closed.

On July 24th, we drove to the hospital to begin a pitocin induction. After we got there I was checked and I was fingertip-1 cm dilated. (yay!) through the night they begin upping the pitocin in small increments. I was handling the contractions very well and so was baby. <3

We were checked again the next morning at 730 and I was only 1 cm dilated. I began to cry because I knew since I was VBACing that I had to make progress or they would have to perform a c-section and I didn't want that at all. The nurses and Dr. were very happy with the progress I made because the baby had moved down more. (I didn't want to hear that because I was so focused on still being only 1 cm dilated.)

Around 1030, they came in and checked me again and I was only dilated to a 2. Again they were very happy because my cervix was shortening and baby had come down more, but I was so stuck on the number I cried for an hour. My DH and I walked for about an hour until I just couldn't handle the contractions anymore, I asked to get into the tub knowing that it would probably slow my labor down but needing a break.

At 230 the pressure was so intense that I just knew that I wouldn't be able to withstand labor any longer. I asked to be checked. I was at 4 cm and had bulging waterbag. She asked if she could break my water, but told me that things would only get more intense after she did so that she would wait until after I got my epi. I really didn't want the epidural though and my husband reminded me how badly I wanted this natural childbirth so I told her to go ahead and do it. Sweet relief!! After she broke my water the pressure lessened (Thank God!!) and the contractions became bearable again.

At this point we tried getting on the birthing ball. The baby was facing the wrong way so I began to start feeling my contractions in the back as well. I got on the bed in hands and knees position and tried to get baby to turn. No such luck. I asked to get back into the tub and stayed in there for hours.

(I don't really know the times anymore since there was no clock in the bathroom so I'm just gonna guesstimate)

Around 5 p.m. I thought I was ready to push and called and asked to be checked. I was only dilated to 5 cm. I was so upset because the pain was unbearable. How do women do this naturally I asked myself? LOL. I finally broke down and asked for some Nubain for the pain. I ended up falling asleep in the tub for the next 1 hour 45 minutes. I don't think I would have been able to make it through without the power nap, but I felt like such a failure for taking the medicine. I had been hellbent on doing it as naturally as possible and I just couldn't do it.

I woke up and begged for more Nubain around 650p.m. They told me that I had to wait until 715. I cried. My body was pushing but when they checked me I was only 7 cm. My nurse told me to try hands and knees through a couple contractions but I couldn't. I kept telling them "I'm pushing" and they kept telling me to breathe through the contractions and not to push because I would make my cervix swell up. They checked me again and I was at 8.5. My DH had just left to go outside and smoke before delivery. Luckily, my dad had texted him that it was happening now and he had to get back up there.

I guess while I was in the tub there was 4-5 nurses preparing the room for delivery. I had 5 people help me out of the tub, and it took 15 minutes. The contractions were right on top of each other and I didn't want to walk. I was freezing because I had been in the tub for 3ish hours so they were also trying to dry me off.

I made it to the bed and laid down. 9 cm...1 contraction later 9.5 cm with an anterior lip. The Dr. tried to push the anterior lip back while I had another contraction. (She is a very brave Dr. because that hurt like h-e-double hockey sticks!! ) I was ready to push. I made them give me another shot of Nubain, which I deeply regret, but I wasn't having them talk me out of it.

I started pushing. My first was a "pathetic attempt" according to my husband. And my body didn't want to wait for contractions anymore, it just wanted to push this baby out. The nurse got me calmed down and I grabbed my legs and pushed 3 times through the next contraction. I had a hundred people screaming "push, push, push, more, more, more" at me and I gave it everything I had. My nose spontaneously started runny (which my husband told me was a bloody nose) and I just picked up the baby blanket and wiped my nose. The next contraction came and I pushed 3 times and baby was out.

They told me husband to tell me what the baby was and he said, "I see a leg." DOH!! Then he told me we had a little girl and they put her up on my chest. I can only remember saying that she was so small. The nurses assured me she was normal sized and that she was perfect. Because of the medicine that I had taken right before delivery she was very whiny and fussy. After they told me it was from the Nubain I was very upset. My poor sweet baby was upset and it was over something I had taken for myself. I felt so selfish.

But anyway, here are the stats:
Born at 7:53 p.m.
Weight: 7lbs 9.8oz
Height: 20" (which at her pedi appointment at 4 days she was 19 3/4" but I know it's not an exact science so whatever.)

I was so surprised she was so tiny because my son was a 37 weeker and he weighed 7lbs 4.5oz. I had totally expected and 8 or 9 pound baby. I am so happy that I got my VBAC and even with the 2nd degree tear this recovery had been much easier and better. I love that I can pick up my almost 2 year old and get down and play.
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Last edited by FallenFromHeaven; August 1st, 2011 at 10:48 AM.
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  #2  
July 17th, 2011, 04:34 AM
quietsong's Avatar Just Another Slacker Mom
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I've not had a VBAC yet and don't know a whole lot about induction, however, it's certainly not a given that you'll need the induction! I had zero progress at 40w1d with my first son - no dilating, no effacing, baby was hardly dropped at all. That was a Thursday. I started having contracts Friday evening, and Eric was born Monday.

I hope things go well for you, and that that beautiful baby of yours is in your arms soon!
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  #3  
July 17th, 2011, 05:05 PM
NutMeg76's Avatar Platinum Supermommy
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I would put off th induction until 42 weeks. You are not 'overdue' until AFTER you reach 42 weeks. Then ask them to do a Bishop's score and only induce if it is high enough, and do not allow them to use proglastinids to 'ripen' the cervix. The use of hte foley bulb is safe though as long as they are careful not to rupture your membranes.

A VERY gentle pitocin induction is not seriously dangerous. There was a recent study in Australia that showed a pit induction still had a rupture rate of less than 1%. Pit augmentation, which MANY more doctors are willing to do had a UR rate of about 2.5%. The theory on that is doctors are more careful about the amount of pit they use for induction, whereas they are more aggressive with augmentation.

I would opt for a gentle induction before agreeing to an elective c-section. Also, if they do induce ask them to turn off the pit once a good labor pattern is established and use nipple stim to keep things progressing if needed.
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  #4  
July 17th, 2011, 07:44 PM
Gray_baby's Avatar Platinum Supermommy
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I had my VBAC at 39w 6d and had a small dose of pitocin. I wasn't induced but went into labor naturally and then had the pitocin a few hours before I delivered.
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  #5  
July 17th, 2011, 09:21 PM
Sk8ermaiden's Avatar Platinum Supermommy
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As far as labor goes, you are a first time mom. It is 100% natural for FTMs not to dilate until labor starts. I was not dilated at all until an hour after labor started (at 42 weeks) but dilated very, very quickly after that. Dilation before labor means nothing. ABSOLUTELY NOTHING. Some women walk around at 4 centimeters for a month, and some are totally closed and go from 1-10 in an hour. We are all different.

That said, I would agree that it is ideal to be able to wait until 42 weeks. It isn't until after 42 weeks that risks increase, however, if that will make your otherwise friendly OB turn worried or hostile, then sometimes it just isn't worth the fight. Because willingness to let a VBAC go to 42 weeks is an absolute sticking point for me (with a 42 weeker with baby 1), I am realizing quickly how weird OBs are about VBAC and postdates.

So generally, all the warnings about VBAC and induction came about because of a time when VBACs were so commonplace and were generally treated just like non-VBACs, complete with tons of inductions and augmentations. Cytotec was regularly used. Dosages weren't really paid attention to.

Now, the precious few OBs who are willing to induce a VBAC are very, very careful about how it is done. Your OB has chosen the safest method of induction for VBAC.

My thought process is this. The risk of uterine rupture is really, really low. Like .2%. So let's pretend that induction is super risky and doubles your chance of rupture (which it doesn't). That would still be less than half a percent. Unless your placenta is right over your scar, a uterine rupture in a hospital environment is almost always going to turn out fine. It is when the placenta is over the scar and so a rupture causes an abruption that things can get scary. So I guess that's where the risk analysis is. To ME, unless my placenta was over my scar, I would definitely take the induction. If it WAS over the scar, I probably wouldn't. To me, I would take a monitored induction in a hospital setting over a scheduled cesarean (so a guaranteed uterine rupture ) any day of the week.

But of course, the best, best thing you could do is try to get as close to 42 weeks as you can before inducing. Not only are you more likely to go into labor on your own by then, but you are also much more likely to have a successful induction if necessary.

I do know many mamas who have had successful induced VBACs - it can be done!
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  #6  
July 18th, 2011, 12:21 PM
Gray_baby's Avatar Platinum Supermommy
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I totally agree about dilation before labor meaning nothing. At my last prenatal appt I was not dilated AT ALL but I went into labor 3 days later and when I got to the hospital that night I was 3cm and 90% effaced. So it can happen fast. I get so annoyed by docs who push women into RCS because they aren't dilating yet.
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  #7  
July 22nd, 2011, 06:54 AM
Mega Super Mommy
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Thanks ladies.

I made it to 41 weeks!! I will be having a Dr. appointment today complete with all the tests. Because my Dr. has been so fabulous about willing to allow me to VBAC I am gonna take the induction on Sunday.

I am still alittle nervous but I think all will be okay. Please pray that my tests come back normal so I do not have to be induced today and my DH can be there for the birth and delivery of our second child.
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  #8  
July 25th, 2011, 07:57 AM
*Candi*'s Avatar Candi
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any updates????
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  #9  
July 27th, 2011, 07:09 AM
HONEYBUNNY61's Avatar Mega Super Mommy
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I'm curious too!
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  #10  
August 1st, 2011, 10:50 AM
Mega Super Mommy
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for update!!
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  #11  
August 1st, 2011, 08:29 PM
queenofthecastle's Avatar Platinum Supermommy
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Congrats on your VBAC!!!! I loved reading your birth story!!
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  #12  
August 1st, 2011, 11:13 PM
NutMeg76's Avatar Platinum Supermommy
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Congrats on your great VBAC!
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  #13  
August 5th, 2011, 01:08 PM
blondie-lox's Avatar Do NOT feed the Troll
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Congratulations! What a great birth story!
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  #14  
August 9th, 2011, 10:23 AM
*Candi*'s Avatar Candi
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Congrats! so happy you were successful!
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