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Old 01-28-2011, 07:52 AM   #1
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VBAC=Induction? WWYD?--Update 2-9

So, I have made it known at my practice that I see that I really want a VBAC. I asked at my last appointment what I should be doing to make that a most-likely scenario, and the CNMW I saw (not my usual one) told me that I was doing all the right things just by taking care of myself and the baby. I then asked if there was anything else I should know about their VBAC policies, and the MW told me that they were fairly standard...that I would need to talk to the OB at the practice sometime, just to go over C/S stuff in case, and they would PICK A DATE FOR MY INDUCTION, start me with pitocin, and we'd go from there. And that, at any time, I was welcome to change my mind and go for repeat c-section.

I was really surprised and asked the MW why I would need to be induced, and she stated that in a VBAC situation, it was necessary that they be "as in control as possible of the situation" because of all the risks. I was kind of shocked, and wasn't really sure what I thought of the situation.

Now that I've had a bit to think about it, it makes no sense to me that they want to induce me. The pitocin contrax, I think, would be much worse on my scar than if I was allowed to go into labor on my own. My first c-section was after a failed induction (DD failed both a nonstress test and a biophysical profile, and wasn't doing well, and then ended up being transverse when I was induced 24 hours later...found that out after 20 hours of unmedicated pitocin and cytotec labor).

I really want to go into labor on my own and deliver on the baby's schedule. However, I'm just thankful I'm being cleared to VBAC at all. This is the only hospital that does it in the area. I also really like my CNMW. I would LOVE to try a HBAC, but I live in Illinois and it is illegal for midwives to deliver at home here. UC isn't an option, either...the idea terrifies DH who thought he was going to lose me during my last delivery.

So, I am going to talk to my MW during my next appointment in two weeks. I am going to tell her very firmly that it is my wish to not be induced as long as the baby is happy and healthy. However, I just don't know if my wishes are going to override hospital/practice policy. So, my question is...WWYD?

-------------------------------------------------------
UPDATE:
I had my appointment on Monday with my usual CNM. I told her what the previous appointment had yielded and let her know that I didn't understand the practice and that I didn't want to have an induction if it wasn't medically necessary. She told me that the reason for the practice is because they want to make sure to have all the necessary staff, etc. there for their VBAC mamas because it is a very small hospital. However, I am more than welcome to forgo the induction if it's not what I want and wait. She told me she had actually just delivered a VBAC last week at 42 weeks with no interventions, and while a 2-day delivery was a long one on both of them, they did great and she was glad the mama had the delivery she wanted.

That made me feel so much better! So now, just a waiting game, I guess.
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Last edited by alwaysfallingup; 02-09-2011 at 08:39 AM. Reason: Added Update
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Old 01-28-2011, 08:03 AM   #2
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Re: VBAC=Induction? WWYD?

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Originally Posted by alwaysfallingup View Post
So, I have made it known at my practice that I see that I really want a VBAC. I asked at my last appointment what I should be doing to make that a most-likely scenario, and the CNMW I saw (not my usual one) told me that I was doing all the right things just by taking care of myself and the baby. I then asked if there was anything else I should know about their VBAC policies, and the MW told me that they were fairly standard...that I would need to talk to the OB at the practice sometime, just to go over C/S stuff in case, and they would PICK A DATE FOR MY INDUCTION, start me with pitocin, and we'd go from there. And that, at any time, I was welcome to change my mind and go for repeat c-section.

I was really surprised and asked the MW why I would need to be induced, and she stated that in a VBAC situation, it was necessary that they be "as in control as possible of the situation" because of all the risks. I was kind of shocked, and wasn't really sure what I thought of the situation.

Now that I've had a bit to think about it, it makes no sense to me that they want to induce me. The pitocin contrax, I think, would be much worse on my scar than if I was allowed to go into labor on my own. My first c-section was after a failed induction (DD failed both a nonstress test and a biophysical profile, and wasn't doing well, and then ended up being transverse when I was induced 24 hours later...found that out after 20 hours of unmedicated pitocin and cytotec labor).

I really want to go into labor on my own and deliver on the baby's schedule. However, I'm just thankful I'm being cleared to VBAC at all. This is the only hospital that does it in the area. I also really like my CNMW. I would LOVE to try a HBAC, but I live in Illinois and it is illegal for midwives to deliver at home here. UC isn't an option, either...the idea terrifies DH who thought he was going to lose me during my last delivery.

So, I am going to talk to my MW during my next appointment in two weeks. I am going to tell her very firmly that it is my wish to not be induced as long as the baby is happy and healthy. However, I just don't know if my wishes are going to override hospital/practice policy. So, my question is...WWYD?
I would wholly agree.

Your wishes will ALWAYS override hospital policy - the Drs or MWs may say otherwise, but at the end of the day it is YOUR decision. They can't force an induction on you & if you go into labour naturally & go in after refusing an induction, they can't exactly send you away.

If you are not happy with it, refuse it and stick to your guns because it is YOUR body, YOUR baby and therefore YOUR choice.

Good luck Mama!
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Old 01-28-2011, 08:06 AM   #3
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Re: VBAC=Induction? WWYD?

DO NOT let them induce you!!! Pitocin is NOT recommended during a VBAC, because of the exact reason you stated! Most of the uterine rupture stories that I've read about, the women were given pitocin. When I VBACed my OB said they could give me a very low dose of it, but i know at the hospital my best friend works at (she's an OB nurse) they arent allowed to give any at all to anyone vbacing. I didnt feel comfortable and with any pit. (and thankfully didnt need it) BUT told my OB that if it came to that I would opt for a repeat c-section, rather than risk it with pit. I would reccommend drinking red raspberry leaf tea, as it is suppossed to tone the uterus and make your contractions more efficient Let your self go into labor naturally, and maybe stay away from the hospital until the last minute!
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Old 01-28-2011, 08:32 AM   #4
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Re: VBAC=Induction? WWYD?

Don't let them do an induction!!
If anything, do 'natural methods', ie, have your membranes stripped.
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Old 01-28-2011, 08:44 AM   #5
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I definitely would decline an induction! That's a repeat section just waiting to happen.

On the flipside, pit is NOT contraindicated in a VBAC. I had a low dose of pit with my VBAC to augment labor. I have also given low doses to patients VBACing throughout my career. But like anything there is a time and a place!
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Old 01-28-2011, 10:07 AM   #6
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Re: VBAC=Induction? WWYD?

I would stay home as long as I can and go to the hospital ready to push. I would come armed with information about VBACs so they cannot scare you into another c-section. I would educate myself about techniques to deal with pain and personally I would hire a doula to help me labor at home for as long as possible. I would go to http://ican-online.org/ and find my local I-Can meeting and get support from people who have BTDT in your area. If you cannot attend the meeting call the Chapter Leader and get help/info that way.

There are natural ways to try to induce and some work and some don't, but they are worth a try when the time is right.

Good luck mama.
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Old 01-28-2011, 10:30 AM   #7
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Re: VBAC=Induction? WWYD?

I had 2 successful VBACs....one in 2008 and one in 2010. I was actually in labor with my first VBAC and dilating on my own and didn't know it til I got to the hospital for my induction. They skipped the Cervadil and let me rest overnight. I was sort of stalled @ 4cm so I was given a low dose of Pitocin. The same thing happened with my second VBAC, except I never had an induction date. My doctor wanted to see if I would go into labor on my own and wouldn't think of scheduling the induction til I was 39 weeks. I went into labor on my own in my 37th week, but I stalled again and did the low dose of Pitocin. I know that its not recommended to do Pitocin after a c-section but I was honestly praising God that I made it through 2 of them successfully. I had ZERO complications. I would definitely tell them that you'd rather see if your body will do this on its own, speak your mind and try to be in control of the situation.
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Old 01-28-2011, 12:08 PM   #8
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Re: VBAC=Induction? WWYD?

you have the right to refuse anything. induction included- its the law. Go with your gut, you know what you want!
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Old 01-28-2011, 12:44 PM   #9
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Re: VBAC=Induction? WWYD?

I know at the hospital I had my first VBA2C at they told me under no circumstances would they induce me. They were a bit nervous because I had delivered 2 kids and never had been in labor or dialated...(I had 2 emergency csections at 34 weeks) and so they said that they were not sure my body would know what to do...umm..okay...

But the hospital that is literally less than a mile away, will do inductions as they see fit on VBAC patients...

But personally, and everyone has to make their own decisions, I would do everything I could to avoid an induction. They do not need to be in control of every aspect of your delivery. Make it clear that you will not be doing the induction, if you are not, and that you have done some research (and do it, show them what you have found from places like ICAN) and you have found that the likelyhood of having an induction and a successful VBAC is a lot less of a reality than ending up with a section. Be educated, and be your baby's and your own advocate. Your birth experiance and babe's health depends on it!
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Old 01-28-2011, 01:22 PM   #10
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Re: VBAC=Induction? WWYD?

I absolutely would not be induced. You dictate your care and NO ONE else. Also midwives do deliver at home in IL, legality aside. It isn't illegal for you to have a HB in any of the 50 states.
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