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Old 08-26-2011, 07:56 PM   #1
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VBAC and pitocin

Thought maybe there was another post on this but could not find it so sorry if this is a repeat!
I was wondering if anyone had experiences with this. I was amazed to hear my ob talk about using pitocin at my visit today when I asked about more natural ways to get my body moving. She said she would not use cervidal or any Cervex ripening drug as that significantly increases risks with a VBAC (2-5%) but pitocin only increase risks from .5 to .77%. Still less that 1% seems pretty good in my book... Especially when the alternative is RCS, I did some research and these stats seem to be accurate. I would love to hear stories of other VBAC moms who did use pitocin.

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Old 08-26-2011, 08:08 PM   #2
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Re: VBAC and pitocin

With my second baby, I had cervidil, prostaglandin gel, and pitocin, and had a successful vbac. This was back in 2001 when cervical ripeners were still used for vbacs and they were popular. We had a successful vbac with pitocin today in my unit. There is risk, but there is risk with contractions of any kind.
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Old 08-26-2011, 08:13 PM   #3
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Re: VBAC and pitocin

I think that pitocin can be used if the cervix is already somewhat ready...but not so much for direct induction. A cervix that isn't soft can't dilate, even with pitocin-induced contractions. I'm thinking that those stats must be for using pitocin in a VBAC as augmentation (after labor has begun), not induction.
I might be wrong about that, but that's just my understanding. Is there a reason that you think you'll need to be induced? That might be in another thread..
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Old 08-26-2011, 08:31 PM   #4
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My first son had shoulder dystocia when I was induced at 40 wks due to high blood pressure. He was 8 lbs 14 oz. My ob would like to see this babe be about 8.5 lbs so that there is not the risk of dystocia again. I have a history of having large kids with my last being 9 lbs 3 oz. So the sooner I go into labor the better as far as sizing goes. I brought it up, just because I have never gone into labor on my own and my own paranoia that it will not occur when we need it to ( ie before this babe gets too big or 40 wks)
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Old 08-26-2011, 08:32 PM   #5
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Re: VBAC and pitocin

I researched a lot for my vbac and it appeared to me that the ruptures talked about online all happened with pitocin. I read you want to have natural contractions and that pitocin makes them harder which is a risk. My ob said he would not use pitocin on a vbac for that reason. I read that it's safer as well to allow yourself to feel and not be so heavily anesthetized during labor. You will be able to feel a rupture which is a sharp knifelike pain and can warn the nurses right away. IMO, do more research on your own, join an ICAN chapter in your area, read Ina May books! Vbacs have a high success rate but there are things you can do to make that success rate even higher which are worth it in my opinion when dealing with this.
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Old 08-26-2011, 08:52 PM   #6
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Re: VBAC and pitocin

Quote:
Originally Posted by songbird516 View Post
I think that pitocin can be used if the cervix is already somewhat ready...but not so much for direct induction. A cervix that isn't soft can't dilate, even with pitocin-induced contractions. I'm thinking that those stats must be for using pitocin in a VBAC as augmentation (after labor has begun), not induction.
I might be wrong about that, but that's just my understanding. Is there a reason that you think you'll need to be induced? That might be in another thread..
Quote:
Originally Posted by Designsbybequi View Post
I researched a lot for my vbac and it appeared to me that the ruptures talked about online all happened with pitocin. I read you want to have natural contractions and that pitocin makes them harder which is a risk. My ob said he would not use pitocin on a vbac for that reason. I read that it's safer as well to allow yourself to feel and not be so heavily anesthetized during labor. You will be able to feel a rupture which is a sharp knifelike pain and can warn the nurses right away. IMO, do more research on your own, join an ICAN chapter in your area, read Ina May books! Vbacs have a high success rate but there are things you can do to make that success rate even higher which are worth it in my opinion when dealing with this.
These together about sum up what my OB told me, and what my longtime friend went through kind of backs it up. My first baby was an induc at 42+5 (I still wasn't dilating at all for an unknown reason). After 3 days of labor, he came forehead first (with a 15.5" cranium) and got stuck. Hello, c-section! Because of his head size and my propensity to not start dilating on my own, my OB strongly advised against a V-bac (I wasn't dilated at all full-term again with #2). And frankly, after 68 hours on pit the first time, I really wasn't arguing.

My friend had a similar experience, except her first was induced at 41 weeks, she was on pitocin for about 48 hours, and then she had a c-section. She was induced again at 41 weeks with her second, but because of the increased risk of pitocin-driven contractions, she was only given a 24-hour window to deliver. When she only got to 4cm in that time frame, she was given a c-section. In her case the pit stressed her uterus enough that she ended up with a hemorrhage post-op.

I'm not sharing these to discourage you, just to give a view of the broad scope of attitudes and outcomes regarding pitocin and v-bac's.
Chances are, if your cervix is already ripening on it's own, then your doc will have a "window" for you to deliver on pit. I honestly don't know if they'd give you an unripened induc when the time comes.
Anyways,
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Old 08-26-2011, 09:23 PM   #7
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Re: VBAC and pitocin

I had pitocin for my VBA2C attempt. They monitored me very closely and didn't give me very much.

The thing is, I was only in labor with the pit, not really on my own...and they could only give me so much. So when I stalled out dilating, they had really nothing to do for me and after a certain period of time (I was now on their clock), I wound up with another c/s.

Your chances of a successful VBAC are much higher if done WITHOUT the assistance of drugs....so I would try that if at all possible.
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Old 08-27-2011, 08:09 AM   #8
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Re: VBAC and pitocin

I've had two pitocin VBACs. The first was a true induction and the OB on call was trying to get my uterus to rupture (my baby had already passed away) as she believed it was my fault for my babies death (wanted a homebirth so I didn't go to a hospital for care). My uterus handled it just fine. With my second VBAC it was an augmentation and it was so very gentle. They never put it up past the lowest dose possible and to be honest my body didn't really need it to be upped. If your doctor is going to induce you with pit. you need to know how. It should be kept very low and if an increase is needed it should be a very small increase at a larger interval of time(at least an hour) to allow your body to adjust gently. You can even ask them to turn it off once a good labor pattern has been established to see if you body will just take over on it's own. If you do it this way your risk of uterine rupture should be very low. In all honesty this is how ALL inductions should be done but that is a whole different discussion! LOL When your LO got stuck, how were you pushing? My son also got stuck, but I was pushing laying on my back which is a really bad position as it closes the pelvis. For my next VBAC I am refusing to push on my back for any reason. I also highly suggest seeing a chiropractor as any misalignment in your pelvis can cause a problem.
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Old 08-27-2011, 09:15 AM   #9
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Re: VBAC and pitocin

Were you on your back when the shoulder dystocia happened? Pushing on hands and knees or your side can lessen the chances of that happening again. Also, laboring in positions that feel best to you are will help the baby to be in a good position.
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Old 08-27-2011, 03:53 PM   #10
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Re: VBAC and pitocin

Yes, using pitocin can and does affect the rate of rupture. However, a low dose pitocin induction is still an option when faced with either an induction or RCS.

I had a pitocin induction with my VBAC and it went absolutely wonderful.


My VBAC story http://lifeextraordinarily.blogspot....ler-81910.html
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