Why some doctors won’t induce for VBAC?

Question

Hi ladies, so my first pregnancy I had a c-section because my daughter was breech. During my c-section my doctor felt around my uterus and said there was no reason why she couldn’t turn head down, she just didn’t want to. My uterus and everything felt normal in shape. This time around my doctor said we can absolutely try for a VBAC. I’m 34 weeks and find out what position baby is in next week. So I’ve seen a lot on here that some doctors won’t let you have a VBAC if baby doesn’t come on time. Why won’t some induce? Can someone please explain this to me?

Answer

basically because medical interventions usually increases the risk of having a c section. also induction is usually stronger than the normal contractions, when it’s stronger it increases the risk of uterine rupture, i’m guessing some doctors don’t want to risk that if you’re trying for a vbac. they’re trying to increase your chances of a successful vbac and decrease the risk of uterine rupture.
if induction is necessary, my doc advised me to avoid chemical inductions like pitocin etc. try for a mechanical induction first like balloon induction before trying with other types of induction.

Answer

Pitcoin does have a slight increase in risk of uterine rupture, but that is in unscarred uteruses as well. Cervical ripeners are not approved for VBAC mom's due to increased risk of rupture. If a doctor will not induce for VBAC is seen as VBAC tolerant as opposed to VBAC friendly. Induction via low dose pitocin and cooks catheder is recommended over repeat C-section by the ACOG despite what most OBGYNs tell their patients.

Answer

Some Doctors will induce using a bulb to dilate the cervix and avoiding pitocin as much as possible because it slightly increases the risk of rupture. Most will not induce at all unless you are already progressing. I was offered induction at 41 weeks if I didn’t go on my own because I was at a 3 at 39 weeks. If I was a 0 they said they would not. 
Its a gray zone for what your Dr is comfortable with. The ACOG supports gentle induction for vbacs and also supports vbac moms to 41 weeks gestation before intervention. I had a successful vbac at 40 weeks and went on my own. My local ICAN chapter was very helpful and informative.

Answer

It depends on the doctor and the hospital. I have to deliver at 38w and my doctor is totally comfortable with an induced VBAC (my first was c-section due to breech as well). She will only do it if I'm 1+ centimeter dilated as she needs to be able to start the induction by breaking water and then will consider a small amount of pitocin if needed, but that's it.

Answer

While I don’t know the exact reason, I do know that induction significantly increases the likelihood of a csec. Contractions from an induction are also typically described as much more painful with induction. Also, being induced and worrying about a possible csec can cause high stress levels which can make your body produce adrenaline. When you’re in labor your body is producing oxytocin, the happy hormone, which causes your cervix to dilate. When you’re stressed or worried you stop producing oxytocin and begin producing adrenaline which can cause labor to slow or even stop.
Basically, induction can lead to a long, drawn out, and painful labor and a high likelihood of an emergency csec. 
Also, side note, I’m by no means any sort of medical professional. This is just stuff I learned from my first pregnancy and my second/current pregnancy, and all the books I’ve read and conversations I’ve had with my Dr. I’m trying for a Vbac this time around after a three day attempt at inducing ending with an emergency csec due to fetal distress. Hopefully this info is helpful!

Why some doctors won’t induce for VBAC?

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