Induced VBAC vs. scheduled section

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Hello all. I posted here a while back about having a potential vbac and got some really great feedback and advice from all of you wonderful Ob-gyn nurses. Now I'm a week from my due date and wanted to present my current situation and see what you think.

I was checked today and I've been 1.5 cm for 3 weeks now. I'm not sure of my effacement and station, but my OB said the head has definitely come down. I've voiced my concern to him about the size of the baby and the circumstances surrounding my last c-section, which he has been very supportive and pro-vbac the whole time. After checking me today, he said he wants me to return on Monday so we can "make some decisions," meaning that I need to choose whether to be induced with low-dose pitocin or have a scheduled section.

According to him, I have about a 60% chance of having a successful vbac. I would really like to try, but I know that failed inductions account for a fair amount of c-sections. To be honest, I'm also a little scared of being induced He told me he would support whatever decision I make unless new circumstances arise that would absolutely require a c-section.

If you're wondering why I have to make this decision and not let nature take her course, it's because if I go past my due date, I really don't have a prayer of delivering lady partslly and will have to have a section anyway. I would much rather have a scheduled c-section with my trusted and respected OB as opposed to an urgent one with some insensitive clod of an on-call doc.

Any thoughts, either personal or professional, would be appreciated.

Thanks!

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Specializes in ER.

Hi,

Don't you think that he has put you in a very difficult position? I hope that he truly means "we" need to make some decisions.

When I was pregnant with my third I was almost two weeks past my due date. The OB office that my midwife worked for had a strict policy to induce at two weeks post term. My first was induced and my midwife knew how strongly I felt about not inducing without evidence of fetal or maternal risk. She came up with a great plan. She would bring me into the office (which was connected to the hospital) and apply cervadil but NOT rupture the membranes. Then I could stay in the office all day and if labor started I would be just like any other woman showing up at the hospital when things really got moving. OR if labor did not start the cervadil could be removed and I could go home and we could try again the next day. She was prepared to present this plan to her back-up doctors as a compromise to keep everyone happy, but I went into labor three days before I hit that critical two week deadline.

I wonder if this may be an option for you? If the membranes are not ruptured you have a lot more barganing room.

Lots of luck to you:)

Tracy

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Well..

I only speak of a couple years experience but, its what is in your heart. Your OB is hopefully as smart enough as most of the OB's ive workerd with. You have to trust your OB on this one. Most of the ones I know are straight up and honest about Vbacking, they want you to have a succesful and the most healthy delivery as possible. They would not let you try unless they really thought you could possibly do it! So go girl GO VBAC!

GOD BLESS :p

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Thank you all for your responses. I've done some thinking and some more research and I think I'm going to go in on Monday and gather all the data I can, including an u/s to estimate the baby's size, placenta position, fetal position, as well as station, effacement and dilation.

If things look favorable, I'm going to wait a few more days and see if I go into labor on my own. Frankly, the pit induction is a little too scary for me, so I think I'm just going to try and be patient for a few more days.

If things don't look favorable, such as a 9.5 lb baby whose head is way up high and posterior, I think I may elect a repeat section. Frankly, the things that scare me are not pain and damage to my nether regions, but something bad happening to the baby or uterine rupture.

Again, thanks for your responses and support :)

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I think you are making a wise decision. What was the reason for your first c/section?

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FTP and alleged cephalopelvic disproportion. I got stuck at 8cm after nearly 24 hours of labor and ended up having an 8lb 12 oz baby.

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