Induction methods for VBAC

[trimestersdoula]

I neeeed to get this baby out in the next two weeks (starting Sunday) or I am scheduled for repeat c/s at 38 weeks.

Anything you can think of I will take.
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[lillymonster]

Well the ACOG just update the guidelines on VBAC, so I would print those out and take them to the OB. New guidelines are to let women go past 40 weeks. Call them up and ask them if they have read it.

http://www.acog.org/from_home/public...07-21-10-1.cfm

[lyterae]

I agree with the above poster.. I'm sorry but I don't think that induction methods are appropriate at this gestation (36 weeks?) or for a VBAC.

Can you just not show up for your c-section? Do you have any alternate providers that will "let" you go into labor?

[trimestersdoula]

To put it mildly, I'm pretty screwed. This city is small with only a few OB's (midwife isn't an option due to meds I am on). There was a bad outcome from an attempted VBAC and now nobody will do them.

The reason for the cesarean is my uncontrollable rising blood pressure.

[trimestersdoula]

And honestly, if this baby doesn't want to come at 36 or 37.6 weeks he won't. I know that. I am just very desperate to at least try.

[LadyCatherine185]

IMO, I would be looking for ways to keep the baby in as long as possible and going with the C/S at 38+ weeks if that is what you have to do. The longer baby can stay in, the better. Is there anything you can do for your blood pressure? Bed rest? Meds?

FWIW, I tried every natural induction method out there when PG with DS, as I went to 42 weeks. In the end I had to be induced with pitocin. Baby isn't going to come unless they are ready.. especially that early.

I am sorry you are in such a tough situation.

[trimestersdoula]

I am on meds, Methyldopa and Labetalol that they are upping on a weekly basis now. I have basically restricted myself to doing nothing but yet my BP keeps rising.

[MyFillingQuiver]

I believe you and I are due the same day? (8/26) I'm just 35 weeks today, and feel no hint of labor coming on..thankfully! I've had a preemie before, and although he was big and plump and had no real issues (34 weeker), he had to stay 3 weeks JUST to satisfy all the tests and overcome all the markers they wanted to see!

Last time around, I was a VBA2C, and found a hospital/OB to support me. At 41+ week, the Ob started getting heat from others at the hospital that may have to cover in his absence..they wanted (the other OB's) for me to schedule a section..my OB stood up for me, and he and I agreed to break my water to get me going, as I had 2 other successful vaginal births before my sections.

It went well, and I delivered just a few hours after breaking my water.

I'm not saying this is the best option for others, nor was it my preferred, but it was a lot of give and take with my situation. This time, I'm having a homebirth, so I may see the far side of 42 weeks, who knows!

All this to say that some OB's will help you along if you are a VBAC and at term. A mandatory "exit plan" at 38 weeks seems ambiguous, as your BP may be no higher at 39, 40 or more. So, the OB who will "let" you do a TOL/VBAC, may be willing to discuss encouraging ripening/birth via natural methods a term, or even something like a foley rather than immediately jumping to a RCS...? Maybe? Hopefully!

[trimestersdoula]

I am due 08/22 so a few days before you.

I have already asked my OB about doing a folley cath, striping etc., but she said she's ever only done a cath once before and it didn't work. I really just wish I could find someone that WOULD work with me but it seems like I am totally on my own....other than the L&D nurses I discussed all this with this afternoon at my NST.

[lyterae]

I'm so sorry you're in this position.

[HeatherB]

I would also not recommend induction at 36wks. What about trying natural treatments for HBP in addition to the meds? Can you get in a pool (at least chest deep) daily? Take passionflower extract? What about low-dose aspirin? It's been shown to reduce the recurrence of pre-e. I'm sure there are other things that *might* help.

Obviously rising BP is a danger for both you and baby. I do hope you can find someone else who will fight for you and the baby, though. I would take things like RRL tea and EPO to get your body as ready as it can be for labor, hoping the LO might like to come a couple of weeks early or that you could find someone to try a gentle induction at 38 instead of an automatic c/s. Neither option sounds all that great, does it?

At any rate, remember that it is all YOUR choice. Be fully informed of the risks and dangers of your condition versus evicting the little one ahead of time. If you do get to 38 weeks and everything is stable, what's the danger in waiting? At what point are YOU prepared to say, "we're done!"? I hate to see anyone get railroaded, even if there are real risk factors involved. Make sure that whatever decision is made is one YOU are in agreement with.

[trimestersdoula]

I guess the only way I can put it is that I am sick of fighting to get my way. I am beyond exhausted....physically, mentally and emotionally. When you have a midwife (the only one in town) tell you that you have no other options it is really depressing.

I am not willing to try anything beyond sex and walking in the 36 weeks but at 37 weeks I have to do everything I can try. I just have to. The only OB who was even willing to try VBAC's is the one I am seeing. Since she attended the VBAC gone wrong she is no basically no longer willing to do them anymore. Neither are the other OBs in town, who were the once a c/s, always a c/s type in the first place and who are now saying "I told you so" to my OB.

I have a fairly new, very large incision on my upper abdomen that has been causing me a great deal of pain everytime I move during this pregnancy and my OB is worried about the integrity of that. The hospital has a "2 years between c/s and next birth policy". I miss out on that by a few months. My OB was going to go out on a limb to help me with the VBAC until the unfortunate VBAC incident. I am also on meds that they keep upping (that make me sick all day), I'm going once a week for NSTs, bloodwork and appointments. I just DO NOT want another c/s and I want this over with.

I know I sound totally selfish in this but I am not going into this blind. I know the risks etc. I just honestly don't know what to do. I have basically run out of options other than begging this baby to come before 38 weeks on his own.

[HeatherB]

It totally makes sense and I don't think you're selfish at all. I can't imagine being stuck in such a rotten situation, and I'm very sorry you are. I'm just trying to brainstorm whatever I can that might, possibly, a little bit help. I hope I didn't make you feel worse.

[trimestersdoula]

Gosh no, HeatherB. You didn't make me feel worse. Thank you for brainstorming
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[Megan73]

Originally Posted by trimestersdoula

I am due 08/22 so a few days before you.

I have already asked my OB about doing a folley cath, striping etc., but she said she's ever only done a cath once before and it didn't work. I really just wish I could find someone that WOULD work with me but it seems like I am totally on my own....other than the L&D nurses I discussed all this with this afternoon at my NST.

She won't even TRY the Foley? There's all kinds of research showing it's effective but based on her sample of ONE she won't do it? I know you're exhausted, mama, but I'd press her on this one. It really could be your best shot to try a Foley a few days before 38w. You have nothing to lose.`

[livinzoo]

I found this: http://www.lifepassages.net/NaturalInduction.html
and http://www.gentlebirth.org/archives/natinduc.html

Please let me know if any work for you.

[JFTB1177]

I carry my babies a long time (DS2 was born at 42w5d!). I had a HBAC with DS2 and my MW was getting pretty antsy herself. She ended up stripping my membranes at 42w4d, I went into labor the very next day, and delivered my son the following morning!

I may not be allowed to go that long this time (I am prob not having another homebirth) but my OB said he'll let me go to 42 weeks. We will be stripping membranes as we get close to that date.

Also wanted to add: I was induced with my first (which ended in c/s). Induction didn't work on me at all, but stripping membranes did!

[trimestersdoula]

Thanks so much, everyone.

I quickly tried a minute of accupressure on myself last night and it gave me some pretty awesome BH ctx. I quit of course once I realized that it may work very well.

DH and I also DTD last night and I went to sleep without going to the washroom. I was woke up to a pretty dirty contraction. It was the only one though thank goodness.

Soooo, accupressure and sex will have to wait until 37 weeks LOL.