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#1 of 38 Old 01-09-2009, 06:31 PM - Thread Starter
 
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Unless something else comes up my OB plans to induce me at 40wks. She told me that pitocin is OK for VBAC, but cervidil is not. So I'm hoping for a favorable cervix! I went into labor naturally with my last VBAC, so I'm nervous about induction. Advice is welcome! I'm happy that a repeat c/s is her last last resort.
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#2 of 38 Old 01-09-2009, 06:46 PM
 
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why is she inducing you at 40 weeks?!

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#3 of 38 Old 01-09-2009, 06:57 PM
 
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Why are you agreeing to be induced at 40 weeks?

-Angela
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#4 of 38 Old 01-09-2009, 07:07 PM
 
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I, personally, would not be comfortable with pitocin and a vbac. Did you have it before? It's pretty awful, stong, forceful (but not necessarily productive) contractions. It seems like it would be more likely to lead to more interventions and another section.

I'd hold off on the induction unless it's medically necessary.

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#5 of 38 Old 01-09-2009, 07:21 PM
 
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I too would not be comfortable being induced and trying for a VBAC unless there are other medical reasons for induction. Pitocin is awful stuff...

Rachel, proud Army wife to my superhero.gif and SAHM to my crazy boys jumpers.gif... Trevor 4/08, Trenton 6/09 and Travis 10/10
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#6 of 38 Old 01-09-2009, 07:32 PM
 
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40 weeks is really early. What if your EDD is off? My midwives don't induce until 42 weeks... and I fudged my dates a bit so it would really be 42w3d. I better not go that long!

And if I do I might refuse. Obviously I haven't told them that yet (or even DH) but I can't even imagine being induced again (c/s for failed induction with DS).

If there is absolutely no way you can switch OBs or refuse a 40 week induction I would try to get labor started by natural means first. I'm taking EPO twice a day orally and at bedtime internally. I've also starting pumping (for IGT not induction) but it definitly gets contractions coming for a bit.

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#7 of 38 Old 01-09-2009, 10:45 PM
 
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I would refuse. I would not tell them I am refusing till near the last minute, they can not abandon you. My 2 VBACs were at 42w4days and 42w2days, and they were just fine.
If there is no reason to induce you, beyond the fact that that is what your OB wants, say too bad.
I have heard that pitocin is safer then cervidil, but that is not saying much. It is still highly unsafe to try to VBAC with.

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#8 of 38 Old 01-09-2009, 10:50 PM
 
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I have heard that pitocin is safer then cervidil, but that is not saying much. It is still highly unsafe to try to VBAC with.
It actually is a pretty significant difference. 1.2% rupture rate with pitocin vs. 2.9% with cervadil - http://www.homebirth.org.uk/vbacinduction.htm

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#9 of 38 Old 01-09-2009, 11:33 PM
 
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I would postpone. If you don't feel comfortable just saying no (which is your right, they cannot force it on you and they CANNOT dump you from service at this point), come up with an excuse to "reschedule" and then oops "reschedule" again. I wouldn't even consider induction until past 42 weeks and it would be a very LONG discussion. Even if you are at 40 weeks, babe will tell you when they are ready to come out. I would be so angry if I was convinced to induce by an OB and ended up with another c/s because my body just wasn't ready to birth.

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#10 of 38 Old 01-09-2009, 11:40 PM
 
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I agree with others, that there is no reason to agree to an induction at 40 weeks, and even if I did decide to induce, before pitocin, I would try other induction methods first, like stripping membranes and cervical massage, or a foley or cook catheter. Also, if pitocin is used for VBAC, it should be very low dose.
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#11 of 38 Old 01-09-2009, 11:41 PM
 
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It actually is a pretty significant difference. 1.2% rupture rate with pitocin vs. 2.9% with cervadil - http://www.homebirth.org.uk/vbacinduction.htm
And isn't it a 0.5% chance without induction? That means pitocin more than doubles the risk of rupture.
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#12 of 38 Old 01-10-2009, 12:13 AM
 
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And isn't it a 0.5% chance without induction? That means pitocin more than doubles the risk of rupture.
yes. although we don't know how the inductions in the study were carried out either - did the start the pit off low and slow? or crank it up like a baby story induction? did they stop it once contractions became regular, etc...

still, better to avoid if possible, though I would choose a gentle pit induction over going straight to the c/s...

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#13 of 38 Old 01-10-2009, 01:28 AM
 
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Inducing right at 40 weeks seems a bit heavy handed if it's just because "you're due". Is there a medical reason? I'd wait, get an NST at 41 weeks if you're still pregnant, and go from there. Try a membrane sweep, sex, even castor oil. Ultimately, do what you're comfortable with. I remember having "the induction" talk with my FP doc this past summer... it went something like this:

Her: so how long do you want to go with this before we do anything?
me: 42 weeks as long as my baby looks good. Hopefully she makes an appearance before then!
her: most people will want to induce at 41 weeks. That's the standard these days.
me: yes, but I really want to avoid that unless there's a good reason
her: ok we'll wait it out unless your baby needs to get evicted. Shall we try a membrane sweep?

Not sure how YOUR talk went, but you can always revisit the issue - right up to, and beyond, the day your induction is scheduled. Good luck!

Mom to James (ribboncesarean.gif 5/2006), Claire (vbac.gif 6/2008), furry kitties Calvin and Bob, and wife to Dennis. 

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#14 of 38 Old 01-10-2009, 06:56 PM
 
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Not to state what has already been said but I would question how supportive your DR is if 40 weeks is the cutoff you are given. Do you have a medical reason for induction because it seems kind of early for your DR to be setting an induction date. IMO...

My DR didn't offer induction until 41 weeks and I was able to hold him off until 42 weeks 1 day. I still regret letting them scare me with the "dead baby" card because my induction ended in a repeat c/s. There will be soooo much intervention to fight if you get to the hospital before you are in labor, even the *friendly* hospitals. That being said, I was induced with a foley bulb, got to 4cm (from 2cm) in about 5 min. and then was put on a slow pit. drip that was upped over 26 hours or so and my scarred uterus and baby handled it just fine! *For me* I would definitely try some sort of induction before going to a repeat c/s. However, I would, and did try all natural methods first (including castor oil). Baby just simply wasn't ready and I will have to be much more patient next time. LOL
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#15 of 38 Old 01-12-2009, 01:00 PM - Thread Starter
 
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Yes I have medical reason to be induced, I cannot go over due. I've been having 2x weekly NSTs since 32wks, biophysical profiles/AFI, growth scans, etc. This is the first OB who is even letting me attempt a natural birth. She said she would start sweeping membranes weekly and break my water if I'm able to dialate to 3cm on my own. I understand how induction at 40wks is arbitrary in MOST cases, but not here...
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#16 of 38 Old 01-12-2009, 02:11 PM
 
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I was induced w/ Ilana at 39 wks. I was 4cm and 0 station. Pit was started at 10:30, they broke my water at 12:30 and she was here at 2:04. 3.5 hrs from start to finish! This was my 2nd VBAC as well so I knew my scar and pelvis were 'proven' etc. Unless baby is here by then, we'll probably induce again at 39 wks. Good luck!

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#17 of 38 Old 01-12-2009, 03:50 PM
 
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I have had pitocin, and would refuse to use it again, especially having had a c-section. A lot of doctors use pit induction for a VBAC, and many of their patients end up with a repeat cesarean. I would keep pushing, and if I was going to induce or do a repeat cesarean, it would be as a last resort and certainly not at 40 weeks.
Something we seem to have forgotten in today's schedule-oriented society, is that 40 weeks is just an average. It used to be that anything from 38-42 weeks was considered full term, but these days OBs give us a very small window with which they are comfortable.
My oven cooks at 400 degrees, as does yours I'm sure. But, it may take an hour to cook something at 400 in my oven, that would only take 45 minutes in yours. Recipes even account for the fact that times may vary depending on the oven. Why can we understand that and go on without question, but insist that something so much more complex, like the human body, has to be ready to deliver in exactly 40 weeks?!

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#18 of 38 Old 01-12-2009, 06:24 PM
 
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When I had my VBAC I was given an induction date. That date hung over my head and I believe kind of stressed me. I thought, "I'd better go into labor before...". I ended up trying castor oil 2 days before the scheduled induction, and whether that was that was the reason or not, I went into labor.

40 weeks is definitely early! Both of my babies were late. My second (VBAC) was 12 days overdue. She wasn't too big either. My EDD was probably just slightly off.
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#19 of 38 Old 01-12-2009, 06:36 PM
 
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Originally Posted by MomtoXane View Post
Yes I have medical reason to be induced, I cannot go over due. I've been having 2x weekly NSTs since 32wks, biophysical profiles/AFI, growth scans, etc. This is the first OB who is even letting me attempt a natural birth. She said she would start sweeping membranes weekly and break my water if I'm able to dialate to 3cm on my own. I understand how induction at 40wks is arbitrary in MOST cases, but not here...

If you are having these tests done though, then isn't 40 weeks still an arbitrary date? shouldn't you go as long as necessary as long as the baby is ok?

Christine, mom to C(7.5) - E(5) - J(3) - B(10 mos)

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#20 of 38 Old 01-12-2009, 10:02 PM
 
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I ended up trying castor oil 2 days before the scheduled induction, and whether that was that was the reason or not, I went into labor.

Argh. I did castor oil twice...nada...had my membranes stripped 3 times...nada. I got induced with a little bit of pit (I was 6cm dilated, 80%effaced for days), my waters were broken and 45 minutes later, DD was born.

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#21 of 38 Old 01-12-2009, 10:17 PM
 
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Holy cow! 6cm for days?! I can't imagine...

Jennifer, LPN and nursing student, Doula, CPST, and VBAC mama x3 to
AJ (5/03), Evan (12/04), Ilana (11/06), Olivia (2/09), and Unity (8/2012)

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#22 of 38 Old 01-12-2009, 11:21 PM
 
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Yes I have medical reason to be induced, I cannot go over due. I've been having 2x weekly NSTs since 32wks, biophysical profiles/AFI, growth scans, etc. This is the first OB who is even letting me attempt a natural birth. She said she would start sweeping membranes weekly and break my water if I'm able to dialate to 3cm on my own. I understand how induction at 40wks is arbitrary in MOST cases, but not here...
Why not overdue? I had a section with my first and while ten years ago it was common to induce to prevent 'large' vbac babies (and my first two vbacs were chemically induced on my due date based on those old studies), more recent studies have shown that size doesn't make that big of a difference in successful vbacs. My last four vbacs were 14 days overdue (with a 10 1/2 lb baby), 8 days over (with an nine lb baby), 8 days over (with an eight lb baby) and 14 days over with an eleven lb baby)

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#23 of 38 Old 01-12-2009, 11:35 PM
 
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I've read some women's stories on here with GD still going past 40 w/ no problems. Why not continue monitoring? If you're set on just getting to 40 weeks due to being worried about complications then just resign yourself to you'll try induction but the method by which you get there is far less important that the outcome. Long as the babe is healthy. Long as you know a rc/s is possible but the risks of GD for you outway that then make peace with that decision. What's important is a healthy baby.

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#24 of 38 Old 01-16-2009, 02:37 AM
 
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Don't do castor oil. I often wonder if the strong contrax I got after taking it caused my tearing. And I wouldn't induce, either, to be honest, unless it was "natural" induction like walking/sex/etc.

Christine, mama to Daniel & Abby, 9 and Patrick, 4. Wife to a rockin' train engineer. Gluten and nightshade-free. Multiple kiddie food sensitivities.

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#25 of 38 Old 01-17-2009, 12:04 AM
 
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No advice but I just want to wish you the best of luck for a wonderful birth. I remember you from an 06 DDC on another site and am jealous you've got another on the way!
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#26 of 38 Old 01-23-2009, 01:18 PM
 
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I heard the same song and dance from the "only pro-VBAC OB in town" about 40 week limits and how safe Pitocin is.... only, I had already experienced the hell of pit induction, and was not going to submit to it a second time.
The reason for my first induction (which became a section) was pre-e, but my homebirth midwife reviewed my medical records, and sure enough, the blood pressure was barely even borderline, and most importantly, hardly any higher than my pre-pregnancy numbers had been, so there was no "dramatic rise" that would make a pre-e diagnosis reasonable, or the induction necessary. I was led down the garden path by a CNM.

Luckily, I smelled how the coffee was brewing at the VBAC OB, and left at 6 months to get a homebirth midwife experienced with home VBACs. My HBAC with a 10 lb baby after 40 weeks went off without a hitch.

Hope you do get to experience vaginal birth and not a section, but it's too bad it has to happen in the hospital environment with people messing with the mother and the labor. Very few make it under those circumstances, especially when they drag out the Pit bull.

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#27 of 38 Old 01-23-2009, 02:19 PM
 
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If all goes well, you may not even need induction if you delivered your last one at 40w1d. I know every pregancy is different, but my experience has been that I seem to deliver earlier with each successive pregnancy (last one at 38w0d, and was 3 cm dilated before I went into labor). Hopefully at least your cervix will be favorable - I think that can make a big difference.

As for the pit, my old OB was willing to use pit to augment labor in a vbac, but my new OB will not use it since she saw some sort of trouble with pit in a vbac when she was a resident. My new OB will only strip membranes to get a vbac going (and only with a favorable cervix). New OB also warns against home measures like nipple stim and castor oil, saying those can be tantamount to the pit in some cases.

Good luck! I hope you go before 40w! I understand that angle, I have to go before 40w also for medical reasons (primarily clotting issues). But I have never gotten that far anyway.
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#28 of 38 Old 01-23-2009, 05:53 PM - Thread Starter
 
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Well my last growth scan showed the baby isn't really thriving and my placenta may be failing. So we're discussing inducing closer to 38wks. That's just 10 days away!
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#29 of 38 Old 01-23-2009, 06:07 PM
 
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Well my last growth scan showed the baby isn't really thriving and my placenta may be failing. So we're discussing inducing closer to 38wks. That's just 10 days away!
I'm sorry- that must be scary. My sis just went through a similar situation- she was GD (controlled by diet) and her placenta was 'flat', she ended up induced at 40wks.

Hoping you and your lo a safe delivery.

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#30 of 38 Old 01-23-2009, 11:48 PM
 
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Wishing you and your little one a safe and healthy delivery!!

Mom to James (ribboncesarean.gif 5/2006), Claire (vbac.gif 6/2008), furry kitties Calvin and Bob, and wife to Dennis. 

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