At my hospital here they will not induce at all for VBAC.
What is this the policy where you are?
They've done it, but they don't like doing it and it really depends on the specifics of your situation. If you need to deliver for medical indication, they will RCS.
Where I'm at they will induce with Pit; I assume at low doses but we haven't gotten to that point yet. In order to qualify, you need to be effaced and dilated to a certain extent. They will not use misoprostol (sp?) or the foley cat. Oh, and they do strip membranes first to see if that gets things going.
Conservative pit induction is considered preferable to an RCS at my hospital. In order, they will try:
- membrane stripping
- foley cath
- nipple stim
- low, low dose pit
Though I personally would recommend acupuncture over any of the above options. Or in combination.
There are two hospitals in my area, but I don't know about one of them. At the other one, they won't do prostaglandins, but will do the foley cath and low dose pit.
I'm in Belgium so YMMV. I switched hospitals to one out of town to get the best VBAC possibilities:
42wks is ok, has 4 baths in 5 L&D suites so I'm guaranteed to get a bath, membrane sweep, low dose pit ok, foley cath ok, CFM and monitoring of internal pressure ok in the bath as long as the numbers look good for labour and birth. My new OB is one of the few in the country who is willing to do a VBAC with breech so she is very skilled. My bean was breech but has now turned--phew!
Artificial prostoglandins are out.
But I'm 41wks +2 with a Bishop Score of 5 so they probably wouldn't be necessary in any case. I bf with DD (17mos) and am doing homeopathics, walking, evening primrose capsules internally because DH is unfortunately sick with flu and not able to make his natural contribution to putting baby there and helping him get safely out. I'd do acupuncture if my budget could swing it. My double electric breast pump and castor oil are on the back burner of ideas for the end of the 41st week if necessary. I should go in for a membrane sweep too this weekend...
I had my second son by pit-induced VBAC almost 4 months ago. They wouldn't use artificial prostaglandins (no need in my case anyway), but in every other respect, everything was done the same as a non-VBAC induction would have been. I'm in Canada.
Gentle pit inductions are acceptable and used if needed at my hospital. I had a pit induction with my VBAC due to preeclampsia.
Foley cath, low-dose pit, or AROM are all used here by the two most VBAC friendly practices. I would personally choose low-dose pit over AROM if neessary. Hate laboring without my water!
I agree! My labor with waters intact until spontaneous rupture around 9cm (pit induced both times) was so much more "mild" compared to my labor with AROM at 2cm....