I am 39 weeks and planning a vbac. We're starting to discuss how we want to handle going past my due date. My ob said he waits till 41 weeks and then likes to make a plan for induction. He does not like anyone going past 42 weeks (vbac or otherwise). He indicated that he is comfortable inducing at 41 weeks for vbac at least in my case since I'm already 2cm and 70% (and won't hit 41 weeks for another 2 weeks). His usual procedure for a vbac induction is to break the water and if things don't get started, then a little pitocin.
I know that the further past 40 weeks I go, a vbac is less likely to be successful and also that being induced makes it less likely as well as slightly more risky. So I'm leaning towards not wanting to be induced at any point, and actually favoring a repeat cs if I go too far, but I'm not sure how far is too far. I'm thinking maybe I would have a cs if I hit 42 weeks.
Has anyone else struggled with these questions? I really want a vbac but I'm not a risk taker at all so even the decision to try a vbac is a big deal for me.
Incidentally, your risk of UR complications does not go up after 40 weeks. Decreased success of VBAC after 40 weeks is due to other issues, normal for all pregnancies. And don't forget that normal term is 38-42 weeks.
Anyway, I went with natural induction methods when I got to the point where I was concerned about time. You could consider those before allowing the doc to break your water, which puts you on a timeline and such. Also, natural inductions tend to be more gentle on your body. When your body is ready, it's ready!
I stayed active and took a very small dose of castor oil in some orange juice. Not everyone's first choice, but beats pitocin hands down!
Good luck and stay positive!
If the baby needed to get out sooner (like there was a non-reassuring NST), or it got to 2 weeks past EDD, I would choose to induce rather than schedule a repeat c/s. I'd opt for induction methods in this order:
0. castor oil (at home)
1. Nipple stimulation (at home)
2. Foley cathether to get dilation (this is where I'd have to have my doc in on the deal)
3. Rupture membranes (yes, this puts you on the clock, but if you're inducing, you're already pretty much on the clock anyway.)
I might opt for pit over membranes depending on the situation with me and the baby. For me, scheduling a repeat c/s was NOT an option because I just couldn't handle that - my first was scheduled at 39 weeks for breech presentation and I never even went into labor. I wanted to know what labor was like just ONCE in my life.
Mom to James ( 5/2006), Claire ( 6/2008), furry kitties Calvin and Bob, and wife to Dennis.
My doctor will not induce with a VBAC ( which is fine, I don't feel comfortable with it either), so I guess it would be a c-section ( after I tried every natural method in the book), but she is also very comfortable with me going into 42 weeks as long as baby and I both look healthy.
knowing what i know now, i would NEVER induce for going past 40 weeks, or even 42weeks! your body KNOWS what to do and it will do it.
some moms gestate a long time and have healthy babies as a result, its ok and its normal.
i was bullied into an induction with dd1 at 40 weeks exactly.
i trusted the CNM who i had care through. and she lied to me. she told me my placenta wouls start dying, that my baby would die and it would be all my fault. she really used alot of scare tactics to get me in for that induction. and because i trusted HER instead of my body and my baby i ended up with a failed induction leading to c-sec. turns out, she went on vacation the following day. she just wanted me to get it done and overwith for HER. not for my baby.
dd2 i had an amazing midwife, trusted my body and my baby. i birthed her happily at home at 40w4days. but had i gone longer we would have still been ok. women just dont fail to go into labor, but sometimes their labor doesnt start on their care providers timeline. thats where inductions come in. to appease the care provider.
Living with an invisible chronic illness.
Fat and hairy. And happy with both *( o Y o )*
If it's a "let's get that babe out because this is taking too long" then I'd say no. If there was some concern I'd agree to NST and fetal monitoring, but I wouldn't worry about anything till after 42 weeks. It's true that some studies show vbac success goes down after 40 weeks, but it's not a huge drop and the studies don't say "why" there is a drop (as in, the studies can't say the drop is due to anything related to the mother/babe... it could be due to hospital policies that induce vbac mamas after 40 weeks with the related decline in vbac success due to induction).
With my first babe labor began at 42 weeks 3 days. With my vbac labor began at 40 weeks 2 days. You may not "go long" even if you did last time, and there's nothing really out of the ordinary (biologically speaking) of gestating till 42 weeks.
Hang in there and happy birthing!
And you who seek to know Me, know that the seeking and yearning will avail you not, unless you know the Mystery: for if that which you seek, you find not within yourself, you will never find it without.
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)
I would not induce or schedule anything until I was 47 weeks.
The risks of VBAC not "working" after a certain point are risks that are doctor-caused. Not baby/mama caused.
And actually I would never schedule anything at all. If there's an emergency, no scheduling. And I firmly believe that babies know when to be born, so there would be no scheduling. I'm not smart enough to know when a baby is ready to be born!
I went 42 weeks with my VBAC, refused any mention of induction. Though I stand by my decision from a philosophical point of view, it may not have been the best decision in retrospect.
I had a wonderfully supportive midwife with tons and tons of VBAC experience. However, my 42 week-old baby was 9 pounds 14 ounces, and failed to descend due to her size despite almost 3 days of labor. If I had let my mW strip my membranes, done other things to try to get baby to come sooner, I probably could have succeeded with my VBAC.
I just don't want to be too black-and-white here. Things are not always so easy or so simple.
I think there is also a big difference between the more "natural" inductions (EPO, Nipple Stim, Sex, Walking, RRL, even Membrane Sweeps and Castor Oil at the most interventionist end of that spectrum) and the more "medical" induction techniques like breaking the water and pitocin. The two types of inductions work differently... the first type is a nudge, the second type is a push.
There are no sure things in birth (though I desperately wish there were), but I still wouldn't induce using medical interventions unless there was a medical need.