Updated: May 23, 2019
When I started my journey to find doctor that would support and allow me to VBA2C one of the questions I asked them was, Do you induce your VBAC patients? Is it safe to induce a VBAC?
I got answers like….
Yes, but in a very gentle way
Oh, that is just not done
I'd lose my license if I induced you
That's a quick ticket to rupture
It's either natural labor or a C-section
Absolutely but, we would just need to take the correct steps (whatever that means?)
It was very interesting to receive such difference answers around the board. It sparked my interest in knowing what the true answer was! Would someone really lose their license if they induced me? Would I really be guaranteed to rupture? With my second baby I was laboring and I begged for Pitocin because my labor wasn’t starting and my doctor refused so, I wondered if maybe that WAS true. It’s FALSE!
Can VBAC be Induced?
Although labor is ideal to start on its own, VBAC moms can still safely be induced and still have a VBAC. According to ACOG, a prior low transverse c-section is not a contraindication to induction (other than the use of Misoprostol Cytotec) so a Foley balloon or Pitocin may be used safely in most women. The problem arises when a practitioner does not believe in doing inductions on women with prior C-section.
Despite the evidence and the ACOG clinical guideline the reality is that many doctors will just not want to deal with it. WHY? Just as those doctors told me when I was asking them or like in episode 6 of The VBAC Link Podcast, the mom shares that her doctors colleagues didn’t support him in taking her as a patient. Doctors receive pressure from other co-workers and hospital administration. There are also hospital policies that they have to abide by so it's easier not to take a “risk” of a lawsuit. The doctor that told me that we could induce in a gentle way even said "I'd need you to sign a form though because you need to understand, I have a family too."
Although being induced does slightly raise risks for women who are having a TOLAC, it's important to know your provider’s stance on it and also to know what ways they may induce if they do medically need to induce.
Ways to Induce VBAC:
You may have heard about that pill that they put in vaginally to induce labor. This is called a Misoprostol also known as (Cytotec). This method of induction is being used all over the world as a way to induce women. It helps the cervix to ripen and the uterus to contract. It does increase the chance of rupture and ACOG does not approve this to be used as an induction method for TOLAC (trial of labor after cesarean) moms.
HOWEVER a Foley balloon catheter that is placed inside the woman’s cervix to help her dilate and release prostaglandins and Pitocin are both save ways to induce.
Medical Reasons for Induction:
Maternal medical conditions where it's medically no longer safe for mama to be pregnant or no longer safe for baby to be inside (diabetes, RH-Blood disease, chronic hypertension etc...)
Chorioamnionitis – Uterine infection
Placenta Concerns- (baby growth is extremely low, signs that the baby is in distress, HR is not showing a safe pattern, abruption)
PROM: Premature rupture of membranes- water breaks and labor doesn’t start after 48+ hours
Fetal Demise- The passing away of the fetus
When you’re looking for a supportive VBAC provider It's suggested to ask them their view on induction and VBAC. Ask what inducing a VBAC looks like to them and how they feel about it. Although it's better to go into labor spontaneously and lots women do so after the 40 week mark all the time, its best to know your providers view in the beginning so you are prepared to handle circumstances that may come up.
Are you over the VBAC myths and want solid data to back up the facts? Grab your FREE VBAC MythBusters guide here.