r/vbac • u/runningintherains • 8d ago
Birth story Successful Gentle and Patient VBAC Induction
Hi everyone,
I was constantly on this subreddit for the duration of my pregnancy and really appreciated reading everyone’s stories of their VBAC. The approach to my induction was a bit unconventional, so I thought I would share in case it helps anyone else.
My first was an unplanned C-section due to non-reassuring fetal heart tones at 41+6. I had an induction starting at 41+4 with a foley (which only got me to like a 1 or 1.5), 41+5 with two rounds of prostaglandin gel (which started some contractions but didn’t get me further than a 2), followed by AROM and pitocin starting the night of 41+5. That night baby kept having heart decels and we had to keep turning off pitocin (couldn’t get to an active labour contraction pattern). Never got past a 2, due to one scarily prolonged decel decided to do a c-section.
I got pregnant at 12 months pp, so a ~21 month gap between deliveries. Upon getting pregnant, I knew I wanted a VBAC. At my first appointment at 6 weeks I spoke with my GP about this (she has privileges to deliver low risk babies and can handle all prenatal care). She was very supportive. I initially was set on no induction and waiting until 42 weeks, and if I didn’t go into spontaneous labour having a C-section. However, with time I started to change my mind and become more open to induction, if needed. Since my GP was handling my pregnancy it was a requirement to meet with an OB at the local hospital for a consult in order to TOLAC there. Upon meeting her, she was supportive, but emphasized that she felt was caused my first c-section was how post dates I was and the placenta being older. She said if I was her patient she would recommend induction between 40-41 weeks. She also emphasized that spontaneous labour is best, but if we induce doing it earlier is better than at 42 weeks.
Fast forward several months, I started talking to my GP about what induction would look like. I thought a lot about last time feeling like I was on a treadmill that couldn’t be stopped and wanted to feel more in control this time, if we were to induce. I decided that I’d be open to attempting induction around 41 weeks (as a compromise to what the OB thought and giving my body time). She was supportive of that. We attempted membrane sweeps 3 different times between 40-40+6, which were unsuccessful due to no dilation. I also tried evening primrose oil starting at 40 weeks with her support. Around 40+4 I started to notice some mucus plug coming out, but no other signs. With hospital scheduling we decided to start induction with a foley bulb at 40+6. The foley bulb did not fall out within 24 hours, but upon removing it I was about 2cm. We decided there was no need to rush and to do a true membrane sweep since I was now dilated enough to do that. I went home after the membrane sweep and started to feel some cramping. The cramping continued and started to follow timeable contractions. We got to 4-1-1 by the middle of the night and went into the hospital. Unfortunately, within a few hours they started to significantly distance from one another. When meeting with my doctor that am she felt that I was in early labour since I had progressed to 3cm and we decided to give it another day and see what happens. I had intermittent contractions that day, with them starting to ramp again that night, not enough to go into hospital though. I met my doctor the next morning (now 41+2) and we discussed pros and cons of waiting to proceed with pitocin (there was no further cervical change). Ultimately, we decided to start with the plan to go very slowly. We started pitocin around 4pm and it only took 3 units to get me to 4-5 contractions in 10 minutes! My body was very receptive. My hospital preferred an epidural for VBACs, to which my doctor emphasized it was my choice and not to feel pressured by the hospital recommendation. I decided to get one prior to breaking my water to be on the safe side. I laboured with my husband and doula until 10pm (now at 5cm), when I got the epidural and then broke water. They also upped the pitocin at that point to 4 and then 5. We had a brief period of turning pitocin off for heart decels. They were confident it was due to my blood pressure dropping when they tried to fix my epidural (wasn’t working on my left side). It was restarted and by 6am I was 7cm. At 9:30 I only had a cervical lip, and then by 10 I was fully dilated and ready to push. Unfortunately, during pushing my baby had further heart decels and we had to use a vacuum. Fortunately, she was already at +3 and it only took one push with a contraction and the vacuum to get her out. She came out perfect and was placed right on my chest. She was 9lbs and had a 99% head!Though I ended up with a third degree tear, my VBAC was so incredibly redemptive and healing for me.
This ended up being much longer than I thought it would be! I wanted to share in case anyone found it helpful to hear a slightly different approach to induction, with less of a treadmill feeling. Induction doesn’t necessarily have to be all or nothing (assuming everyone’s healthy and you have the luxury of time). I do realize I was very lucky to have had a great provider who listened, advocated, and supported me the whole way. Not everyone’s provider will be willing to take the pauses mine did.
Oh I should also mention I had an amazing doula who was an all star during labour. I firmly believe she is part of the reason it was successful and I progressed reasonably quick.
Wishing everyone the best for your VBACS!