Re: A REPOST Vaginal birth after c-section vs. Elective repeat c-section/ VBAC vs. ERC

• Messages sorted by: [ date ][ thread ][ subject ][ author ]
• Next message: Amanda: "Cyst"
• Previous message: Garry E. Siegel, M.D.: "Re: A Question on delayed cord clamping"
• In reply to: Barb: "A REPOST Vaginal birth after c-section vs. Elective repeat c-section/ VBAC vs. ERC"
• Next in thread: Clesia: "Re: A REPOST Vaginal birth after c-section vs. Elective repeat c-section/ VBAC vs. ERC"

>
>1. I was wondering if you knew if that study lumped ALL VBACs together,
>including those who were induced.

Can't remember exactly, but I'm sure that the researchers compared VBACs natural labor versus induced to come to their conclusions. >
>2. Also, I have heard contradictory reports on which induciton method
>is safer for a VBAC. I have read several places that Pitocin is the
>preferred method because of the greater degree of control (dosage, etc)
>available, whereas elsewhere I saw that some doctors prefer low doses of
>Cervadil. I was under the impressiuon that it was a gel to be smeared
>on the cervix for ripening, but myOB told me that it is actually a strip
>of some kind. Can you clarify this for me?

Cervidil (a med on the strip) has been associated with a higher complication rate for ripening in VBACs. Cytotec is not to be used in VBACs.

All inductions are riskier than spontaneous labor in VBACs, with Pitocin alone safest, but still worse than natural labor.

(snipped a bit) >
>3. setting,
>there is not time to place an epidural, and I have read that havig an
>epidural in place during the TOL might increase the chances for ERC
>because the epi might slow labor. MY question, is it better to try
>first for an induction-free and drug-free VBAC but risk a section with
>general anesthesia or just opt for the induction or epidural and risk a
>chance of a ERC but with an epi already in place? Any thoughts?

A spontaneous labor is my first choice for you if you want a drug free VBAC. I would not induce a VBAC who has lost a baby unless the circumstances are exceptional.

You might want to consider doing a spontaneous VBAC until you reach a certain date (like your due date), and if you've not labored by then, well, have a scheduled section. I have patients do that all of the time, and the section date is planned way in advance, and can always be cancelled.

--
Garry E. Siegel, M.D.
Private Practice
Roswell, GA

Advice herein does not constitute a physician/patient relationship.
Always consult your own doctor as you see fit.
No private emails.

• Next message: Amanda: "Cyst"
• Previous message: Garry E. Siegel, M.D.: "Re: A Question on delayed cord clamping"
• In reply to: Barb: "A REPOST Vaginal birth after c-section vs. Elective repeat c-section/ VBAC vs. ERC"
• Next in thread: Clesia: "Re: A REPOST Vaginal birth after c-section vs. Elective repeat c-section/ VBAC vs. ERC"