VBAC: Labor Induction

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VBAC: Labor Induction

Topic Overview

When labour does not start on its own and delivery needs to happen soon, contractions can be started (induced) with medicine. Some doctors avoid inducing labour when a woman is trying vaginal birth after caesarean (VBAC). But others are okay with the careful use of certain medicines to start labour or strengthen contractions.

For a woman who has a caesarean scar on her uterus, there is a chance the scar can break open during labour. This is called uterine rupture. Medicines used to induce labour may increase the risk of uterine rupture.

When a VBAC labour has not started on its own, certain medicines, such as oxytocin, may be carefully used to help start labour. Oxytocin may also be used to get a slow labour going again. Oxytocin is less likely than the medicine misoprostol to increase the risk of uterine rupture. Misoprostol is not recommended for use in VBAC.1, 2

In one large study, uterine rupture occurred in:1

  • About 14 out of 1,000 women who were induced with misoprostol.
  • About 11 out of 1,000 women who were induced with oxytocin.
  • About 4 out of 1,000 women who had a spontaneous labour.

Inducing labour in a woman trying a VBAC may also increase the chance of needing a C-section. Women who try to have a VBAC may be more likely to have a successful vaginal birth if labour is allowed to start on its own (spontaneous labour).1

References

Citations

  1. American College of Obstetricians and Gynecologists (2010). Vaginal birth after previous cesarean delivery. ACOG Practice Bulletin No. 115. Obstetrics and Gynecology, 116(2): 450–463.
  2. Martel MJ, et al. (2005). Guidelines for vaginal birth after previous caesarean birth. SOGC Clinical Practice Guidelines No. 155. Journal of Obstetrics and Gynaecology Canada, 27(2): 164–174.

Credits

By Healthwise Staff
Primary Medical Reviewer Sarah Marshall, MD - Family Medicine
Primary Medical Reviewer Anne C. Poinier, MD - Internal Medicine
Specialist Medical Reviewer Femi Olatunbosun, MB, FRCSC - Obstetrics and Gynecology
Last Revised May 31, 2011

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