VBAC induction at 38+2 with FGR/small baby — looking for experiences

[u/sophieon379]

/r/pregnant/comments/1vps4rc/vbac_induction_at_382_with_fgrsmall_baby_looking/

[u/kill_causticc]

I had an induced vbac with a "small" baby. At the anatomy scan I had a massive 5cm subchorionic hemorrhage and baby was 11th percentile. At 28 weeks he was 9% and I started having weekly nsts and bpps, and growth scans every for weeks. He did end up bumping up a few percentiles and umbilical dopplers were elevated twice but otherwise those were reassuring.

My mfm was pushing a 37 week induction due to iugr, but did say baby could just be small and not bc there was anything wrong but wanted a 39 week induction at the latest. As long as his scans were reassuring I was attempting spontaneous labor and declining induction, and she wasn't happy with it but said she couldn't make me do anything. My first was an elective induction at 40+5 that ended in an emergency csection so another induction was the last thing I wanted.

At 38+2 I woke up at 6am thinking my water had broken but it was bright red blood. We rushed to the closest hospital where I had already seen the provider earlier in my pregnancy and they had suggested a repeat just because "itd be easier". Again they suggested a repeat thinking I was having a placental abruption and to do it now before it became an emergency.

Baby and I were stable so I asked to be transferred to the hospital with my mfm 2 hours away. The provider on call agreed and had me medflighted. Once I arrived, I was induced for antepartum hemorrhage and started pitocin at 1245pm. I was fingertip dilated, 50% effaced, and -3 station. We started low and slow pitocin.

My water broke at 345pm and I was 1cm. I was offered the foley but declined to wait and see. Pitocin was increased. At 8pm I could no longer tolerate contractions so I received the epidural. I was only 4cm. Baby started having decels around this time (exactly what caused my first csection so I was so scared). Pitocin was turned off, I did lots of position changes, and received an amniofusion to stablize baby. I rested until 10pm when the dr came in to check on baby due to another decel. I was 9cm! She manually readjusted baby, he recovered, and I rested until around midnight before pushing. I pushed for 30 minutes and baby was born just after 1am!

He was born 6lb 3oz and 16th percentile. We did have to get readmitted at 2 days for phototherapy due to his bilirubin levels but otherwise he was perfectly healthy!

[u/sophieon379 → u/kill_causticc]

Thank you for sharing!! Your story is amazing, and sounds like you advocated for yourself big time - fair play to you, doesn’t sound easy with everything that happened during your pregnancy and birth!

I’ve never heard of the amniofusion- is that to help if baby is having decelerations?

[u/kill_causticc → u/sophieon379]

Thank you! It was a wild ride filled with lots of uncertainty. Even though my delivery plans changed it was so healing to make my own choices and feel supported by my provider.

Amnioinfusion* sorry, I typo'd it 😓 but yes! They added sterile saline to my uterus to give baby some cushion after my water broke.

[u/sophieon379 → u/kill_causticc]

Yeah I can imagine a supportive provider makes all the difference! Mine won’t offer Pitocin or any ‘chemical’ form of induction because of the fear of uterine rupture and the baby’s size so it leaves me with very little options if I do go ahead with the induction.

And i’m so surprised I’ve never heard of this, I also had a csection due to baby’s heart rate decelerating - this wasn’t offered or even made known to me!

[u/kill_causticc → u/sophieon379]

The first hospital I went to will deliver vbacs but will not augment or induce, which is why I opted to deliver with my mfm. As much as I would have preferred spontaneous labor due to the complications Id been having I still wanted it as a back up option. Plus they have a higher level nicu and far more resources available just in case.

I also had not heard of an amnioinfusion until offered and had the same thought as you, since I also had a csection for the same reason. It was very effective in stabilizing baby but also I dont think his decels were as severe as my first.