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VBAC and induction with Foley Bulb

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ventobaby Posted: 11-24-2009 9:13 AM

Anyone here had an induction with a Foley Bulb catheter?   I would love to hear your experiences so I can make a decision about what to do, so here is my story:

I am planning a VBAC but my midwives want this baby out sooner than later because I am very tiny (4'11") and the baby is getting pretty big.  No other health concerns at all.   I am not a big fan of inductions but they feel that if I wait much longer I will end up with another c-section automatically so they want to try the non-chemical approach to induction so I can have a VBAC.   I am trying to weigh the pros and cons of waiting vs. inducing at this point.  I was due on 11/22, so the baby isn't really late yet and my DS was born 5 days late via c-section after close to 48 hours of labor, just fyi. TIA

DS1 b. 12/31/06, BF for 16 months and 1 week

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blueginger replied on 11-24-2009 12:38 PM

So what is your main concern?  Whether the induction will increase your chance of csection?  Statistically inductions do up your changes for a csection.  I did have a vaginal delivery w/ the induction of DD and she turned out to be 9 lbs.  It was a tight squeeze, but she finally came out!  I did have to end up getting an epidural- the contractions w/ an induction are basically like giving your uterus jet fuel! 

What is your concern w/ the Foley?  I had a foley during my induction, but it was removed so I could push w/o obstruction. 

Me (33) DH (37) 

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ventobaby replied on 11-24-2009 2:50 PM

just that it is harder to find stat's on a non-chemical induction and was wondering what other folks experiences were.  It should fall out around 3 cm's since that is about the limit of its expansion (only 2 if they use a latex free cath.)  thanks for your experience, I am glad to hear it worked. 

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Sheryl replied on 11-24-2009 3:03 PM

It's worth knowing and looking at the Bishop's Score if you're considering induction. How high that score is is relative to the success of an induction.

Good luck!

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iamready2go replied on 11-24-2009 3:19 PM

blueginger:

So what is your main concern?  Whether the induction will increase your chance of csection?  Statistically inductions do up your changes for a csection.  I did have a vaginal delivery w/ the induction of DD and she turned out to be 9 lbs.  It was a tight squeeze, but she finally came out!  I did have to end up getting an epidural- the contractions w/ an induction are basically like giving your uterus jet fuel! 

What is your concern w/ the Foley?  I had a foley during my induction, but it was removed so I could push w/o obstruction. 

I am guessing you had Pit though, right? The OP will not have Pitocin during her induction because of the increased chance of rupture due to a previous c-section. With a VBAC, it is kind of you have to go on your own or they section you past a certain date. I think she is looking for people who had a foley bulb put in to help their cervix dilate in a non-medicinal way.

 

OP~ How big was your first baby? I feel your pain. I was hoping for a VBAC with my second son, but he ended up being transverse/breech (he kept going between the two, even as they were prepping me, then switched to frank breech and started to engage that way and he needed some prying out when they did the section). Unless you have a condition such as gestational diabetes, it is unlikely that your body will make a baby bigger then you can deliver. I really suggest the ICAN website and forums for VBAC research. In the forums you might find someone who has had a natural induction. I am getting a lot of help there in revving up to tell my OB I will not take no for an answer when it comes to a VBA2C.


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Calladona replied on 11-24-2009 4:09 PM

I have no experience, but personally I'd keep waiting.  Remember your size, baby's size, those are NOT the most important factors.  You pelvis is made to stretch in amazing ways during labor.  Baby's head is made to mold like crazy.

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blueginger replied on 11-24-2009 4:42 PM

Ok, I understand now!  Of course you can't do pit w/ a VBAC- I obviously still have baby brain!

 

Me (33) DH (37) 

DD (3-6-09, 9lbs, 20.5 inches, and perfect!)

Angel @ 6wk2d confirmed at 8wk5d on 5-13-10

 

 

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Calladona replied on 11-24-2009 7:08 PM

It's not necessarily true that you can't do a pit induction for a VBAC...  Some doctors are nervous about it, but others will do it - there's some controversy about it.  From my reading as long as it's done very slowly and carefully, it can be safe.

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tobyisrnewfie replied on 11-25-2009 8:51 AM

I had 2 VBAC, both induced. One induced before the "new" rules, one induced after the "new" rules.

1st VBAC was w/cervidil, then pit. Baby was fine. He was 41w

2nd VBAC was with foley cath. It did nothing, then they gave me the cervidil-had baby about 6 hours later. Never needed pit. This baby was 42w1d. I think he was just ready. 

The Foley induction only works if your body is ready. You're already "past" dates, so maybe just stick it out. Maybe at a 1week past dates, consider induction. Is the baby posterior? That could make things difficult, too.

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amg replied on 11-25-2009 10:26 AM

A foley catheter really isn't any different than any other method; it won't work if the body isn't ready.  ACOG's last practice report on induction was VERY positive towards the Foley Catheter.  They found more vaginal births when a Foley was used in conjunction with pitocin (don't know if your midwives are planning to use pit, but that's an FYI).  Also, something else to consider, your height isn't a good predictor of whether or not you can birth vaginally.

Here's a snippet from www.vbacfacts.com regarding induction for VBAC (note that even with chemical induction agents, the rupture rate is still VERY low, even lower for labors that are "augmented" with pit):

Rates of Rupture: Spontaneous vs. Induced/Augmented Labors. When attempting to approximate your risk for uterine rupture, it’s important to differentiate between spontaneous and induced/augmented labors. Landon 2004 featured the VBAC labors of almost 18,000 women and found varying rates of rupture based on spontaneous vs. augmented vs. induced labors.

Spontaneous means that labor starts on its own. Induced means that the laboring mom is given drugs, usually Pitocin, Cyotec, and Cervidil, to start labor. Augmented means that the laboring mom is given drugs during labor, usually to speed things up or to restart a “stalled” labor. Specifically, they found the following rates of uterine rupture: 0.4% (N = 24) in spontaneous labors, 0.9% (N = 52) for augmented labors and 1.0% (N = 49) for induced labors.

They further broke out rupture rates by type of induction: 1.4% (N = 13) with any prostaglandins (with or without oxytocin), 0% with prostaglandins alone, 0.9% (n = 15) with no prostaglandins (includes mechanical dilation with or without oxytocin), and 1.1% (N = 20) with oxytocin alone. Overall, they found 0.7% of women experienced a true uterine rupture with an additional 0.7% experiencing a dehiscence. Lyndon-Rochelle 2001 found that women with spontaneous labors had a rupture rate of 5.2 per 1000 (0.52%) while labors induced without prostaglandins (7.7 per 1000, 0.77%) and labors induced with prostaglandins (24.5 per 1000, .24%) experienced rupture rates 4.7 times and 1.5 times higher respectively.

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ventobaby replied on 11-25-2009 11:15 AM

Thanks for all the info everyone!  I have spent a ton of time with ICAN at the suggestion of my midwives.

Since these new forums are a bit awkward I am going to answer questions as I remember them.

My DS was a section after 48 hours of labor.  He was OP, floating and asynclitic.  I had a band on my uterus after such a long, obstructed labor and I finally got an epidural(42 hours into the labor), my blood pressure crashed and my DS had some prolonged heart rate decelerations and I started having massive amounts of blood in my urine.  My DS was only 7/10 but his head size was in the 110%  so that plus the other factors brought on the section.  We know this baby is NOT OP, he is at -2 station (my DS never made it that low!) and I am 80% effaced, 1 cm dilated already. However, this baby is estimated at over 8 pounds (I know ultrasounds can be off by a pound in either direction) and I am contracting, just not in a regular pattern yet, no sign of a band anywhere although they can be hard to see on ultrasounds.  So things are moving, just slowly.  I should also add that while my due date was 11/22, if you go based on my O date it would be today.  I think I am just creating more anxiety for myself at this point and I should just relax and this LO will come out on his own!  Thanks again for all your thoughts.

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CandCfam replied on 11-25-2009 11:28 AM

I can't speak to the Foley question, but Pitocin isn't fun with any delivery, but it is absolutely doable with a VBAC. My second was 8 lbs and 15 oz and 10 days past my due date, and I had a slow pit drip with her (and an otherwise unmedicated birth).

 

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MrsBee replied on 12-01-2009 2:14 AM

The thing that is great about foley is that it won't work unless you're ready.  It just gets things going.  Foley can't be done if you are 3 or more cm dilated (the bulb is about 3cm).  It works by putting pressure on your cervix, which encourages the release of prostiglandins.  It's very safe :)

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ventobaby replied on 12-07-2009 1:31 PM

just wanted to thank everyone for their responses

the bulb worked like a charm, i went from fingertip to 4cm in 15 minutes.  my labor was slow but productive, ended up with pit at 8 cm to get to 10

i ended up with a section again, but that was because of some serious heart rate decels from a compressed chord

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MrsBee replied on 12-07-2009 2:00 PM

Great job mama. :)  Thanks for sharing your success with foley.  It is an often forgotten choice for induction.

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