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When labor does not start on its own and delivery needs to happen
soon, contractions can be started (induced) with medicine. Some doctors
avoid inducing labor when a woman is trying vaginal birth after cesarean (VBAC). But others are okay with the careful use of certain medicines to start labor or strengthen contractions.
For a woman who has a
cesarean scar on her uterus, there is a chance the scar
can break open during
labor. This is called
uterine rupture. Medicines used to induce labor may increase the risk of uterine rupture.
When a VBAC labor has not started on its own, certain medicines, such as oxytocin, may be carefully used to help start labor.
Oxytocin may also be used to get a slow labor 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
In one large study, uterine rupture occurred in:1
Inducing labor 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 labor is allowed to start on its own (spontaneous labor).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.
March 29, 2013
Sarah Marshall, MD - Family Medicine & Femi Olatunbosun, MB, FRCSC - Obstetrics and Gynecology
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