VBAC: Labor Induction

Topic Overview

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.^{footnote 1}

In one large study, uterine rupture occurred in:^{footnote 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 labor.

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).^{footnote 1}