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.¹

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 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).¹