Anyone had an induction following an EMCS?

[mackerella]

DS was born at 36 weeks by EMCS, following a failed induction attempt. There were complications in the pregnancy that meant he was monitored closely throughout and had to be born quickly as soon as it became clear that his condition was deteriorating. I was given a choice between ELCS and induction and chose the latter - but not surprisingly, they couldn't get labour established (first pregnancy, baby not fully engaged, etc.) They didn't try very hard with the induction: I had a pessary for 24 hours but still hadn't dilated enough after that for ARM, and given the urgency of the situation, it was decided not to proceed further with the induction (e.g. a syntocinon drip) but move straight to a CS. I was ok with that because we just wanted DS to be born as quickly as possible before he got any sicker.

I'm now nearly 17 weeks pregnant with DC2 and wondering what my options are for birth this time. DC2 will be affected by the same condition as DS, so I know I'll be monitored throughout and will probably have to deliver at short notice between 32 and 36 weeks (before that, they'll try treatment in utero). It's pretty unlikely that I'll go into labour spontaneously before 36 weeks, so am I right in thinking that my only options are ELCS or another attempted induction? Is it worth trying an induction, or should I just go for the planned section? Would I even be offered an induction after a previous CS - I think the risk of uterine rupture is higher?!

[LubyLu2000]

I'm not in the UK so not sure if it would be the same there but I had an ELCS 1st time. When deciding whether to have another ELCS or VBAC this time the consultant said that they wouldn't be able to induce me cos of the previous caesarian and if there were any problems they'd pretty much proceed straight to an EMCS. As I've got a bit of a higher risk of a difficult labour I've decided just to go straight to a ELCS. Good luck

[MrsHuxtable]

As far as I know you can't get induced with a drip after a CS. So maybe they would go straight for a CS?

[PacificDogwood]

mackarella, I was told in no uncertain terms that a 'full' induction ie including synto drip, was not possible after CS. Pessaries and ARM, yes; syntocinon to augment labour, no - the risk of scar rupture is too high.

It sounds like you are in a difficult situation all round - I hope everything will be ok for your and DC2.
Would you consider an elCS? They can be rather nice experiences.

[mackerella]

Thanks for the replies, very helpful. I actually spoke to my midwife this afternoon and she confirmed what you've all said: that they will not induce me with hormone drip due to previous CS. As they couldn't actually induce labour last time with just pessaries, and as I'm probably going to have to deliver even earlier this time, I think I'll give up on the idea of an induction/vaginal delivery and just agree to an ELCS

I agree that an ELCS could be a nice experience, PacificDogwood! My previous CS was not actually an "emergency" in the sense of a crash section, but it was done with only a couple of hours' notice (delay because I'd already eaten breakfast when they decided to do it ). I think it went down in my notes as a "scheduled emergency" whatever that means! Even so, it was very calm and orderly, and I felt that I was in safe, competent hands. I guess an ELCS would be like that but even more so.

[olivo]

Mackerels, I had an emcs with DD1- she wouldn't have made it without. I was then told that I could not be induced with DD2 and due to polyhydramnios and diabetes, was offered an ELCS. It was an amazing experience for us both, compared to the worrying rush that produced DD1 safely. I knew to take it easy and healed well, driving after 2 weeks.

[bonzo77]

I had a similar situation with both pregnancies. Ds1 failed early induction due to failing placenta. No contractions of dilation after max doses of pessaries, drip and ARM. Then a non-crash EMCS. With DS2 I was initially told no induction but if I laboured naturally they would try ARM and / or augmentation if required and I consented. Or I could have a CS if I preferred. In the end, I had a semi- elective CS as scans showed a failed placenta and it was believed that DS would not cope with labour anyway.