induction or elective c-section with pre-existing diabetes?

[hoxtonchick]

i am a bit ahead of myself here.... and i posted this on another thread but it got a bit lost so am starting a new one (thanks MI & tamum for your advice already).

i'm 14 weeks pregnant with my second. i have diabetes & therefore will be induced before term. last time it was 39 weeks, this time they are muttering 37 but will probably let me go to 39 weeks. i know that this induction is necessary. however, ds just wasn't ready to be born at 39 weeks. it took a dose of prostin, having my waters broken & a synotocin (sp?) drip, 24 hours of labour, ventouse AND forceps to get him out. and i was lying down, continuously monitored for all this time. i had an epidural which worked well (specially as they kept topping it up ), but it wasn't a very pleasant experience.

my obstetrician assures me that it wasn't that unusual for a first labour & this one is much more likely to just pop out. but surely if i'm induced early, this baby won't be cooked either. so i have been thinking that maybe an elective section would be less traumatic & i would feel more in control. though of course the main objective is a healthy baby (ds was absolutely fine, & weighed 7lbs10 so not enormous at all). so help, please, i'm lookinf for some words of wisdom from mumsnet's finest!

[pinkmama]

Hmmm, a dilemma and can't help you with HC. Having had a c section, I would never ever go there again, but mine was emergency, and as such think its a very different experience. Hope someone can help. I will feed you chocolate before and after, which ever you go for!

[hoxtonchick]

you are ace pm

[SoupDragon]

If your first wasn't a biggy, why the need for induction? Couldn't they monitor the size and see what happens?

Not the same, but I was just short of gestational diabetes (if that make sense!). They wanted ti induce me 2nd time round because DS1 was a biggy but I refused and went into labour 2 weeks early naturally anyway.

[kid]

Hi HC, glad to hear the pg is going well, 14 weeks already!
I've had an emergency section and an elective section and they were both very different experiences. Same amount of pain afterwards though! But I felt much more in control the 2nd time round (elective).
Personally I would ask for as much info as possible on every single visit (I'm sure you have already) and basically go with their advice. They will obvioulsy be keeping a closer eye on you. Plus you've still got quite a while to make up your mind and change it again and again, thats what I did anyway!

[hoxtonchick]

they will induce me regardless of the size soupy, as if you go to term the risk of stillbirth rises quite dramatically (something to do the placenta deteriorating earlier). it's a standard protocol as far as i can make out. i'd love to go into labour naturally, though i suspect that they'd still tie me to the bed & stick loads of drips into me for good measure. good thing i'm not angsty about having a natural birth...

thanks for your advice kid (hope ds is in a better mood btw). i think my worst case scenario would be a failed induction followed emergency section.

i haven't mentioned a possible section to any medics yet. am saving that up for quiet day!

any other advice very much welcome.

[pupuce]

I agree with your OB and I specifically replied to you ( a minute ago) in thread on Guardian article.

[hoxtonchick]

oh thank you pupuce - i was hoping you'd see it - off to read your advice on the other thread now.

[SoupDragon]

Had a feeling there was more to it with "true" diabetes. Can't they monitor how the placenta is functioning and make a decision later? PITA if it means extra trips to the hospital I guess.

Chances are your second birth would be easier than the first though. You could always go for an induction (as late as you can make them let you go ) with the proviso that if there is no progress after a set time you go for a c-section. DS1 was virtually 24 hours from very beginning to bitter end and was a ventouse delivery so your's wasn't that unusual for a 1st labour.

[pupuce]

Have you read this thread it is very much applicable to your situation because your labour (even induced) is EXTREMELY likely to be faster and the outcome a straight forward vaginal birth without instrument,.... baby has been through this canal once, will do it again!

[SoupDragon]

"baby has been through this canal once" = "stetched out of it's once taut, pristine shape"

[pupuce]

Soupy - you are one of a few people who had instrument delivery twice but you are such an extaroridnary woman

[SoupDragon]

Nooooo, you'll be pleased to know that DS2 was instrument free (bar a pair of scissors for an episiotomy - my choice)

[edam]

Oh sweetie, so sorry you are worried about this. Would lunch help to take your mind off it? We've made a date, haven't we? [frantically racks brain...].
No ideas, sorry, but will do some digging.

[pupuce]

Oh I have a bad memory than !

[hoxtonchick]

i go to the hospital practically every week as it is & that's just at 14 weeks.... poor ds says in a plaintive voice "are we going to hospital AGAIN today mummy".

i think 39 weeks is the absolute maximum. though i do have very good diabetes control so maybe that might sway them. but even if it's only a theoretical risk, i'm much happier with the baby out rather than in. and 1 less week of being pg isn't a bad thing...

[hoxtonchick]

hello edam. i'm not worried as such, but i just want to be prepared. control freak that i am!

i think we're having lunch a week on monday (24th).

[tamum]

I've just remembered, hoxtonchick- a good friend of mine is diabetic, quite brittle, and she had her first two by CS. For the third one she decided to try for a VBAC and got a lot of encouragement from her consultant. In the end she couldn't because the baby was transverse, but they didn't section her until her due date or soon before, and there were no plans to induce if the baby had been in the right position. She was in hospital for the last few weeks and had a lot of monitoring, but maybe it's worth raising the issue of not being induced a bit more forcefully if you are willing to spend longer in hospital being monitored?

[SoupDragon]

Absolutely, HC. If it helps, I went to hyponotherapy prior to having DS2 because my memories of DS1s labours were so horrid - similar to yours really, on my back being monitored, synotoci drip, oxygen, the works. It really helped me relax and view everything more positively. Whether or not it made any difference to the outcome I'll never really know but I slept well, felt relaxed and DS2 did come 2 weeks early as I'd requested in my hypnotherapy plan

(and I hope it's your memory that's bad and not mine Pupuce )

[hoxtonchick]

ooh, 2 great positive stories from you both. have never in my life considered hypnotherapy soupy, but there's a first time for everything! not sure i'd want to be hospitalised for a long time tamum, not sure either ds or i could take it, but interesting to hear they let her go to term.

[SoupDragon]

I'd not considered it before either!!

[hoxtonchick]

was it the power of mumsnet?!

[edam]

HC, funnily enough we've got an article on hypobirth coming up... will dig it out for you (hasn't actually been published yet, I don't think).
I've got to be in Regent's Park for 1 on the 24th, are you OK for an early lunch?

[hoxtonchick]

early lunch ok with me. which end of regent's park have you got to be?

[hoxtonchick]

just updating this. i'm booked for an induction next week when i'll be 38+2. diabetes control is fine, baby is a good size (2.8kg according to yesterday's scan...). very fed up of being pg in this heat, & ds has chicken pox. fingers crossed for an easy induction.