Early induction vs csection at 37 weeks(25 Posts)
I was diagnosed with obstetric cholestasis today and the hospital wants to deliver baby at 37 weeks. I go to see the consultant tomorrow to talk it though. I want to go armed with questions and an opinion really.
I'm worried about an induction at 37 weeks as I understand that the process of induction, especially early induction, has a high probability of a string of interventions and csection. Might it be best to opt for csection, if I can, rather than start with induction? I don't know but I am worried. I'm 38, this is my first baby and there are no other complications. I'd appreciate any of your thoughts.
Lots of people are induced and find it OK - no doubt loads of them will come along and post after me! However, my induction was a total nightmare - baby just wasn't ready to come out, and ended in EMCS after 3 days of the medics trying every possible way to fight nature!, so I would not consent to induction again, and would go for ELCS instead every time.
Once I actually got my section it was all ok, recovered really well, much better than many of my friends who had stitches/tears/other injuries after forceps etc.
I had an early induction with my first. Totally painless, but exhausting and nothing happened. Ended in an EMCS because I demanded one after 3 days. If I'd had my time again I'd have pushed for a cs from the start. I was very stressed, by cervix was far from ready and baby not engaged. In your position, unless my cervix was already showing signs of ring ready, I'd be going straight for the cs.
I agree that early inductions are more likely to be horrible and gruelling and ultimately unsuccessful, because the body just isn't ready to go into labour. In your shoes I would choose ELCS without a doubt. Everything I've been told about ELCS says they're lovely, calm affairs.
I had a wonderful drip induction at 37 weeks, no need for epidural. induced for pre eclampsia symptoms.
Thank you both of you for replying. I had a midwife appointment a few days ago, before diagnosis, and baby's head wasn't engaged or even in right position yet. I've not had any Braxton hicks so I am worried about what happens if they induce me when there's no signs of readiness.
Posted that while others replying - thank you for your replies too!
Personally after having two c-sections, the second following an unsuccessful syntocin drip induction I would totally 100% go for a c-section. For me the last hour or so on the drip was about the most horrible experience of my life, and the fact that I chose that option made it much much worse. But of course that is only my experience and yours might well be completely different. The c-section I had with ds was in contrast a totally relaxed experience, with no fear or pain. Just very surprising as we had been planning a home water birth two weeks later...
Ha ha - yes, I'd got a home water birth booked in, so this is a turn up for the books!
I had three days of labour before an unplanned CS and it was exhausting to recover from (not induced, but had a sweep etc). Part of me wishes that the docs had intervened earlier, but I was so keen to try to have a natural birth I'm glad I attempted it (that's very personal & not rational!). Can you agree at what point they will intervene (after 48 hours I really think I was in no fit state to see things through)? If you decide to go ahead with the induction, my advice would be to be assertive about minimising the number of people in the room and try to keep it a comforting dark 'cave' as much as possible. What's your instinct telling you? Will you be disappointed not to give it a go, or do you find the idea of a planned CS reassuring? Both are very valid feelings.
It's a difficult one. I had an induction for being post dates. It didn't go well and I ended up with an emergency section. Having said that DD was in an unfavourable position and not budging. I'm not sure what the stats are for early inductions
But I wouldn't be surprised if the success rate is higher than for post dates.
I think in your position I would agree to induction but have a low threshold to switch to a section if things are taking a long time and you are getting tired.
I think it's a personal decision with no right or wrong answer. you could end up with a CS after a failed induction anyway I personally would go for the CS. I may be wrong but it being your 1st baby, your age and an early induction make it statistically more likely to end in a CS anyway and as others have said a planned section is generally calmer, more relaxed and easier to recover from.
I was overdue and ended up with a failed induction. No horror story as I had an epidural but it was a 3 day process and I was totally knackered before I even came home from hospital - with hindsight I would have been better going straight for a CS. My second planned section was 100x easier to recover from - even though I was chasing after both a toddler and newborn.
I was induced and the pessaries and gels didn't do anything for me. The drip did, but it was pretty horrendous and I ended up with forceps which were definitely at the bottom of my "wish list", well below a CS. If I was doing it again, I'd do the gels and pessaries and if they didn't make any difference then I'd ask to cut my losses and go straight for a CS.
I had obstetric cholestasis and went for induction at 37 weeks, it took two or three pessaries to get labour going and ended in an emergency c-section as the baby was breach. With my 2nd OC pregnancy I was planning induction but ended with C-section as my liver results spiked so they wanted a really fast delivery.
In the run up to the second birth I had had a sweep (my cervix was slightly open already at 36 weeks) and I was having strong Braxton hicks so figured induction had potential. Otherwise I had agreed with my consultant that we would have gone straight for c-section. You can get them to exmine you and assess how favourable / likely induction would be to work.
If I did it again I would probably opt for induction but accepting a) it is a slow process and b) a c-section is still a real possibility. (After 1 c-section my hospital won't offer the drip, just pessaries).
There are advantages of going into labour even if it doesn't come to anything in terms of chemicals releasing that help babies lungs etc (but if you opt for c-section / no induction they will offer you steroids to achieve this).
There is lots of support and advice on the ICP support website and Facebook page (and also a telephone helpline). Including lots of women who have got on fine with an early induction - as well as others who haven't and ended up with a c-section. There isn't one right option.
Good luck and remember it is great news they have identified when they have.
Thank you for your input everyone. I'm off to see someone this morning about it and to 'book an induction.' I hope I'm seeing a consultant but it's Sunday and it's just occurred to me it might be just a routine midwife thing and I've got SO MANY questions.
Mainly I've been up all night worried sick about baby's movements, I think they're fine but I basically want her kicking all the time to reassure me she's ok in there.
Anyway, thank you. It's touching that, during times of need, other people are out there willing to spend time typing for a stranger.
I've had inductions, 2 were long winded affairs, 2 were far far easier!!!
You could say you'll see how pessaries etc. go but you don't want a drip. I could completely understand why you are considering asking for a C-section. I booked for homebirths but always ended up going truly overdue with no sign of anything happening!
Hope the appointment goes well.
He also didn't think it was worth going for pessaries but asking for section instead of drip. Hd thought you should either 'give full induction a proper chance' or not.
I had the same dilemma- docs wanted to induce me at 38 weeks because of my heart condition. Closer I got to the date and the more I researched about it, I didn't feel comfortable with the risks and potential EMCS so asked consultant for Elcs at 38 weeks instead. I'm booked in for New Year's Eve!
I had an induction at 36+5 due to pprom and infection. It failed and I ended up with a crash C-section. I've had a crash C-section and an elective C-section and I think the recovery and pain is about the same (but I got more sympathy with the crash C-section!) so I would go with induction.
I met with consultant today and talked for a long time. He said he'd book me for induction but that at my next appointment with a different consultant (Saturday coming) I could let them know if I wanted a section. I spent all day thinking about it and had to go back in to pick up some medication and said to the midwife that I had decided on the section. She agreed with me and said she would book the last slot for me (six slots a week, five already gone).
She rang to let the consultant know and he said that he wasn't happy with this and wanted me to speak to this other consultant, as agreed, on Saturday. I'm now worried that the appointment will be booked up by someone else and I'll be 'forced' to have an induction. Also, I want it sorted, I don't want it hanging over me all week.
Do you think it's worth ringing tomorrow to insist the section is booked and then we can discuss as planned on Saturday (since they've already done that with booking me in for an induction?)
Difficult for you and they shouldn't be giving you options and choices and then trying to snatch one away from you. I would try to speak to them as you suggest.
Fwiw I had prem rupture at 35 weeks but no labour. Given the choice of induction or elcs and went for elcs as it felt too early to be favourable for induction. Went v well and was happy with my choice but I know other women have had good experiences the other way.
Sorry for the stressful time you are having. I also had signs of OC with my second pg so got a cs at 38 weeks but didn't have to fight for that as had already had one cs so they were not pushing me towards vbac. At least they didn't try very hard.
Hope you manage to get some rest amid the discomfort and the anxiety.
I would ring tomorrow, yes. You don't want to spend all week worrying. If I were you, I'd want the piece of mind of having it booked NOW.
You arent being unreasonable. You've weighed up the pros and cons and made a decision.
For what it's worth I was induced at 36+2 with dd and needed no intervention, actually went into labour much easier than they expected. It was pretty intense though...
If you're sure it's the way you want to go I'd say yes phone tomorrow and insist on the slot.
I did ring and have a slot booked for both an induction and a section. Appt this Saturday to discuss with / persuade consultant. I'm glad I wasn't diagnosed earlier as they couldn't have done anything and I'm struggling to sleep for worrying if the baby is/isn't moving. It's really odd to know I'm not going to pregnant for much longer!
that's good ginger
And good luck with whichever route you end up with.
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