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Induction procedures

(25 Posts)
GoooRooo Mon 17-Aug-15 18:55:10

In my last pregnancy, my waters went at 37+1. I didn't progress so the next day I was induced, first with the gel pessary and then a few hours later after nothing had happened they put me on a drip and that worked eventually.

During that labour I found the pessary and all internal examinations very very painful. To the point that I had an epidural purely because of those VEs. Much, much worse than the contractions. I realise now that I could have refused the VEs so that had been my plan for my current pregnancy.

Today I saw my consultant (high BMI, over 40 years old so have to be consultant led) who said at 39 week they would do a sweep if I haven't had the baby by then.

I do not want a sweep, ever. The thought of it makes me quite tearful. I find smear tests really, really painful and no one ever believes me but I do and I found the VEs the same. The thought of a sweep makes me feel awful.

If I refuse the sweep there is a good chance they will then want to induce using a gel pessary. I don't want that either!

Presumably I can refuse anything, but if I do that what will happen? Will they refuse to go to a drip without going through the sweep/pessary procedure first?

How do I persuade them to go straight to the drip?

In an ideal world I will go into labour myself before then but I am not holding out much hope!

CultureSucksDownWords Mon 17-Aug-15 19:07:23

Refusing a sweep should be very straightforward matter of saying no if they ask.

It seems reasonable to me to refuse the gel pessaries as well, and ask to have the drip instead. Could you ask the consultant about it at your next appointment?

Also, have you thought about asking for a C section which would avoid all of this as well?

GoooRooo Mon 17-Aug-15 19:10:26

My next consultant appointment is the 39 week one (I'm 34 weeks) so at that point I assume they will suggest I get examined and have a sweep. I will be saying no. I wonder if they will let me go over 40 weeks rather if I insist on not having the sweep or the pessary. I don't want to go over. I want this baby out!

I don't want a C section either if at all possible - I have had abdominal surgery in the past and the recovery was awful. I don't want to do that with a newborn and a 3.5 year old.

CultureSucksDownWords Mon 17-Aug-15 19:19:00

I didn't have any VE before labour, just one sweep which I agreed to as I was already a couple of days over due date. I could easily have said no to the sweep, as it was offered rather than pushed iyswim.

I think you need to have a discussion with your consultant about all of this and explain what you won't agree to. If they try and persuade you to agree then I would ask them to explain why they think the sweeps/pessaries/VEs are necessary, and what they are concerned would be the risk if you refused. Ultimately you can refuse to consent to any treatment but it would be a lot less stressful if you were able to get agreement (or at least not opposition) from the consultant.

GoooRooo Mon 17-Aug-15 21:22:31

Thanks Culture. When the consultant today said about the sweep I just let him carry on, I couldn't muster up the strength to say 'no, I don't want that' but I think I'm going to have to brace myself for it. I wish I didn't have to wait five weeks to have that conversation as I'm going to be so worried about it by then.

lunalovegood84 Mon 17-Aug-15 21:30:37

You can definitely refuse a sweep, no problem with that. However, you cannot have the syntocinon drip with intact waters as far as I'm aware. How do you feel about just waiting to go into labour? Or asking for an ELCS?

dragonflyinthelillies Mon 17-Aug-15 21:36:14

I too found VE very painful, I had gas and air for some of the sweeps I had which helped massively.
Although they did nothing and I wouldn't have any again, you can definitely refuse.

I could be wrong but I'm pretty sure they can't give you the drip until your waters have gone. The point of the pessary is to get your cervix to a point where they can break your waters.

If your cervix is favourable then you could probably skip the pessary, but you would need a VE still and another one to break your waters.

In short I think it's impossible to have an induction without VE

Nobody can force you to have an induction and it hopefully won't be required. But it is definitely worth taking over with your consultant

GoooRooo Mon 17-Aug-15 21:36:20

I definitely don't want an ELCS. That would be my least favourite option.

I don't really want to wait to go into labour and go over 40 weeks either and they are not keen for me to do that because of my age and increased risk of still birth.

I feel like I have no choice but to allow a VE/sweep/pessary/amniotic hook in order to be induced and it fills me with absolute dread.

GoooRooo Mon 17-Aug-15 21:40:32

dragon I'm sorry to hear you suffer with the VEs too, it's hideous.

Lonz Mon 17-Aug-15 21:48:56

I wasn't induced or anything, but had my waters broken "to deliver baby". The waters don't need to be broken and there is no significant evidence that shows breaking the waters speeds labour up at all. Baby's can be born with the waters intact. Could you ask them about this?
If I had known I wouldn't have allowed my waters to be broken.

Why are they obsessed with breaking waters? It's only to see if there's meconium there but surely there's signs of fetal distress.

ohthegoats Mon 17-Aug-15 21:54:53

'I wonder if they will let me'

There are no maternity police, no one is going to come and drag you to delivery. Make a choice about what you're happy with and stand your ground.

GoooRooo Mon 17-Aug-15 21:57:02

But I don't want to go over 40 weeks ohthegoats

What I want is to get to 39 weeks and for them to say right we're doing a sweep, I say no, they say gel pessary, I say no, they say drip, I say yes.... but I don't think they'll allow it.

I think they'll make me either have a sweep/pessary, or insist I just wait until I go into labour naturally. Neither of which are options I care for and I can't see how I can force them to let me have the drip.

CultureSucksDownWords Mon 17-Aug-15 21:58:07

My waters went spontaneously after the pessary, so it's absolutely not a certainty they would need to artificially rupture your waters.

You could maybe contact the supervisor of midwives at the hospital and ask to have an appointment with her to discuss what is possible and what is not.

GoooRooo Mon 17-Aug-15 22:05:01

That would still mean having a pessary Culture, which I don't want.

I think I'm going to have to resign myself to eating shit loads of pineapple and curry and trudging up and down the stairs for as long as I can bear once I hit 37 weeks.

Sillysausage2 Mon 17-Aug-15 22:09:34

I would much rather have the sweep if it meant going naturally myself rather than being induced.
I was induced on my second last week after going 13 days over again. I didn't have the gel this time as your cervix doesn't close gully after your first baby so they can break your waters without it.

Examinations and sweeps are uncomfortable but for me they are nothing like the pain of the intense false contractions caused by the drip and I would have done anything to avoid it again. Unfortunately there was no avoiding it, I had a really good midwife who only increased the syntocin dose once as I was having proper contractions myself.
My first labour lasted 7.5 hours from when I started the drip but this one was only 2, I was very upset over not going myself and really dreading it (I even tried castor oil) but it really wasn't as bad and it's the end result that counts

CultureSucksDownWords Mon 17-Aug-15 22:19:33

Having had a read of the NICE guidelines (googled and found various versions) it looks like just using the hormone drip to induce labour is not recommended, and that the pessary is more effective and results in less C sections.

So I guess it's likely that the hormone drip would not be offered before the pessary.

My point about the pessary earlier was that you could be "lucky" and one use of the pessary could start the whole process off. You could then refuse further VEs, so it could just be one examination (for the pessary) and no more. Or, you could just go into spontaneous labour anyway, hopefully.

GoooRooo Mon 17-Aug-15 22:35:14

My experience of the pessary last time was that it was AGONY to put it in. Followed by several VE's to see if I had progressed at all (I hadn't) followed by yet another VE before they would put me on a drip. At least 6 VE examinations by that point, plus another half a dozen at least while I was on the drip - while I sobbed through each and every one of them.

GoooRooo Mon 17-Aug-15 22:40:38

I should say the induction took ages. Waters went 3am Monday. Pessary went in 9am Tuesday. Drip went on Tuesday evening at some point. Baby was born 9pm Wednesday night. It was looooooong.

CultureSucksDownWords Mon 17-Aug-15 23:07:26

That's really similar to my experience too. It actually took two goes at the pessary to get anything going, waters broke after 2 days plus in hospital. Then it all ground to a halt, contractions stopped, so they started the drip. Another 30 hrs of pointless contractions followed ending in an EMCS as DS was completely mal-presented and basically stuck. So about 5 days in hospital before DS was born!

Let's hope that you have a spontaneous labour this time and don't need to go through that whole palaver again. If it does happen, I guess you can stress that VEs need to be as few as possible.

GoooRooo Mon 17-Aug-15 23:13:17

Yes let's pray to the labour Gods grin

I have to get this baby out myself. It's the only option.

DunderMiffed Tue 18-Aug-15 03:43:58

Were the VEs painful from the very beginning? It may be that the pessary was painful because your cervix was already sore from the VEs up to that point? I found my cervix got sore and the VEs got worse and worse but the pessary (which was first) wasn't that bad as nothing else had been done that day. I used gas and air for the last examination before my epidural (drip here too) and it was better. I wonder if you could have a diamorphine injection before the pessary? Might help with the pain and relax you a bit.

BBQueen Tue 18-Aug-15 03:57:38

Hopefully you'll go into labour naturally, but if not (and I mean this in the kindest way possible) you might have to resign yourself to the (relatively) short lived pain of VE and use all the pain relief options available.

If you compare it with the potential pain associated with ELCS, which you might avoid, then it might be more manageable.

GoooRooo Tue 18-Aug-15 07:50:08

BBQueen that is exactly what I might have yo do to avoid a c section but it's still such a stressful prospect.

Dunder. Yes painful from the first VE before they even inserted a pessary. I have the same painful problem with smears so I think it's just one of those things I suffer from. My mum is the same. I can't use gas and air - it makes me vomit.

DunderMiffed Tue 18-Aug-15 10:19:43

I couldn't stand the gas and air either, I would speak to the consultant about the pethidine or diamorphine injections if the pain is causing you this much panic - again I have no idea if they would help with this type of pain but worth asking.

I know how knobby this sounds but i did pregnancy yoga and the breathing techniques were really helpful every time my epidural wore off.

GoooRooo Tue 18-Aug-15 12:19:35

I know how knobby this sounds This really made me smile - it's like you know me. I am the least likely person ever to try yoga. I'm such a cynic, but I really appreciate you trying to give me alternatives to deal with it!

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