Were you informed of the risks of induction?

[minifingerz]

RCOG has done an audit of birth outcomes at hospitals across the U.K.

The national induction rate for first time mums is now about 33% and about a third of these will result in an emergency caesarean, with about another third needing forceps or ventouse.

Wondering how many first time mothers are told that the most likely outcome for an induced labour is c/s or instrumental?

Was anyone here actually given these figures when they discussed induction?

Do you think women should be told this?

[minifingerz]

[[https://indicators.rcog.org.uk here]

[minifingerz]

here

Sorry!

[TheGruffaloMother]

I was told absolutely nothing about the risks. In fact, it wasn't even presented as optional. I was just told when they'd booked an induction in for and that if DD didn't arrive beforehand, I had to go.

She was a forceps birth after multiple complications.

[FATEdestiny]

Induced for DC4. I was told the risks. Ended in EMCS (after 3 children with unassisted virginal births).

I refused induction for DC3 on the basis that they moved my due date according to 12w scan. But I knew my original date wss right based on conception and knowing my menstrual cycle very well.

So I was exceptionally confident I was right. Having said that they made it very difficultto choose not to be induce. I had to travel (40m each way) to hospital daily where I sat on a monitor and was pressured talked to about the risks for 20-odd minutes. They really frightened me.

But but but!

The bottom line is risk. There is a risk to not inducing. There is a risk to baby when assisted or c section deliveries are necessary. It is better to have a healthy baby in non-ideal circumstance rather than risk the death of the child for your ideal birth.

[Crumbs1]

I do,think people need to,do some research and take on some of the responsibility by asking questions. I knew risks 25 years ago, so information is out there. I refused induction and mine usually went over 42 weeks. Two were 43 weeks. All fine and state of placenta was monitored daily so no great risk. The twins were less but still 41 weeks. I clearly had a long cycle and was intended to have longer gestation. Induction could have created significant problems. There are very few babies that remain in Utero until the child can walk.

[minifingerz]

I really wish people would stop bandying around comments about 'ideal birth' when all women generally want is the best chance of a birth which doesn't end up with them having emergency surgery or experiencing severe pelvic floor damage from a forceps birth. Most women aren't looking for an 'ideal' or an 'experience' they just want a birth which doesn't involve lots of birth injuries. It's hardly frivolous or naive.

[Purplebluebird]

No, I was not even told I was having an induction until I came to the hospital for what I thought was a check up! I was already in labour by then so didn't need it in the end :P

[LBOCS2]

I wasn't told any of the risks (I knew them anyway, having done some research myself).

But... I had preeclampsia. So the baby needed to come out, escalation of intervention or not.

[TheGruffaloMother]

I do,think people need to,do some research and take on some of the responsibility by asking questions.

So you'd do away with the medical need for informed consent because if you Google enough you're bound to get the most reliable and up to date information eventually? How far does that attitude extend then?

[PinkSwimGoggles]

no nothing. just the risk to me and baby if I weren't induced.
but anyway, nothing was presented to me as choice in anyway. more like the consultant and midwife made their decisions and presented them as done deal.

[FestiveStinkyPants]

I was informed about the possibility of an assisted birth (forceps/vontouse) and emcs with induction of dc 4, still went ahead and chose to be induced.

With Ds 1 I was young (22 but midwife thought I was 16 till after birth and she checked my notes) my waters broke and I was booked in to be induced 36 hours later, no one told me about any risks then, luckily Ds arrived after 33 hours.

[SocksRock]

Yes. By the NCT. Who had a great big chart that started with induction at the top, and circled down through what they called the spiral of intervention to a big box at the bottom with DEATH MATERNAL AND/OR CHILD in it. As a consequence, when I needed an induction due to being 13 days overdue I was absolutely fucking terrified. Never forgiven that woman, I had a panic attack in the car on the way to hospital.

[minifingerz]

I'm done with having babies but if I was doing it again now I would want to be offered a planned c/s if waiting to go into labour myself or an induced birth with a 60% chance of ending up with surgery or instruments weren't acceptable choices for me.

[minifingerz]

Socks, best not to know possible outcomes?

The epidural consent card informs women there is a small risk of permanent paralysis.

C/S consent forms list death as a possible outcome.

[Crumbs1]

Gruffalo mother, no I expect fully informed consent hence reason to ask questions and expect answers that provide sufficient information on which to base my decision. I think we all have some responsibility for making sure we get that information rather than complaining afterwards that nobody told me.

[Coldhandscoldheart]

No. One of the big issues I have with the experience I had was the lack of information I was given. I was completely blindsided by the sudden instruction that I was to begin induction that evening (persuaded them to put it off til the following day), so was not ready to ask questions.
I wasn't given any written information.

Bear in mind, I'm an educated HCP. I became almost mute with shock & fear. I did not feel it was optional, or that I was consenting. Ended with emcs.

[MyDarlingWhatIfYouFly]

I was told nothing about risk of section/forceps. I had to fight for 48 hours rather than 24 hour wait after waters breaking. I was told nothing during induction (I was barely spoken to) and they just kept turning up the drip higher and higher despite zero dilation and baby clearly in distress.

Thank god the shift changed and a senior midwife hit the emergency button as soon as she saw the trace - it was so urgent by that point that they put me under general. I had no idea if my baby would be alive when I came around.

Worst experience of my life. I was into hypnobirthing and totally natural birth before this. If I have any more it will be a planned section and I'm not budging. The lack of information before and during made a very unpleasant experience a highly traumatic one too.

[FATEdestiny]

Are you projecting minifingerz? That's a very defensive post you've written.

Whilst it's not actually relevant to what I wrote or the points made in the opening post, I'd disagree that "Most women aren't looking for an 'ideal' or an 'experience'". I'd say a large number of expectant mothers (first time mothers especially) have unrealistic expectations on what their birth will be like.

Back to my actual point, before projection misrepresented it), the bottom line is that safety must always come first. Over birth trauma, injury and everything else - life is still more important.

I did a lot of research on the risks surrounding induction refusal. There is no huge jump in risk at 12 days over. It's a gradual increase in risk. I do appreciate they have to draw the line somewhere.

I took the risk to refuse induction for DC3 only because I knew the dates were wrong. So I knew my personal risks were lower because they were based on the wrong date.

I suspected the same was true with DC4 but was less certain of my dates. For this reason I didn't refuse the induction. I firmly believe if I'd have had no induction I'd have had no c-section. But what if no induction had have meant no live child? That's the risk. It's massive.

Doesn't the UK have the very high stillbirth rates compared to other western countries? I don't know how induction, assisted births and c-sections affects these figures.

[TheGruffaloMother]

Crumbs, the OP is asking how much people were told, not how much information people managed to research or prompt themselves. Expecting people to know what questions to ask, especially working at the exhaustion levels of a 9.5 month pregnant woman, is extremely unrealistic. Especially given that you could spend the best part of 9 months wading through all the research out there surrounding all the possibilities in labour.

And, frankly, it's really insensitive to come out to a thread asking how informed people were about the realities of induction and essentially tell everyone on the thread that they should have taken more responsibility.

[SocksRock]

I would have loved a balanced discussion of the pros and cons. Possible side effects with evidence based sources. What I got was a lecture stating that the most likely outcome of an induction was a spiral that would lead to the death of the mother or child.

[Crumbs1]

UK has twice stillbirth rate compared to Iceland -although still very low. Less likely to be around induction and managed birth (where damage tends to be to mother) than older mothers, higher BMIs and a generally less healthy population.

[minifingerz]

"first time mothers especially) have unrealistic expectations on what their birth will be like."

I agree with that.


It's 10 types of wrong that women are led to believe they have a good chance of a straightforward birth then subjected to procedures which make it unlikely, in settings where physiologically normal birth is like hens teeth.

[coxsorangepippin]

minifingerz thank you for the rcog link. I couldn't see the stat on the proportion of induced births that end in instrumental delivery. Could you link to that one or tell me where it is? All the other stats you mention I found easily.
Thank you!

[minifingerz]

"What I got was a lecture stating that the most likely outcome of an induction was a spiral that would lead to the death of the mother or child."

So you weren't told the risks of postmature pregnancy and you were told that if you were induced you and/or your baby would probably die?

Shocking.

I hope you made a formal complaint.

[minifingerz]

Cox, look at the figures for caesarean. The figures for induced labours ending in emergency c/s are in that section.