Induction after previous natural labours

[Smoochyschmoo]

I'm due to be induced next week (at term) due to health issues if I don't go myself before then, I've previously gone into labour twice spontaneously so don't know what to expect but I've heard some horror stories...

Firstly with having 2 previous vaginal births does this make it more likely the induction will work quicker? My cervix is soft and 2cm dilated of that makes a difference too...

Secondly is it worth dragging DH in with me when I first get started? I know it can drag on...

[FATEdestiny]

It's with some trepidation that I answer...

Three natural, virginal births with spontaneous labours. DC4 was induced (overdue). I reckon my body knew what it was doing because none of this drawn-out stuff you hear about with inductions taking ages. No contractions for about 4 hours after pessary then suddenly they started. And boy did they start!

I'm used to slow, gradual build up of contractions. This went from zero to a million in, like, a nanosecond (so it seemed). No gaps between contractions 20 minutes after they started. Constant waves and high level pain. I assumed I was ready to push.

Cervix had other ideas, it was evidentally not as quick-off-the-mark as contractions were. No dilation. Pessary pulled out because baby showing signs of distress - on the assumption contractions would slow. They didn't.

Category 1 Emergency C-Section (means baby had to be born within 20 minutes of the decision).

I had no epidural in place and no time to site one, so mine was a general anethetic. I don't really know what happened but the trauma of it all affected DH tremendously. I'm thankful I have few memories of those few hours.

I have an adorable 2 year old now though. That is all that matters from it all.

[Smoochyschmoo]

Eeek fate! The midwife has said obviously even though it's booked I don't have to go through with it, but I'm very much struggling to get through the days looking after my other dc so think it would be for the best. In the meantime I'm bouncing on yoga ball hoping this helps my cervix along.

My consultant said being induced shouldn't increase the change of emcs but I've read otherwise , first was forceps and that recovery was bad enough!

[DoctorMonty]

Hi Smoochyschmoo
Short answer - yes - your womb will already have oxytocin receptors left after your last two deliveries so it should be relatively plain sailing for you.

If your cervix is soft and 2cm you may not need the pessary/gel, they may go straight to breaking your waters. If your body starts contracting after the breaking waters, you may not even need the drip!

The good thing about the drip is it starts low and can easily be turned down or stopped. The gels cannot be stopped once they're in, so if you are very sensitive to them it can lead to the situation FATEdestiny describes. Theoretically the pessary is more controllable because it can be taken out, but it takes a short while to wear off.

The purpose of the vaginal gels/pessaries are 1) to make it possible to break the waters, and 2) prepare the cervix and require less time on the drip. In my experience, doctors tend to be keener to perform a difficult ARM (water breaking), midwives tend to err on the side of giving you vaginal prostaglandins to ripen the cervix further. If you're really worried about what FATEdestiny describes, you can ask them to break the waters whenever possible, and to use a pessary rather than a gel. Then, if you start to get significant contractions, you can ask for an examination immediately.

Personally, it sounds like you might be able to go straight to the waters-breaking phase.

Finally, contrary to popular belief your consultant is right - there has been a couple of good studies now suggesting induction does not increase the chances of emergency CS (in fact, slightly decreases it) and similarly does not affect the rate at which people need forceps etc. There will always be individual cases like the one above that buck this overall trend of course.

Hope that helps!

[goingagain]

I would ask for least invasive methods, if health issues allow. I had two natural labours after waters breaking spontaneously for first two babies. With no.3 I had a sweep on morning of due date - was 4cm and v favourable (my body seems to do that though, I was 4cm for days with no.2 who was 5 days late in the end). Later that morning I had some bleeding, more than is apparently normal. I went back in and consultant (seeing someone privately) wanted to 'get going'. He wanted to break waters to check they were clear (baby was showing no signs at all of distress). He did that and they were fine so I asked just to be left for things to crack on, which they did.

I acknowledge they could break my waters as they were basically bulging at 4cm but worth insisting on the path of least intervention if you have had two straightforward deliveries before?

[Smoochyschmoo]

Thank you doctor how very informative! I'm hoping my cervix works in my favour, today was sweep number 2 - its soft and 'at the front' she said it's still quite long though but that it tends to dilate and thin at the same time with subsequent labours so she said that doesn't mean anything really.

going I agree it's a shame to mess around with induction when I've gone myself previously, especially as 2nd birth was lovely and straight forward, this is why the consultant suggested waiting until 40 weeks rather than 38/39. I'm so very desperate now though, I'm in excruciating pain most of the day and my dc are suffering as a result 😣. I'll see how things look with my cervix when I go in and see what options are available, although hopefully baby will appear before then (last one was 9 days over though so unlikely!)