Advised to have c-sec at 41 weeks, and no induction.

[Divvy]

Just been to see a lovely consultant today, due to my c-section 1 year ago, after 3 VB.

My history is

1st baby 4 days early, vb
2nd baby 12 days late, vb
3rd baby 11 days late, induction, vb
4th baby 12 days late induction, emergency c-section. due to failure to progress, and fetal distress.

Consultant is shocked about the last c-section (so was I!) and can see no reason why I didnt labour as before.

Has advised a c-section at 41 weeks, but the ideal is to go into labour myself, and he advises againt induction this time.

I am very happy with his advice, but dont most have c-section booked for 37-38 weeks?

Also I doubt very much if I will go into labour myself, so would it not be best to go for c-section at 37-38 weeks?

Whats to be gained from the extra weeks? (apart from hoping I go into labour)

Leaves me in a limbo still, dont it?

Thankies

20+3

[sophiewd]

Oh Gosh don't know what to say, I have just been booked in fro section at 39 weeks, was induced with DD but failed to go into labour and had section as DD was distressed. They did try to persuade me to do VBAC but didn't want to as didn't want an emergency again. If you have made up your mind that you want to have a section then I should talk to consultant again and push for an earlier section. Good luck with what you decide.

[Lulumama]

well, you have had 3 VBs, so odds are you could have another this time..... failure to progress is such a catch all term, and really, if you went into labour spontaneously, there is every chance you could deliver vaginally.
i had em c.s first for failure to progress, and i know exactly why i failed to progress.. perfectly normal VB second time

37-38 weeks is not ideal for a c.section, closer to the due date is as less chance of breathing difficulties in the baby.

why don;t you want a VBAC?

some consultnats won;t induce after a c.s due to the increased risk of rupture

[mazzystar]

I think that they try to do sections as close as possible to 40 weeks now to avoid potential neonatal breathing complications

As I understand it the chances of uterine rupture are increased with induction post c/s. Not sure by how much, but my consultant also advised against it, though would have allowed it had I wanted.

Try not to think of it as limbo - more Plan A and Plan B.

[Divvy]

Plan A and Plan b sounds alot better, thanks

Not against vb, but just dont see me going into labour myself from track record.

I would much prefere a vb, as I found the c-sec much more painful than my births. I think its cos I wont be ready for it mentally.

[needmorecoffee]

after 3 sections I was told I would have another one at 42+1. Went into labour at 42 weeks exactly. They don't like induction for a vbac as it increases risk of uterine rupture.

[Lulumama]

if you would prefer a VB , go for it , with a cc.section perhaps at 42 weeks as a back up plan.. it seems from what you have posted you do go over 40 weeks!

a good proportion of induced labours can end in c.section , if the body is not ready, then induction can be slow . also, if you have an epidural or are immobile for long periods of time, that can slow or stop labour...the position of the baby can be a factor, one that is still quite high or is not in a great position can slow labour too

[bigcar]

Going for a section at 41 weeks has probably been advised to give you time to go into labour naturally on your own first. If you don't want a vb ask for the date to be bought forward.

[maxbear]

No one should be booked for a cs before 39 weeks unless there is a very good incdication (high bp, poor growth of baby etc) If all elective cs were done at 37 - 38 weeks there would be more babies needing special care for breathing problems. Why would they do a cs at 41 weeks? Is there any reason not to wait until you go in to spontaneous labour and if it really isn't happening to have a cs at 42 weeks? Sounds like you have a section happy consultant to want to do that in someone with your history. Good Luck

[whomovedmychocolate]

I believe the figures are: uterine ruptures for VBACS after 1 section - 1 in 200 (but this is all sections, some are more risky - classical incisions, higher on uterus incisions etc). The risk when you have induction with syntocin induction in particular is much higher and highest with something called cytotec.

There are no collated figures in the UK which associate induction with uterine rupture (we don't collect them) but the figures from the US suggest the risks are something like 1 in 150 after induction with a VBAC.

(According to the exceptionally boring obstetrics manual I'm ploughing through - I'm looking for evidence but at this rate I'll just batter my obstetrician round the head with it instead - it's thick enough!)

So that'd be why they don't want to risk induction. The more enlightened consultants seem to have recognised the relationship between induction and rupture.

In terms of dates, planned CSs have moved from a standard 38 weeks to 39 weeks plus for women who have an established history of post term dates.

God I'm getting boring in my old age

[Divvy]

Ah thanks for the info, I was thinking of older school, when they were 37-38 weeks, but now I see that its the normal now.

Plus as he does want me to really go into spontaneous labour, the longer the wait the better.

Personally, I am not happy to go over 12 days late, just because it causes me alot of emotional stress.

The reason he came up with failure to progress for me was that maybe, as the baby was still very high up, and even though the contractions were very painful and strong, they were not pushing the baby down for some reason.

So after induction, he said, that the prostaglandins can pool on the cervix, and cause it to swell, which he thinks from my labour records is what happened to me.

Why the baby would not come down, and cause the needed pressure, he doesnt know.

[terramum]

Divvy can I be nosy & ask why you aren't happy going past 40+12? You wouldn't technically be late then as the normal length of pregnancy length is anything between 37 & 42 weeks....and from your OP it does seem your body just cooks babies for the longer side of normal iyswm.

[Divvy]

Nothing other than too scared to wait any longer than that.

Is that a good enough reason? Dont know?

All I know is that all of my over due babies have all pooed, either before or during labour..is that normal for over due babies?

Seems I know so little, but am scared of so much!

[Lulumama]

a good proportion of post dates baby will have pooed. not neccesarily anything sinister . some women need to cook their babies longer than 40, 41 or even 42 weeks. there is not a huge amount of stuff about as not a lot of women get that far due to induction of labour

[FAQ]

divvy - you could go into labour on your own - don't doubt your body.

I had spontaneous rupture of membranes with DS1 and DS2 - with nothing else happening. Ended up with a CS with DS1 (no contractions at all - long story....), DS2 (at KGH where I presume you'll be) I was induced 4 days after my waters had gone and had my VBAC. Both DS's were in odd positions too.

Was pretty convinced my body didn't know how to go into labour........but I did (and my waters didn't go first) and I had an amazing birth with DS3 in a perfect position

[Divvy]

New problem now!

After seeing my dd in hidious pain during her labour on Saturday/Sunday.....I think I just want to go straight to a c-section now!

Seeing her like that has done me no favours mentally!

I know I was like that during my other labours, but to see it happening to someone else......and there was ALOT of screaming on that labour ward that night!

It was hidious.

Maybe cos its just happened its so fresh now, I have 19 weeks to forget about it now....lets hope I do!!

[Divvy]

Oh, and after 4 girls, we are having a boy! Very happy with him.

After holding dd's son, I realised that I would quite like a boy myself!