Induction of labour - did you push for it?

[mears]

Out of interest - most of the questions regarding induction of labour from posters suggest that women are being offered induction post dates when they do not really want it.

IME as a midwife, many women in our unit push to be induced before 42 weeks. They are advised to wait but the consultants say they cannot resist the tears!

What are the experiences out there?

[gingerbear]

Nice thread title mears!

My waters broke on Due date, but labour did not start for more than 24 hours. The hospital's policy was to induce at 24hours post waters breaking in case of infection. (I know from asking questions here on mumsnet that that policy is questionable these days)

[Toothache]

Mears - I would've pushed for induction had I not had both of mine at 39wks. But with my 1st I was in hospital with high BP for the last week. Each time the Doc came round I asked/begged them to induce me!! They were going to but the day before I went into labour spontaneously.

With dd I had a sweep at 39 wks, started contracting properly 2 days later and when they asked to break my waters to speed things along I said YES!. So although I was never actually induced, I did take them up on their offers the 2nd time to speed things along.

[Mosschops30]

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[expatinscotland]

Just curious, can you ask for a c-section over induction?

[mears]

You can ask but would be advised that C/S is not advisable unless there is a reason for it. Always best to have baby by vaginal route if possible. A scarred uterus can have an impact on future pregnancies.

Rather than have C/S instead - do not have induction unles there is a reason for it.

If you get to 42 weeks and have not gone into labour spontaneously then C/S may be a possibility depending on clinical findings. More women would go into labour on their own if they were not interfered with so to speak.

[emmatom]

I have a chronic back problem and had bad SPD so when I got to the point of not being able to function, with a toddler already in tow, I self referred to the hospital.

I said I wanted to be induced, a very pleasant consultant who said you know your body etc. etc. and I was booked in the next morning.

I wonder if it helped that I was a mature mum, who just expected to get what I knew I was entitled to.

[coppertop]

With ds1 I was offered an induction at 41 weeks. I'd had problems with my blood-pressure throughout the pg and the consultant told me that it had got to the point where the risks of waiting outweighed the benefits to ds1. I was happy to go along with this so have no idea what the reaction to a refusal would have been.

With ds2 I had been told quite early on in the pregnancy that I would probably need an induction to avoid complications. Again I was happy to go along with the medical advice and didn't feel as though I was being pushed into anything.

[expatinscotland]

Thanks, mears. Being pregnant again makes me think about issues like this. We do not want any more children after this. I had a very traumatic labour and delivery, and am looking at having to go on anti-depressants antenatally. Needless to say, I have a lot of anxiety about labour - even tho it occurred naturally for me the first time.

[mears]

Although you know your body Emmatom, many women have the same idea and are then totally shocked when induction does not work or ends up in C/S.

I think many women do not realise what induction is like.

[emmatom]

Oh I see. I was obviously lucky then.

[Nemo1977]

i wasnt offered induction until i was 12 days past due date and then they booked me in for 2 days later. To be honest if it had been offered earlier i would have puched for it as i was sooooo uncomfortable and anxious i just wanted to make sure baby was ok as u read all horror stories about placenta deteriorating etc. Also if i hadnt been induced the idea of trapsing tp the hospital every morning while they did obs didnt appeal at all.

[CarolinaMoon]

I was desperate not to be induced . I was offered either induction at 11 days overdue or a biophysical profile scan at 9 days with induction at 14 days overdue if that was favourable, so I chose the latter. In the end I went into labour spontaneously at 13 days overdue. Still ended in a cs tho, ho hum.

[debs26]

i did - was 7 days over with 1st, 7 days under with 2nd. went into labour spontaneously with 3rd and wish i had waited with other two, it was so much easier. if i had been told how unpleasant induction was i probably wouldnt have done it. 2nd time i didnt know it was worse as i had nothing except first to compare to and i was scared that i would be as exhausted as i was 1st time round when i had barely eaten or slept for about two weeks (just because i was so uncomfortable and had no room for food - gave me horrendous stomach ache). complete lack of info. midwife and doc seemed so worried about scaring me by telling me the truth they actually made it worse. i could have prepared myself if they had been honest and been less scared, confused and more able to make the right choices

[anchovies]

I didn't want to be induced as wanted to do everything possible to avoid a cs. I was induced and ending up with a cs!

[mears]

Here is another aspect which as a midwife I find frustrating.

We may have an induction list of women who want to get started. Some have had to have repeat doses of prostin. Unfortunately the labour suite may be extremely busy and then women start to get angry and frustrated that their induction has not been started. The last thing that we will do is start inducing women when we have a busy unit with midwives all busy.

Women who have a clinical need for induction will get taken first. Post dates inductions have to wait but often women don't seem to understand that.

To me the induction process can be such a frustrating experience for women stuck in hospital where they would have been better off at home, in their own beds, waiting for nature to decide when the time was right.

I hasten to add I am talking about normal, problem free pregnancies.

[Nemo1977]

mears we had that explained to us and that even though we were booked for induction it didnt mean it would happen that day etc due to short staffed wards and demand for mws. I was also one of the people who needed repeated prostin gels..think they tried about 5 before just putitng me on drip and breaking my water the next day. Once that happened birth only took hr n half but i remember dh panicking as the mw came in and told him she was off to theatre with someone who was having a cs.

[Socci]

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[Socci]

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[Prufrock]

I do think that it is wrong of hospitals to induce women post 42 weeks becasue that's the norm - I think it's often because it'seasier for them to induce than check that fluid is OK etc.

I do disagree with you regarding early inductions though mears - I was very angry that when I was induced at 36.4 weeks I asked about statson how long it would take/likelihood of it working, and was quoted them without taking into account the fact I was 3 weeks early. I had to deliver then, and ould have greatly preffered to go straight for a c-section, or at least try only one lot of gel and then have a c-section when it was obvious that my body was not responding to the drugs because it just wasn't ready to give birth. Instead I had to wait around for 2 uncomfortable days, usingup a Labour ward bed, until a new consultant agreed to "give up"

[SueW]

The NICE guidelines say that:

at 40 weeks, 57% of women will have had their babies
at 41 weeks, 74%
at 42 weeks, 82%

Isn't it about time we started defining pregnancy in something longer than 40 weeks when women have only slightly more than 50:50 chance of having their baby by the current accepted (in the minds of most of the general public) length?

I believe 'term' is now medically defined as 37-43 weeks but this woolly idea is more than most people want to get their head around, in a world where they are used to having most things under control. If 43 weeks is fine, then give women a due date accordingly and a membrane sweep, if wished, at 42 weeks. At least then they would pretty much know they would have their baby by the date they were given.

As long as pregnancy is normal, healthy, etc.

[pupuce]

My experience is that my clients feel they really should say yes at 42 weeks as they get scared of leaving it longer.... and then tehy try everything themselves too (sometimes at great expense). Of course my clients are probably not run of the mill !
Many women think that past 42 weeks it gets very dangerous to carry on, and apart from CTG they are unaware how they can be monitored. I think postdates are poorly explained.

[CarolinaMoon]

good point SueW. i tried to assume i would go well overdue (doesn't make it any less uncomfortable tho) and was really vague about the due date. i got soooo fed up of people asking 'yes, but what's the actual due date?' - well, i'll just get my crystal ball out shall I...

[tortoiseshell]

I pulled away from it - having been induced with ds at 40+12, and having booked for a home birth, was very anxious to avoid induction. Pupuce was great on here in encouraging me to hold out, and I saw a fab consultant, who said to leave it until 40+15, and then he was quite happy for me to be monitored. Dd was born 40+14, and was a very quick straight forward home birth, so was well worth holding out against induction. I was all prepared to have to fight for right to wait, but would have been very worried and anxious had I been given the 'You're putting your baby at risk' which some of my friends had.

[tabitha]

No, I was the opposite in face as I practically begged them not to induce me with dd1 (hospital wanted to induce me at 10 days late. I held out and she was born 14 days late). I have to admit that, after monitoring me, they were perfectly happy to let me wait a few days.
With ds, I was induced (2 x sets of prostin pessaries) when I was 14 days late (according to hospital's scan date) but it didn't work. After discussing discrepancies between scan dates & my dates with consultant, they were happy to let me wait until I went into labour naturally, which I did 8 days later, provided I came into hospital to be monitored every second day.

[LottieG]

Argh! Was induced with dd and it was HORRIBLE!! Went from 2cm dilated to her being born in 2 hours.

Would do anything to avoid it again.