Induction - yes or no?

[barnconversion5]

I have just read a similar thread to this on Childbirth but it didn't get any responses so I'm hoping the people in Chat would be able to offer some much needed pearls of wisdom?

I am 39 wks & have been offered an induction due to 3 instances of reduced fetal movements. To clarify, baby has been moving throughout but the patterns have changed quite significantly in the third trimester from quite violent kicks/punches to more the fluttering stomach of earlier pregnancy & much less often. At my routine midwife's appointment yesterday she advised me to go in to be on the safe side & this is when they started talking about an induction.

Since the positive monitoring session yesterday, baby has moved quite a lot overnight & today so I'm feeling reassured but I can't shake the feeling that I would rather he/she was here & safely via induction rather than hanging on for a (possible) spontaneous labour. On the other hand, I would rather avoid the medicalised nature of an induction & possible increased risk of c-section etc.

Has anybody been in a similar situation or has any helpful advice to give a nervous & possibly overthinking FTM?

Thank you for any replies!

Not the same situation but I was really keen to avoid induction. However at 40+14 I still wasn’t in labour so went for it and it was so different to what I expected.

The pessary worked for me so no drip, and I was able to walk around, have a bath, sit on birthing ball in the shower etc in early labour, and then even when on the monitor midwife knew I was hoping for an active labour and helped me move around/pace/bounce/rock etc. Definitely not stuck on my back as I’d feared.

So might not be very helpful, but just to say I’d go for it sooner if I felt it was right for my baby next time around, because the midwives were really supportive of my preferences and I gad a good experience, and I’m sure I’m not the only one (and I know from my own reading lots of people who share are doing so because they had a rough time. That happens too of course, but really birth is such a leap into the unknown that that’s a risk however your labour begins.)

I'd find out what your Bishop score is. If it's less than 6 or 7 then I'd ask for c-section instead of induction.

You aired your concerns. She suggested that baby might be better out sooner rather than later.

Could you live with the decision to wait if it goes wrong?

Me I had spontaneous labour with DC1 lovely and calm.
DC2 was induced, 2 pessaries, one long hot bath, 4 wee pills (2x paracetamol, 2x codeine) and baby was in my arms.

My regret is it wasnt the agony I was expecting so didn't realise how far on I was therefore DH missed the birth.

I had an induction for reduced movements. The pessary worked and I went into active labour quickly (completely missed the early stage whilst I was sleeping). Baby was facing the wrong way and got stuck. Ended up with an epidural and forceps.

You have to weigh up the risks. Good luck!

Thank you both for your replies!

It's reassuring to hear that you had a "pleasant" induction Verbena - as you say, you are normally reading the more complicated, negative experiences which of course also happen but it's always good to hear both sides & makes me feel a little more confident!

Thank you Kaytee, I'd not heard of the Bishop score before and just done some reading - I will bring it up tomorrow when I'm back in for more monitoring.

I think my main concern is that as I've not been pregnant before and have nothing to compare this pregnancy to, I'm concerned that I'm overreacting & there is no real need to go through with an induction but they say if movements change......

I would 100% get an induction if advised to by a medical professional. 100%.

I wouldn't take risk, personally. I was induced after I wasn't dilating quickly enough during labour. It was pretty horrendous, I admit, but I'd much rather that than have something go wrong.

That's just my personal opinion

Avoiding..... this is EXACTLY why I feel I shouldn't wait but then baby is moving more once again & I'm stuck in that dilemma of doubting myself (I do have form for this).

It's so helpful to hear these instances of pessaries working as I was (perhaps wrongly) under the impression that they usually don't..... I don't cope well with being stuck in a room on a bed & the prospect makes me really anxious so this is my major misgiving. The pessary working and being able to move about would be my ideal situation second to a spontaneous labour.

Annalogy.... it wasn't so much advice as "this is our policy" because there have been three instances. The doctor said if this was the first time then all the readings throughout pregnancy (& during the monitoring) have been so positive & I'm low risk etc. that they wouldn't be concerned.

The replies are making me feel I should talk to them tomorrow about going forward with it - is it worth asking for a sweep & waiting a day or two? Also, any idea on the time frame of when you opt for an induction & when they start it or is that simply down to availability etc.?

Truthfully I didn't think the pessary could put you into active labour either.
Despite my friend having a similar experience to me. I thought she was a very rare one off. Like me she had backache her waters went, and baby born in minutes.

I was induced for postdates with ds1. I was clear that I would not accept induction for ds2 or ds3 simply for that reason, but that if there was something other than mere dates indicating that birth needed to happen sooner than later, I'd take their advice. That said, if I had been told before 40 weeks that the baby needed to come out asap I'd have been more inclined to ask for a c section than attempt an induction (unless my Bishops score indicated induction had a good chance of success).

My induced birth was absolutely fine, btw- had a pessary, nothing much happened for hours and hours (they said they were picking up significant contractions on the monitor but I certainly didn't feel pains), my water broke suddenly in the early hours, strong and frequent contractions began immediately and ds1 was born 2.5 hours later with no intervention needed.

I did at the end of the second stage need forceps and episiotomy, but that was nothing to do with induction and everything to do with having a back-to-back, brow presentation 10lb9oz whopper! And care was fantastic throughout and during recovery.

Your hospital may be part of the AFFIRM project which has a clear pathway for dealing with instances of reduced fetal movement, towards reducing risks and instances of stillbirth.

I’m guessing the info they gave will all be on your notes, so it depends whether you want to just keep an eye on baby and their activity for the next couple of days or just go in.

A reduction in movement (or being anxious about it happening again) is frightening in itself which might work against the oxytocin needed for labour progressing - so while an induction might get intense quickly, you’re going to be in hospital with monitoring etc available to you to help with some reassurance.

HulaMelody - I think this is the conclusion I'm coming to - kind of it's better safe than sorry & I would have so many regrets if something did go wrong & I hadn't taken action.

Gosh.... 10lb9oz Verbena!!!!!

Really don't think I'm cut out for this childbirth malarkey!!!

I was induced due to leaking amniotic fluid. I want to reassure you that even if you find that you do need the drip as well as the pessary, that doesn't mean you won't get a positive birth experience.

I needed the works with DD, and yes, I did find that it restricted my ability to move around - with the drip in one arm, blood oxygen and heart rate monitoring on the other, and two sets of monitors on my bump (one for the baby's heart rate, the other for contractions), I was confined to the bed. When I needed the loo, it took two midwives to take me and all the equipment and then untangle me when I got back.

But! It was fine. Honestly. I panicked a bit when I realised I would be immobile, as all my coping mechanisms were planned around being able to move. But I was so well supported by DH and the midwife team, so well listened to and cared for that it didn't matter. DD's birth was still a lovely, positive experience.

My only advice would be to be open about pain relief options - but that would be me advice to anyone having a non-induced labour too.

Good luck!

I was induced at 41 weeks due to maternal high blood pressure (it was the earliest they could book me in) and it honestly was fine.

The pessary was fine and I got an epidural before the drip so even though my labour was 26 hours it only really hurt for about two.

I didn't need any instrumental help either as they turned down/off (can't remember which) the epi when I needed to push, and as most of it was pretty painless I wasn't too exhausted.

I ended up with a few tears, two 2nd degree front and back and a couple of grazes but that had nothing to do with being induced and everything to do with him coming out facing sideways instead of backwards and with his hand by his face.

My bishop score was very good though, if it wasn't I'd probably have requested a c section

Hey I've been induced twice my first was horrific only because I was on my own not knowing what was going on and tbh I think I will was already in labour she was born in 45 minutes naturally no pain relief and I had no stictches or tears at all. My second was induced I had mild period pain that went to pushing within 3 pushes he was out, again no pain relief and no after care needed. I would choose induction again x

Really don't think I'm cut out for this childbirth malarkey!!! we’re evolved for it and in my experience midwives are brilliant even when things aren’t quite straightforward.

Next time I’m planning a smaller, right-way-round one , but am absolutely not put off having another and the benefit if they’re big is they’re not quite so hungry and give you a wee bit longer between feeds. I bet you’ll surprise yourself.

Best of luck and keep us posted.

Truthfully I didn't think the pessary could put you into active labour either.

I was induced on my due date with a Bishops score of 6 and the pessary put me into active labour. I had a fairly uncomplicated birth - which is a good thing as the labour ward was incredibly busy and I was ignored throughout despite meconium in my waters.

Having said that, I would avoid induction unless there was an extremely good reason for it. For reduced foetal movements I would go in for monitoring and if that showed the baby seemed healthy I would not choose induction. I also would not accept induction simply for being overdue.

My induction was DC3 (so not sure if that has a baring on things) but I was examined once before the pessary went in and then I was left to it.

Had intermittent traces every few hours and the usual BP checked every few hours too.

I was actually told I could leave the hospital for lunch. I decided not to as I did begin to have niggles immediately after the pessary went in (and did so for the duration)

The pessary worked for me so I can't say what happens if it doesn't but I was 22 hours in, proper contractions started and baby arrived very fast and I didnt even manage G&A. So mine was a very positive experience. Natural delivery, no tears of grazes and no need for any medical intervention (which is a huge irony as the only reason I was induced and couldn't use the birth centre is because I needed monitoring in labour and it was so quick they barely got me to the delivery room.... I'd been moved from another delivery room just an hour prior as I wasn't in labour, went into labour in room 2 but it wasnt a delivery suite so I went to room 3. Another bloody irony, they should have just left me where I was )

I can't offer advice on your particular situation, but I can tell you that every experience is different, and that just because one persons induction didn't go well it doesn't mean that yours won't (if you have one).

I've had 2 inductions, both because I was overdue. My first was long and horrible, but not the worst by anyone's standards, and not due to the induction itself. I had an epidural which slowed my labour, and I became poorly with an infection. So although it was rough, I had no problems with the induction itself.

My second went swimmingly. I was induced with the pessary at 4pm, labour properly started at 6am, and DS2 was born at 10.20am. It was a really positive experience, and though he was born back to back, it was a very straight-forward birth.

Both births were vaginal, with

*With next to no issues

Hit post too early!

Like previous posters my circumstances weren't the same as yours but at 2 weeks over due I had an induction last week, I had a pessary put in at 6pm and baby was born dead on 1am. I had posted on here as was worried about induction and all that could possibly come with it but other than not having any time for drugs other than gas and air it was all very quick with no complications

I got induced at 39 weeks due to 3 episodes of reduced movement (quite similar to yours in fact) movement just got lighter and less frequent although did still happen. Turns out cord broke on delivery as was paper thin so the baby moving less was a way they were conserving energy as weren’t getting all the nutrients. (Even though previous scan showed good blood flow through it etc) all I can say is i would pick induction every single time and I did not have a straightforward birth with a long recovery albeit healthy baby

2 inductions here. First was a good bishop score, rupture of membranes and baby in six hours with no more intervention. Second had pessary with BS of 2, then ARM and drip the next day. Baby in six hours, pain well controlled and little damage. Recovered really well.

Both brilliant and would 100% go for induction if I was to have another.

BTW, the pessary is intended to ripen your cervix if your bishop score is unfavorable. It's only intended to get you to ARM stage. If it's enough to put you into labour it's a bonus. I was a bit worried about the drip, but actually it was very controlled and absolutely fine.

I’ve had two inductions. First was shocking and took 4 days because the mat ward was full and they needed me there to break my waters. However it wasn’t so shit that I didn’t ask to be induced early the second time (mh reasons).

My take is childbirth is always a bit shit. At least with an induction you know when it will be shit and you’ll get a dedicated midwife and a very quick epidural if you need one.

Good luck making your decision kx