Does anyone know the percentage of inductions that end in instrumental delivery/EMCS?

[AngeloMysterioso]

I’m 40+3 today and have been told if I get to 40+10 I’ll “have” to be induced (I have GD). From what I can gather a large percentage of inductions seem to end in an instrumental delivery and/or EMCS- it’s certainly gone that way for literally everyone I know who’s been induced, which isn’t a small number- so if it’s going to come to that I would rather schedule an ELCS and save myself the potential pain/physical damage/MH issues (I have a preternaturally visceral fear of instrumental delivery) and if I go into natural labour before that, great!

I know there’s a whole week to go yet and baby could show up any time, and I know that natural labour could still end in c section, but my mental health is hanging by a very thin thread currently as it is, and I don’t want to spend the next week terrified that my worst fears about childbirth are more likely to come true with every passing day.

I’m going to discuss this with my MW team tomorrow but was wondering if anyone knows the official statistics on this? I’ve done a bit of googling but can’t seem to find the right information.

Nobody??

I am a biomedical scientist (althought not specifically in anything to do with reproduction) and have questioned this myself. I spend a few hours looking through medical research data bases for an answer to no avail.
Hopefully someone else will answer and this will provide a bump.

I don't know the figure but I think it's quite high. You can add me to the list of people that had an emergency C-Section following induction too!

The numbers are quite old but I find this at RCOG
www.rcog.org.uk/en/guidelines-research-services/guidelines/induction-of-labour/

OP, I don't have the stats to hand but I remember being given them when discussing my induction 5 years ago (so may be out of date). I recall it being something like 30% resulting in EMCS for my hospital (I don't remember now whether that was just EMCS or surgical intervention too). I remember thinking the odds weren't great tbh. I do know quite a few people though that got through induction without resulting in intervention. It's just I know a lot more that DID end up with intervention (me included, I had an EMCS and it was an emergency). After a fairly traumatic experience with DC1, I initially considered VBAC but only if labour was spontaneous as I felt the odds of induction leading to intervention were too high. In the end, I went for an ELCS for DC2, and it was the right choice as I too was terrified of facing instrumental delivery after previous complications. For DC1 I'd hoped to do a water birth but due to some high risk factors that got ruled out by the time I was term, and I felt completely comfortable that both my birth experiences were sections - I have never felt I lost out by not giving birth vaginally - although of course it would have been bloody good not to go through the emergency situation.

I had an induction and instrumental delivery with dc1. It was actually fine. It was also my worst nightmare when I was pregnant, but if you told me I had to do it tomorrow, I'd be fine with it. My recovery was great as well. Very few stitches, (I had been using something called an epi no, which I think helped, but it's basically like perineal massage which I think you could still do at your stage, but don't quote me)!

Dc2 was a ELCS, which was a lot less tiring and a lot quicker than dc1 birth, but recovery was harder and it for some reason took much longer for me to be able to have sex again after dc2 without discomfort. I have no idea why. They also were about a second away from using forceps during the CS, but then dc decided to cooperate. I think instrumental deliveries are quite common in CS too!

Both births were fine, but neither were a walk in the park. Seems that is the case for the best majority of births.

There is no right or wrong way to give birth and it never goes to plan. Don't have it in your head that instrumental means an awful birth and ditto CS. Both are usually fine.

*vast

I remember looking into this and it was quite high, but I can't remember where I got the data from - somewhere deep within the NHS pages of their website.

If you look in the childbirth section on here, there are a few threads on maternal request c-section which had this sort of data. Been a few years since I looked though.

Statistics vary from hospital to hospital - hopefully your midwife will be able to tell you the stats for your hospital . Discuss your fears around birth with her .

I was induced for GD at 38 weeks and had a perfectly straightforward vaginal delivery.

Anecdata aside, the info I was given by the GD midwife was around 1/4 of inductions ending in c-section. I don’t know if that was UK wide or just my particular hospital/trust. What I wasn’t told which bugged me was the reasons - I.e. what proportion of those were inductions due to being overdue, elective inductions, inductions for e.g. blood pressure or GD. They did also tell me the proportion that resulted in vaginal births with forceps, ventouse etc but I can’t remember it, this was a couple of years ago.

Hopefully they’ll give you all the information at your next appointment to make an informed decision.

Thanks for the responses all.

I am currently hoping to have a water birth, but that’s something else that’s off the cards with induction- I can labour in the water but not deliver, apparently.

I’m less worried about c section than instrumental, at one point I was considering requesting an ELCS and not even attempting a natural birth.

I’m less worried about c section than instrumental, at one point I was considering requesting an ELCS and not even attempting a natural birth.

I was exactly the same - I even had it in my birth plan to go straight for CS! But honestly, it wasn't that bad and my recovery was completely done with within a week. Me telling you that probably won't change your mind if you're set on a CS. I almost asked for one too with dc1.

Tbh, it makes very little difference. If you want one just ask for it. Both are risky, but that's childbirth! There is no risk free option, so it is just down to personal preference.

However, if you told me I had to go through my induction and instrumental delivery tomorrow vs my CS and recover, I'd personally take the former. Just don't give me a newborn to look after please !

Just wanted to add to your list of people who have had straightforward induction.
Both my DC were induced and had very few problems throughout the process.

I went into labour naturally with DS1, still ended up with a spinal in theatre having forceps. I failed to progress, didn’t have an epidural either.

My DSis has been induced twice, first time not an assisted birth. 2nd was assisted - but she’d had an epidural and his head was tilted so needed forceps to get his head out correctly.

With my 2nd I was due to be induced but had a sweep and went into labour naturally - Have you had a sweep OP?

I had to have forceps, this was also my worst nightmare, but actually recovery was okay. The only painkillers I had in the days following were paracetamol, and as I'd already had a spinal my stitches painless, and also have healed nicely. If you are really worried then please talk to your midwife, looking at stats doesn't really help as you could be 1 in a million. C section can be a long recovery.

Also, I don't think my pot belly will ever recover from my CS. Just a vanity issue though, so obviously it was worth it! But it still isn't great. Whereas, I felt exactly as I had before after vaginal birth, within about a week. Had sex again after a few weeks with no problems etc. It was much harder after dc2 and it took months till I could have sex again without real discomfort. Again, it was worth it, but I think women are sold this idea that a CS means zero damage to that area, but actually, the baby's head can sit pretty low. As I said before, my surgeon was about to use forceps to get my doc's head out during my CS, as he was really jammed in there. Just because the damage is internal doesn't mean you can't feel it!

I never would have advised people to go for VBs before I had my DCs. I would have been secretly thrilled if the doctors had told me I had to have a CS with dc1. But since then, I really would go VB if I could.

But again, it's so personal and there is no right or wrong way. Both of my births were totally fine. I could do either again if I had to, but again, I do not want a newborn to look after please and thank you.

I would imagine that induction takes place mostly when baby is rather late...so the head bones will possibly be starting to fuse...making a vaginal birth possibly more difficult.

Newborns have soft moulding skulls, whether it is week 37 or 42, bionic. Barring some severe problem with the skull formation, the bones don’t ‘fuse’ until around age 2.

My dc's head*

Not my doc's head! Why would her head be jammed in there 😂? Sorry .

I didn’t mean completely fused together! Just hardening. The bones less likely to move easily and it makes a straightforward delivery more difficult plus the baby would be possibly be bigger

I was in your position with GD and requested a planned c section. I'm so glad I did. My baby was huge and wouldn't have been able to get out without help. It was a relaxed procedure, and healing was fine. You might have to push for it (pardon the pun) but thet shouldn't refuse you.

Just to add to the anecdata, I've had two inductions (both at 40 weeks) - and both led to a VB without instrumentation.

But I think it is something you need to discuss with your midwife to get the stats and procedures for your specific hospital.

I was worried about the high stats for our hospital too and I was induced on drip at 38 weeks, waters had gone and contracting frequently but not dilating. I had a vaginal birth, no intervention. Used pethidine as pain relief. So it's not set in stone.

I was induced after 23 hours of labour, 10cm and 2 hours pushing they told me I was having forceps and episiotomy but she was too far up so had emcs x

Unless baby is incredibly big (while accounting for the US machine's margin of error) or there's a problem with your placenta, there's no reason to induce. Just tell them you're not doing it, full stop. They can't make you. Unless there's nothing else for it, natural onset of labour is always best and the most comfortable. I would imagine for baby too.