It’s a birth one…

[parker380]

If 1/3 of labours in your trust were induced

50% of inductions are EMCS

And 50% of births overall in your hospital trust in any given month were caesarean sections - including both planned and unplanned

What would you choose for yourself if there were risk factors which meant they want baby here before due date?

Our hospital’s maternity unit has also reportedly been at capacity this week and diverting labouring mums to other hospitals and using the birth centre for beds.

I like statistics and I’m looking at all of this and thinking my chances of an interventions-free birth seem pretty remote. My experience of care so far as an outpatient has been pretty good, I cannot fault it. I agree with the consultant that there are medical indications for baby to come around 39 weeks and trust them with this. I am wondering about going straight for a planned CS. This is what others in my due date group have done but equally I don’t want to select major surgery if I don’t have to, but perhaps that’s a less stressful option than labouring in an extremely full hospital for days and then requiring the surgery anyway, as an emergency.

I don’t want a football team and have plenty of support around me for recovery. DH will have 3 weeks off work. I’m back and forth on this and cannot make up my mind, no matter how much research and how many similar threads on here I read.

Is it your first?

I had a vaginal birth with DD1 and was then induced at 37 weeks with DD2 due to PPROM. My induction was great - 11 hours start to finish, no more painful than my first.

But if you're looking at statistics, is an induction more likely to end in a c-section if it's the mother's first vaginal birth?

From the way you've written your post it sounds as though an elective C section is the best bet. What concerns do you have about that? (Sorry - that sounds narky. I don't mean it in a challenging way - I'm genuinely asking what your concerns are so that posters can allay them.)

Thank you. Just major abdominal surgery, the recovery time, pain afterwards, effects on breastfeeding, effect on future pregnancies (if we have any more).

Yes, first. Yes first time inductions are much less likely to be successful than those in subsequent pregnancies so I’ve read.

In your shoes I'd go for the elective c section if baby has to be out by a certain time. I'd definitely not go for induction. You never know, you might go for the c section and baby might come naturally before your date. Good luck with whichever one you choose 😊

Honestly I think it’s a really personal decision, statistics can help give you a picture of your chances to an extent but only you can decide how you feel about your odds and what you preferences are/how you think you could cope with the different outcomes.

My daughter is 6 months old now and I was induced, I knew my chances of that induction resulting in a c section were around 50%, but personally for me I was really keen to avoid a c section as I didn’t like the idea of major surgery and recovery. An induction gave me at least the chance of a vaginal birth and for me that was important, induction wasn't nice, took a long time and I ended up having an episiotomy and forceps delivery which wasn’t nice and it wasn’t the most pleasant, but it did mean that really within 3 ish days after birth I wasn’t really in any pain (everyone is different), I was walking, carrying baby, going shopping etc without being in any real discomfort and by a week later I just felt back to normal (again, I know everyone is different though). I stayed in touch with 2 of the women on my labour ward who both had c sections and they were still really struggling with pain and discomfort 2/3 weeks later, and I can imagine how hard that must be and how I would have found that.

I knew that a c section wasn’t my preference but was totally prepared to accept that if I needed one in the end then I could cope with that, I knew there was a chance and made as much of an educated decision on it as I could. I was at peace with that.

I do know though one of my friends was in basically the same situation as me and she opted for a c section rather than an induction because with the statistics she didn’t want to risk the stress of an emergency c section and preferred to just have a plan and know what was going to happen.

My local hospital is like this.
I had an induction which ended in emcs.
Next time I just had the planned I feel I should have had first time!

I was induced - first and only baby so far. It was a very long process but it was fine.

All fair points. But equally, all of these will be magnified if you end up with an emergency CS. It's so hard to know what the right answer is.

Bear in mind that emergency C sections following failed inductions don’t necessarily feel like emergencies. I had a successful induction but friends who had to have a C section following a failed induction were not rushed off to theatre with medics looking panicked and alarms going off. In one case the induction drugs failed to cause any contractions at all so they slotted her into theatre for a C section when it was convenient that day and another’s baby was having some decelerations on the drip (this is quite common) so they moved to C-Section. That one happened quite quickly but she already had an epidural in so they just bolstered that and did the section of few minutes later. So quick, but calm.

Yeah this OP. My induction didn’t progress much for the first 24 hours and they told me if it didn’t pick up then I’d have to be booked for a c section the following day, so not an emergency situation, just that induction didn’t work.

I think I’d go straight for a planned c-section. I had an emergency one after a very long and painful back to back labour with DS by which time I was exhausted and subsequently really struggled to bond with him. My recovery was fine and I didn’t really need painkillers after the first couple of days. In fact I forgot a few times I’d had major surgery and had to be told to rest.

I had a planned c section at 39 +1.
Now I did feel like I'd had surgery and unfortunately had PPH. However, breastfeeding went well, and within a few weeks I was out having little walks, and I had no lasting side effects of the ELCS.

I didn't want a long induction. I was incredibly anxious for my entire pregnancy due to IVF, previous losses. Everyone agreed it would be better for me if baby was born on a specific date without any delays. I also absolutely couldn't have coped with any interventions, ventouse, forceps etc. And of course no one could guarantee that this wouldn't happen.

I’d go with a different hospital frankly. In the trust where I had both mine, 10% are planned home births and they have a lower than average rate of intervention. I had 2 planned home births that were very straightforward. I got one-to-one care and a named midwife, with my 2nd, all antenatal appointments were at home (except scans or anything that required the hospital). The quality of care made a huge difference in outcomes, I think. Ultimately though, it’s about agency and being in control of your choices. I think you should opt for what will be most likely to give you choice, agency and control.

I was induced with the drip but baby got stuck entering the birth canal so ended up in EMCS. As PP have said, it didn't feel like an emergency. Baby born 2 hours after decision for a section so not a true emergency. I felt in control of the decisions (and had thought about all the different labour routes) so had a good c-section experience. But I said I would never be induced again.

Tried for a VBAC with DC2 and was successful. Had a great experience. With that baby, I was advised not to go beyond 40+6. So I had a c-section booked for as late as advised and hoped to go into spontaneous labour beforehand.

Pregnant now with DC3 and will try for another VBAC. If any funny business, very likely to go straight to c-section rather than be induced but need to look at sucess of induction stats following a spontaneous birth before deciding.

I had an induction with my first and it went really well. Something people don't often talk about here is if you are favourable for induction. I would book an induction with the proviso that if you are not favourable and/or it doesn't progress within 24 hours, you would like to have a c-section. I was told I could ask for one at any time.

In my opinion, the worst possible sucessful birth outcome is to labour for hours and hours and then have a emergency c section.

You end up exhausted from the labour, emotionally wrecked from the decision making of going for an emergency c and if the baby is ok, and then the physical trauma of anesthetic and a c section. And you have a new baby to look after and get no proper sleep for at least 12 weeks.

If you will need to be induced early with a high chance of ending up with a c section, I would go for a planned c section every day.

What’s more important than looking at the general numbers for the Trust is to find out what the chances are for women like you, ie. those with similar medical and obstetric histories - your obstetrician should be able to help with that and support your decision making. ‘Normal’ birth by any of the available routes is a retrospective diagnosis (even elective sections get surprisingly funky from time to time) and it’s important to focus more on your specific set of circs and where your balance of acceptable vs unacceptable risk lies.