In labour - need urgent advice!

[Ineedadvicee]

Well.. kinda in labour, kinda not!

Waters broke 27 hours ago, arrived at the hospital shortly after they broke but contractions failed to start. The hospital said that if nothing happens in 24 hours (24 hours after works breaking), they will start the oxytocin drip to get things moving. Apparently they can only allow 24 hours as you are more prone to infection once waters have gone.

Problem is… the 24 hours are up but there are no beds on labour ward so they want to take me in for a c section. I’m gutted because I haven’t even been given the chance to try for a vaginal birth… of course I need to follow their advice but it seems so unfair that the reason for the c section is purely down to lack of beds, not because of anything medical?

I don’t know what to do…

The decision may now be out of your hands but I had a similar situation and if I’d known what I’d know now I’d take the section in a heartbeat. The oxytocin drip was horrifically painful as really the baby wasn’t ready to come and the contractions were basically constant as they couldn’t get the drip levels right. It was a cascade of intervention which ended up as an instrumental and a PPH. My second birth was an absolute breeze in comparison - very easy, no drugs. On my birth plan for my second baby, I said I wouldn’t consent to the drip again and if a similar situation arose I’d want to go to section.

Agreed. Major abdominal surgery is a wonderful thing when it comes to saving babies’ and mothers’ lives. To do it for the sake of an empty bed?

I had major abdominal surgery for something else 9 months ago, and I still struggle to sit up from lying down (I have to roll over to my side and push myself up), and have painful nerve tingling, which can apparently last 2-3 years. It’s not fun, and I’d be really passed off if I’d have had to go through all of this unnecessarily, for the sake of no empty beds on a labour ward. (And I’m super fit, BTW—I do fitness 5x per week, so it’s not that I’m in bad health.) Abdominal surgery is a BIG DEAL.

I’d do the safest thing for my baby. If they need to be delivered which they do. Then I’d have the section.
ive had 2 sections and it’s not grim at all. Recovered fully within 2 weeks. I was up and about within hours and pain free by D3 and doing housework/driving etc. after a couple of weeks. Way better than induction which I’ve also had and much faster recovery.

But it is major surgery that comes with it's own risks and it should never be the default option unless the mother wants it.
She is perfectly entitled to try and induce and then if it becomes necessary to have a c section after so be it.
I think it's disgusting that she's not been given any other options.. Just sounds like they want to do a c section because it's easier for them.

I know that by now a decision would have been made by OP one way or another. But if my waters had broken over 24 hours ago and nothing was happening I would go for the c section as the quickest way to get the baby out.

My third had to be a c section after spending the last two weeks of the pregnancy in hospital. It wasn’t my first choice and it wasn’t a great experience, and it took me a long long time to reconcile with the whole thing. But three years on the experience is less vivid and I have my wonderful DD, which is much more important than how she arrived in the world.

The options aren't really about beds though. For medical reasons their protocol for a woman at term whose waters broke more than 24h ago is to somehow get the baby out whether that's induction or section. People might disagree with that cutoff but it's not a totally non-medical one.

If being induced OP needs a proper delivery room on labour ward with all the various equipment available not just a trolley in a hallway somewhere. (Is she meant to lie in said trolley for a week waiting for labour?)

The old Nice guideline used to talk about starting labour off 24hrs after srom with the aim of delivering within 96 hours. That 96 hour thing doesn’t seem to be in the current guidelines.

as a midwife I agree this is a very odd approach but in almost 20 years I have never known maternity services to be in such a dire state. There are many issues to consider - it may be the case that the hospital does not have a bed on labour ward and a midwife available to care for the op but if has a cs she can be cared for by a post operative nurse. The local hospitals may be on divert and unable to accept a transfer.
The op could be offered antibiotic cover for her prom but if the hospital does not anticipate having a midwife or a bed available anytime soon then they are at risk of her labouring without the capacity to provide appropriate and safe care.
I don’t know the specifics of the ops hospital but I can imagine the challenges being faced if this is considered the preferable option for her. I wish her well and hope a resolution has been found.

Phone around other nearby hospitals, Op.

C-section isn't minor.

Best of luck with everything. This is so upsetting and infuriating because your decision making is being taken out of your hands not by an emergency medical situation but by their shortages and lack of facilities. It is maddening. If this was being advised purely because it was the safest option for you and your baby of course you might be disappointed but you'd accept it. I'd be feeling so pissed off. Make your decisions now in light of the current circumstances with you and your baby always at the heart of things. This curve ball feels very disempowering, but you always have a voice. Make sure your DH/ DP understands your needs and can advocate for you if you are not able to. You might need some counselling after as this really could knock you sideways emotionally. I've had an emergency c-section and a VBAC. Lovely baby was the result of both. You've got this xxxxx

Induction can take days. I was in a bed for five days. Induction didn't work so I had a c section. Was out the next day.

I was induced the moment my labors team realised my waters had gone prematurely because of the risk of infection. It’s disappointing they’ve left you for 24hrs tbh. The risks go up massively AFTER 24hrs so really if things weren’t moving they should have had you in much sooner. I also didn’t want c sections due to the recovery and I totally understand how worried you must be feeling. You’re in an impossible situation. My friends with planned c sections all did much better. Sending you well wishes!!

I had PROM and delivered in Aus and they induced me as soon as PROM was discovered and wanted baby delivered ideally within 24hrs as risk of infection increases so significantly after that is what they explained to me. So not starting labor but baby actually here. I had an induction that night and delivered the next early afternoon thankfully. I’d have needed a c section if my labor had stalled much longer as they won’t mess around with neonatal infections these days.

If the midwives are recommending a C-section I would absolutely go and have one asap. There is a lot of recent literature about what goes wrong when people pursue natural childbirth against good medical practice (in some cases because of their own preferences, in some cases due to midwives being too focused on natural childbirth). The most important part of childbirth is getting a baby out safely and healthily - and having had two C-sections they are excellent for that.

There’s also a lot of literature about what can go wrong with a cascade of medical interventions. Particularly unnecessary ones as is being discussed here.

Medical intervention is not unnecessary here - that's the point - it's just whether its an induction or a c-section. They can't do the former (plus anecdotally I've only heard 100% negative stories about inductions) for reasons out of the OP's control, so the option is a c-section which is generally a very safe procedure with very good outcomes for babies and women. Natural childbirth I'm sure is great if it works (as it has for plenty of my friends) - but if its not working I believe you focus on getting your child out in a safe manner, not chasing your ideal birth experience.

Sorry for the late update and thank you for all the replies.

Baby still isn’t here, I decided to opt for the c section but then they got incredibly busy in the theatres and told me that they would monitor me. I then changed my mind again during the early hours and decided to wait for a bed on labour ward seeing as I was already having to wait for a theatre slot, which I didn’t really want any way!

However.. still no bed on labour ward and a slot in theatre is now free so I’m due to go down any minute.

I haven’t had the best experience and feel really sad if I’m being honest. I do regret not trying to be transferred but I’ve been tired, emotional and it’s been a bit of a shambles from the start.

OP you have dealt well with a very tricky situation, when you are out of theatre with your baby you should give yourself a big pat on the back. Birth is hard enough (no matter how baby arrives) without plans being derailed because of something totally out of your control (ward capacity). Be super kind to yourself. As I mentioned earlier, no matter how baby arrives it is special. Having experienced both types of births (vaginal and ELCS) I would not trade one for the other. One is not superior to the other. I promise you.

Good luck for your CS - sorry things haven’t worked out as you hoped, but a healthy baby is the most important thing here, as disappointing as it is that you didn’t get the birth experience you’d hoped for.

Oh bless you, it all sounds so stressful. Hope your CS goes well, think of those lovely cuddles with your beautiful baby!

Oh OP, really sorry to hear this! It’s hard enough to feel like you are in control with something so hugely variable as labour, let alone to have all the choice taken from you. Best of luck and at least you will have your baby today, which is so exciting.

@Ineedadvicee , wishing you all the best with the C/Section. I am sorry it is not been the best experience or what you hoped it will be.
You will soon be holding your baby. A healthy well baby.
Waiting for a happy update later.

<Big Hugs>. I hope this difficult experience is over with soon. Looking forward to your updates. x

Friends daughter qualified as a midwife in England. Spent some time in different hospitals. Was like a warzone in one city hospital. She felt mothers and babies were at risk. Not the fault of the department just the sheer volume of patients. She returned to Wales on her mum's advice rather than quit. Now she works in an area where the birth rate is lower, they can pick up on issues faster. Mum and babies are safer.

It really is a postcode lottery.