Induction - posting for traffic - any midwives or others can advise?

[wombatron]

Apologies for this being in the wrong place, but I do need some speedy answers.

Long story short my home birth plan has gone to pot (as they sometimes do) and I'm facing induction. I'm either due to go in this evening or tomorrow at 38+6 today or 39weeks if tomorrow. Attempted a sweep successfully yesterday and midwife said I was 3cm dialted and if she'd wanted to she could have broken my waters.

Sadly the sweep doesn't seem to have taken much affect within the first 12 hours as id hoped but I've been active non-stop since I got home yesterday at 4.30pm (with exception of nights sleep) and then this morning since 7 (just had a 2hour nap to conserve some energy).

The plan was to be propes first for 24hrs, then the prostin ... then we start looking at the drip if I am ok to continue.

Though the midwife that did the sweep did say that I may not need all the steps if I'm dialated and soft.
If I'm still 3cm (or more) on administration can they not just break my waters? Will they need to administer the prostin or the gels if I'm already favourable and dialated 3cm or more?

Sorry if that's not coherent, the hospital feels like it rushes you through a bit and does what's easier for them and I do wonder if it's always what's best for me. Thank you!

Hi, is this your first baby? Why have they recommended induction so early?

Why are you being induced @wombatron ?
I cancelled mine with my first because I believe that for the majority, babies arrive when they're good and ready and induction makes things longer and harder than they need to be. As it turned out my baby came that same day anyway!

If there's an overwhelming reason that your baby needs to be out in the next day or so then your doctor will have insisted that you go in. How are you feeling about it?

Oh I'm sorry I forgot this part @Stopittt79 @QueenEnid

First baby.So they weren't happy with the growth of the baby - I had a day where I didn't feel it move as much (Tuesday) so went to the MAU. From there they asked if I wanted induction which I wasn't really sure why for, and the consultant midwife agreed to me leaving if I came back the next day for monitoring and a scan. So they have had me in for monitoring (Tuesday, Wednesday and Friday) and a scan on Thursday. The scan showed as dropping from 50th centile to 10th growth wise and they have recommended induction.

I'm not high risk in their eyes, but I think for them it's better safe than sorry. It seems I'm naturally getting myself there and I am quite frightened of induction.

Baby is estimated weight @ 6lb 9oz as of Thursday. So doesn't seem particularly small, but it is obviously less than what they estimated on my growth chart at 8.5lb (though they did say that's not really that accurate).

I don't think simply breaking your waters is the recommended treatment anymore (I forget why)
Why don't you want the gels and pessaries? (No judgement either way but they're relatively easy to deal with)

The drip does make it more painful, make sure your waters are broken before they use that

The aim of the pessaries are to get to a stage where breaking your waters is possible. If your cervix is quite thick still then they might do the pessary first to try and give you the best chance of contracting, but if it's thin then they'll likely just break your waters straight away. Good luck

Am watching with interest as currently in same boat... am currently 38+2 with our first and induction has been mention due to low growth...

Bubs is currently guesstimated at 6lb2 and Doppler is high end of normal so as yet we’ve been booked in for extra monitoring and Dopplers with a veiw to a stretch and Sweep at 39 weeks...

Really hoping to avoid full on induction as I don’t want an out of control extra painful labour...

Hope it all goes ok for you op if your in a position to update pls do xx

My first I was induced at 2cm dilated due to fetal concerns. Propess appeared todo nothing but I went into labour 2 hours after it was removed and she was born 40 minutes after the first contraction (15 minutes ‘official’ labour)

DC3 I was 3cm and we went straight to breaking the waters. Went into labour quickly maybe 30 minutes later and she arrived within 3 hours from waters breaking.

Slow growth and reduced movements is a high risk factor for stillbirth. I’d be cautious about declining induction.

My personal experience of induction was positive and I think if you’re ready it is often fine and it sounds like you are.

Oh and both mine were 39 weeks so early inductions.

@partysong I don't particularly want any of it and they don't really give me answersbut I was wondering if they still did just break the waters but perhaps not now due to lack of labour and infection risk.

I thought the pessary and gels were to soften and open the cervix, but if mine was soft and 3cm (or hopefully more) already I wondered if I'd need it, that's all or if I could have my water broken would that kick start the rest of labour. Do the gels also do other things for labour?

I had premature rupture of membranes and needed induction. I was 3cm and had a favourable cervix before I needed to be induced so they didn’t do the pessary. They did manually break some remaining waters and gave me as long as they could to go into labour properly so I could use the pool. I did need the drip though as I just wasn’t ready.

I went in for induction at 38 weeks (because of complications).

Was found to be 2cm dilated on arrival so they took me straight to the delivery room and broke my waters. Contractions started immediately and my son was born 3 hours later with no further intervention.

Fingers crossed you have a similar smooth time

I had a sweep and was induced at 38.3 weeks! I was 1 cm dilated and soft, had the pessary around 10 am, waters broken 10pm and baby born at 4.03AM! Induction isn't always awful! Your body is clearly ready for labour to start maybe breaking your waters will start it all of xx

I had an induction. All done in 2 hrs. They're not always bad.

Oh you're all making me feel so much better. It was the idea of waiting for 24 hours, then another 24hours, then another if they broke my waters. I'm hoping I can use the pool!

Dilatation of the cervix is only one factor in a primigravida
How high the presenting part is in the pelvis is relevant
the length of the cervix and its thickness is equally relevant (effacement)as that needs to occur first
The cervix is a long thick tube with two openings the internal and external Os effacement and dilatation starts at the internal Os and as it gets taken up it thins and dilates you are eventually left with the external Os which becomes classed as fully effaced and thin which is often about 3-4 cm with good uterine contractions and a well fitting head dilatation will then continue and established labour progress
Induction is a process to stimulate the above to happen
Without knowing more than dilatation it is difficult to make a judgement on how easy an induction would be or. What method is most appropriate
Good luck HTH

The gel and pessaries are synthetic prostaglandins which help to soften and dilate your cervix.

When you go for the induction the midwife will do a vaginal examination and you’ll be given a BISHOP score which is to assess if your cervix is ready for induction. The Bishop score is based on the station (position of the baby’s head), dilation, effacement (or length), position and consistency of the cervix. A score of eight or more generally indicates that the cervix is ripe, or 'favourable', meaning there is a high chance of spontaneous labour, or response to interventions made to induce labour.

Vaginal examinations are subjective so even if your MW said you were 3 cm and she could break your waters the MW at the hospital will complete a vaginal examination and calculate your Bishop score. She will either offer you the pessary or the gel to further soften and efface your cervix, or if she can reach your waters she will break them. You’ll then have a further vaginal examination within 2-3 hours and if you’re not any further dilated or not having contractions or if they become irregular you’ll be put on a hormone drip to start/increase the strength of your contractions.

You’ll be able to use the pool unless you need to have the hormone drip.

If you're 3cm already then it seems your cervix is favourable. Good luck!

I was induced at 36 weeks had been having pre term labour that they had been stopping off and on from 28 weeks was 4-5cm dilated cervix was short and soft. They went straight in first step breaking waters left for a couple of hours to see if anything ramped up itself which it didn't (baby threatened to come so many times then at induction it didn't want to shift typical !) And then they put the drip up baby born couple of hours later all in all from start to finish 6 hours
Good luck OP !

Take the less art it is more successful than ARM alone x

Pessary

Thank you all. I actually spoke to a really helpful midwife, I'm urgent but not emergency and the labour ward is full at the moment so still time for spontaneous labour!

She did also say that as I am not having contractions they won't break my waters as a method alone, so I will have either the gel or pessary to start those and I'll need continuous monitoring as growth issues are sometimes due to placenta issues and contractions can put more stress on the baby and that when in labour so I can say farewell to a water birth, but if I'm ok so far along they will let me labour in the pool for a some stints at a time. Baby is still moving but if that changes go to the MAU.

In the meantime there is still 24 hours for this sweep to have worked (remaining positive) and I can feel pressure and movement down there so fingers crossed.

I was induced at 38+3 for small gestational age. I never had any pessaries though. I got to the hospital at 1cm, had my waters broken and was hooked up to the drip to start contractions. DD arrived 7 hours later.
Maybe they have different policies in different hospitals but don't worry, it'll be over before you know it. Induction is a boring waiting game but it's not so bad.

@sayanythingelse how did you find the drip? They did just say (I've come in for monitoring as induction is not happening today due to the wards being busy) but as I may be dilated (obviously pending all the checks) I could potentially be put on the drip straight away. The drip was actually my line in the sand and I didn't want to go there.... I'd discussed ELCS with my
Midwife a few days ago if pessary and gels didn't work.

I was induced by breaking my waters only - no pessaries/gel needed as I was already a couple of cm dilated, and no drip as contractions started a few hours later.