To refuse induction due to covid

[leggingsandwellies]

Due DC2 in a few weeks time and it's looking likely I might need to be induced. No partners allowed on induction ward at all, no women allowed to leave induction ward at any point. With DC1 I was on induction ward for 4 days and it was horrendous and very traumatic.

Would I be being unreasonable to request a section instead of induction as I can't bear the thought of doing that again but by myself this time? Found it traumatic for a multitude of reasons.

No, I would in your situation. In my last induction it was my partner who noticed the baby’s heart rate had dropped leading to emergency transfer to labour ward. I would not have noticed, was in too much pain, and no midwife in room with us.
Had an emergency section in the end anyway.
I hope you get what you ask for

You are well within your rights to ask for a section. I didn't have an induction last time but ended up on the drip for 8 hours without pain relief (long story) and I've made it clear that it won't happen again. If my labour is not progressing as it should I'll have a section, not 8 hours on one intervention after another. The doctor has agreed to it and put it on my notes.
Good luck OP, wish me the same, today's my due date!

Long inductions are awful. Did you have a section last time or have naturally in the end?

I’ve refused to be induced this time and have elected for a section- but I had to have an emergency section last time after 4 day failed induction. (Not refused due to covid, I just don’t want another failed induction and then section. Chances are 1:4.
I’d rather an elective and had it booked at 19weeks pregnant.

Some trusts let you go home after induction to progress at home, is that not an option?

Of course you’re not unreasonable to request a c section if you consider the risks more acceptable than the risks of an induction. Presumably if the hospital wishes to induce you there is a medical need for the baby to be born soon, so if you are unwilling to consent to induction but happy to have a c section they should accept this.

I was planning to refuse an induction if necessary because I wasn't comfortable with various aspects of the process. I don't blame you for not wanting to be stuck on your own on an induction ward for days on end, especially with no guarantee it will even work.

I'd have no hesitation in requesting a c section in your position

You should discuss it with your midwife. A middle ground option would be to decline induction on the ward and ask to go straight to labour ward and just have your waters broken. As you have had a baby before there is a reasonable likelihood of this being possible. Obviously if your cervix is tightly closed that won’t work but a high proportion of women who have given birth before have a cervix that is already slightly open by the time their induction date comes around.

We usually still offer the usual gel/pessary before trying to break the waters because there are some benefits to doing that but if you don’t want to go to the ward it would be worth discussing the pros and cons of declining it with your midwife.

@WorriedNHSer

You should discuss it with your midwife. A middle ground option would be to decline induction on the ward and ask to go straight to labour ward and just have your waters broken. As you have had a baby before there is a reasonable likelihood of this being possible. Obviously if your cervix is tightly closed that won’t work but a high proportion of women who have given birth before have a cervix that is already slightly open by the time their induction date comes around.

We usually still offer the usual gel/pessary before trying to break the waters because there are some benefits to doing that but if you don’t want to go to the ward it would be worth discussing the pros and cons of declining it with your midwife.

I’m 34 weeks with my second and v likely to need induction and this is my plan - fingers crossed! At my trust it’s a Cooke balloon not a pessary and all it did was open my cervix over days so I’d much rather go straight to the waters breaking & drip if I can, as it worked well for me. Also I think DH is allowed to be there from when they set the drip.

Thanks all. I've been told I wouldn't be allowed straight into labour room to have waters broken, under no circumstances could I leave the induction ward and do any of it at home, and I asked about maybe having the first pessary and seeing if that worked but was told no, would have to be the whole two pessary and gel thing once I've started. I did manage to have a vaginal birth last time but still feel very traumatised by the whole induction experience!

With DC2 I arrived at the hospital to be induced (medical reasons) - they checked me on the antenatal ward and I was already 2cm (was having no contractions etc, they said it’s very common with second or subsequent babies). They took me straight to labour ward, broke my waters and DC2 arrived 2 hours later (no drip, no pessaries).

I would escalate to the Head of Midwifery and request that you are given an internal by the community midwife prior to going to hospital. If you are already dilated enough to have your waters manually broken there is no reason they cannot take you straight to labour ward and do it when you are admitted.

Obviously if you don’t want to go through induction in any form then yes you should absolutely be entitled to a c-section - maternal request is enough of a reason.

Good luck!

Why are they thinking you need to be induced? You can go to 42 weeks safely if a normal, healthy pregnancy.

I had cholestasis last time and my bloods are heading that way this time too, hence the probable need for early induction again

My experience of induction was hell, was in hospital 11 days overall. And got severe pnd from it and had a section anyway and then a poorly baby from things been missed and ignored. No way would I go through that again and a million percent no on my own! Do what you want to do/what is right for you, your baby and family. Hope all goes well.

Oh OP I could have written this back in September. I feel for you.

I also had a traumatic induced labour with my first a few years ago, and was convinced I would refuse induction in favour of a section for any subsequent children. It took a long time to come to terms with my birth experience.

From someone who’s been there and come out the other side, I will say what everyone said to me (which I didn’t believe) - second labours are usually faster, and there is every chance things will be different this time. Even if you do end up having to be induced.

What really helped me was speaking to a senior midwife from the birth reflection service. It was invaluable and without it I don’t think I could have gone through with another induction. Would this be an option for you?

This time round I waited for two days alone on the induction unit prior to having my waters broken, which was actually fine. Lots of online tv programs, films, and reading. The peace was bliss! The labour was shorter (9 hours vs 36) and I had the vaginal delivery I was aiming for. I was so worried and yet couldn’t have asked for a better outcome.

Hypnobirthing also helped. As a PP said you can go past 42 weeks with expectant management, which I considered but was too risk-averse to go through with.

At the end of the day if you want a section, ask for it. I’d never go through another traumatic induction for any money.

So sorry for the essay. Sending all the virtual hugs 🤗

My only worry about asking to have my waters broken on labour ward is that I would need to be checked on the antenatal ward and if I'm not very dilated would feel stuck there, if that makes sense, without my partner, and I'm not the most assertive of people so would find it difficult to demand a section instead at that point. If I can get the section agreed to now I feel it'll make my life a lot easier.

I would much rather give birth vaginally and am very much hoping to be allowed to go to term this time and to go into labour spontaneously, but it's looking more and more likely that this won't happen currently!

OP I feel for you. I had a traumatic induction and there is no way in hell I’d have been able to do it without DH. He was my absolute rock throughout. Please advocate for yourself and escalate it if needed, don’t be fobbed off. Good luck and I hope everything works out for you

OP, what a tough situation to be in. I think you are absolutely right that if you cannot go full term, to request a c-section and refuse induction. I can’t see any reason why a consultant would refuse you this.

OP if you would much rather give birth vaginally, would you have any regrets further down the line about booking in for a section now? Not being an arse, just sometimes it helps to lay out your options and think about some possible scenarios.

Obviously nobody can predict what is going to happen but it seems like you have three options at the moment:

1 Wait for spontaneous labour - assuming all is well with baby have you any idea how long you might be prepared to do this? Would you accept a membrane sweep to try and hurry things up?

2 Accept induction of labour at the end of this waiting period or if deemed necessary beforehand. You could stipulate in your birth plan after a certain amount of time in labour, or if facing an assisted delivery, that you want a section

3 Ask to book in for a section now

Is there a medical reason you may not be “allowed to go to term?”

If it's obstetric cholestatisis/ICP - look up the charity ICP support. There's been updated research in recent years. If your bile acids remain low then there isn't evidence that there is any greater risk to the baby than for any other women giving birth- you can find details from the charity.
Also in terms of what you are "allowed" - it's always your choice whether to have an induction- so even if they advise it and you want to wait a few more days and see if something happens naturally its your choice.

Op I was induced with my first in the first lockdown. Partner had to drop me at the front door and wasn’t allowed in at all until I was in active labour the midwifes came and met me to help with my bags and stuff at the front door. 3 days later, by myself in a room begging for relief and being so scared they finally sent me to labour ward, got to see my partner for the 17hrs I was in active labour which I can’t really remember as I was in that much pain by that point, then for an hour after my EMCS then was taken back to the ward and didn’t see him again or anyone at all part from the staff for another 5 days ( nothing to do with me but DD was quite poorly and wouldn’t feed ) it’s totally put me off having another baby if I’m honest.

I would never get induced again it was horrific and I know it would be different if we weren’t in a pandemic but since you know, I would push for a section. None of the faff and they are trying to get you in and out as quickly as possible so you shouldn’t be there too long.

Good luck @leggingsandwellies hope everything goes well for you and your dc

Thanks all- I'm sorry so many of you have also had traumatising inductions. The doctors have agreed to my request of section instead of induction, and I have another consultant appointment next week to review my cholestasis bloods and see if early delivery is necessary following current guidance.

Being induced (for me) was horrific. I was fine then BAM and still everything that could go wrong did. YANBU OP.

Good for you OP.

I'd be sure to make them aware that all the draconian 'under no circumstances' approach to induction has been a major factor in you opting for the more expensive for them and invasive for you (but doubtless probably safer and less stressful under the conditions they wished to create) elective section!

How far do you live from the hospital? Ask if you could have regular monitoring as an outpatient (in DAU) until you are favourable for ARM (breaking of waters).

The biggest indicator for a successful vaginal birth is a previous vaginal delivery. The labour, unless very complex, has less bearing and virtually all second births are far quicker and smoother than first. You could say that you put in the hard work the first time to benefit you later.

Discuss options with your team. You are perfectly within your rights to decline IOL but there are plenty of middle ground options to explore before you ask for major surgery that may have been medically unnecessary.

Having had both a long induction and a section I would go for the section every time. Induction was hideous for me and the experience left me with PTSD for years afterwards. I had a lovely section the second time (I had to have one, I had placenta praevia) but I would choose that again for SO many reasons.