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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

To be reluctant to agree to an induction in these circumstances? WWYD?

108 replies

TinyCIanger · 04/11/2021 10:40

Am currently 36+1 weeks pg with DC2.

About a month ago at 31+4 I paid a visit to maternity triage on a Sunday evening because I’d been bleeding- not fresh blood but dark brown, but wanted to get it checked anyway. Whilst they were doing the speculum exam the midwife remarked that quite a lot of fluid was coming out- I mentioned that I’d been having the odd small trickle for a few days but not huge amounts, and I’d dismissed it as runny discharge (apologies if TMI).

Because of this the midwife concluded that my waters had gone early, and I was admitted for 48 hours as there was apparently a 60% chance that I would go into labour in that time. On my notes the volume of fluid that was lost was estimated to be 40-60 ml. I was given steroid shots to help boost baby’s lungs and put on a 10 day course of antibiotics.

Very early the next morning I was transferred to delivery as I’d been having tightenings, roughly 4 in 10 mins- by the time we actually got round to delivery it had settled down and in hindsight this was more than likely just BH. Otherwise it was an uneventful stay.

I had a scan later that day that showed there was still plenty of fluid around baby, and it’s looking to be a good size. Have been coming in to hospital for regular CTG checks which have all been fine, I’m taking my temperature twice a day which has never gone above 36.9°, bloods and urine have all been normal and baby is wriggling like an octopus so generally, everything seems to be going exactly as it should be.

However due to this suspected PROM (which I’m still dubious about) the “plan” is to induce labour at 37 weeks. The reason for this I’m told is because baby is considered full term at this point and the risk of developing an infection increases from 0.5% to 1-2%.

I really, really don’t want to be induced for several reasons.

I don’t want to force my body into labour, and force the baby out, before either of us are ready.

My birth with DS was rough- I tried for a water birth and was in the pool for a few hours (after waiting 12 very painful hours to progress from 3 to the all-important 4cms when they finally moved me to delivery), eventually after 21 hours of labour and at least 8 hours of agony I asked for an epidural but by that time I was fully dilated so it was no longer an option. 2 hours of pushing followed, but in the end DS was delivered by ventouse with me on my back, legs in stirrups and an episiotomy. Turns out he was back to back, which nobody realised until his head was out. So I was rather hoping for a slightly smoother experience this time around.

If it comes to needing the drip I know I’m going to need an epidural, so that again means no water birth, and an increased risk of birth injuries and instrumental delivery. I am preternaturally terrified of forceps so this prospect scares me shitless. Also increased risk of the whole thing ending in EMCS which means a longer, harder recovery and will impact more on my ability to take care of DS and baby.

DS (aged 2) will be staying with PILs when the time comes- inductions can take days and I really want to keep the time that I’m away from him to a minimum.

All these concerns aside- I just keep thinking this “PROM” happened a month ago and they’ve been happy to leave us be since then, and that aside everything seems to be progressing well. All the checks and tests and scans and whatnot have been fine, perfect in fact- and the amount of fluid lost seems so small, and the level of risk so low, that I’m wondering just how medically necessary an induction really is.

I’ve got a scan tomorrow and am meeting the obstetrician on Monday when the “plan” will be finalised, so I need to gather my thoughts around this- on one hand, I’m not a medical professional and part of me thinks I should just go along with whatever they say because obviously they know best, but then I keep thinking they’re suddenly leaping to being super cautious at 37 weeks after leaving us to it for a month and all these other doubts come into my head.

OP posts:
WendyJames35 · 04/11/2021 14:10

The idea of inducing you at 37 weeks is because you'd then have reached term. If you haven't shown any signs of infection or complications prior to this, the baby is better off not being delivered until then.
I think it is wise to take advice from those who have spent years training and working in their specialist field!

TableFlowerss · 04/11/2021 14:15

I struggle to understand why people would disagree and argue with medical professionals because they don’t want to do be induced and they want to have a dip in the pool etc..

Some of the comments on here, you’d think they offer them for fun because they get paid per induction. Hmm

TableFlowerss · 04/11/2021 14:15

It’s what’s in the babies best interest nothing more

AllieTM · 04/11/2021 14:18

I experienced PPROM and ended up being induced as I developed a very nasty infection which came on suddenly (I went from perfectly fine to gravely ill within 6 hours).

The chance of this happening is small but can be very serious for you and the baby which is why they push for inducing, I assume.

I would discuss your concerns and see how you can move forward in a way you’re happy with and doesn’t cause you undue risk.

Hope it goes well!

TheDuchessOfDork · 04/11/2021 14:37

@TheKeatingFive

Ask for an elective section. If medical advice is to get the baby out then get it out in the least distressing and predictable way.

This is what I would do

Me too.

I've had an induction with drip (at full term 39+5 but because my waters broke but labour didn't start) and it was hellish. 3 days, epidural, instrumental emergency delivery, injuries. Awful.

ELCS for second was a breeze, at 39 weeks, out of hospital in 48 hours and a far, far easier recovery that the first time!

Chiwi · 04/11/2021 14:38

I had an induction at 37 weeks. 5 hour established labour, 20 mins of pushing and a lovely healthy 7lb baby. No epidural, just gas and air. It wasn't bad at all actually a lovely experience, everyone labours differently so I'd do what was in the best interests of my baby every time.

lobsteroll · 04/11/2021 14:54

I'd opt for an elective c-section as well.

StripyHorse · 04/11/2021 16:40

I suspect I had PROM with DD2 but when I phoned the midwife at the time they didn't seem to think it was (didn't ask me to go in). Think this would have been about 35 weeks? Can't really remember now.

I then had a scan at 38 weeks as I was measuring small - turns out I had reduced fluid around the baby. They induced me at 39 weeks (pessary first which did nothing, then the drip).

I was gutted at having to be induced, I had planned a home birth and really didn't want to go in to hospital. But...I felt really looked after. Because I was there 2 days (1 day with nothing happening) the midwife picked the best of the birthing suites for me 😉. She was great at moving the bed into a comfortable position for me when I got tired of bouncing on the birthing ball (who knew they could essentially turn them into a chair!). It was also a far quicker process from steady contractions starting to DD being born than it had been with DC1.

I suppose what I am getting at - is discuss your concerns with DP and midwife; it may not be the experience you hoped for but it may be better than you imagine. All the best.

HeyFloof · 04/11/2021 17:23

@nodogz

Ask for an elective section. If medical advice is to get the baby out then get it out in the least distressing and predictable way.
This.
Merryoldgoat · 04/11/2021 17:32

Having had the induction when I wasn’t ready which was an abject waste of 5 days I’d look at this:

en.m.wikipedia.org/wiki/Bishop_score

Find out what yours is before agreeing. Mine was 1. If I’d known beforehand I’d never have agreed.

ELCS is much better than an EMCS after a failed lengthy induction where risk of haemorrhage increases.

User0ne · 04/11/2021 18:02

Drs and nurses calculate risk on a population level and base their recommendations on that. It doesn't consider what's best for you (or your baby) as an individual - you are the person who does that.

Maternity care is the same as all other medical care - you can decline it for whatever reason you want. It's perfectly legitimate to say that you don't think that induction is right for you at this point and that you'll let them know if you change your mind.

If you are happy to own your decisions then make them yourself. If you aren't let someone else do it for you. I've declined many things while pregnant/labouring (3dc) - it isn't always easy but they are your decisions to make.

DuggeeHugs · 04/11/2021 18:06

There's no way I'd agree to an induction - I foolishly agreed to one before and it failed. It would have to be ELCS or wait for things to begin naturally.

TheOriginalEmu · 04/11/2021 18:14

This reply has been deleted

Message withdrawn at poster's request.

TheOriginalEmu · 04/11/2021 18:16

I dunno wtf happened there…‘start induction it gets harder to stop it escalating to more intervention’ is what I was going for..

GertrudePerkinsPaperyThing · 04/11/2021 18:22

I agree with those who say err on the side of caution in terms of dates. The main thing is to make sure the baby is born safely, and avoid an emergency situation.

I would also think you have the right to ask for an elective section (well, you always do) and that it might be the best option in this case.

GertrudePerkinsPaperyThing · 04/11/2021 18:26

Just to reassure though, I had two inductions at 38 and 40 weeks- no drugs, no intervention. So it’s not all bad.

They were going to let men have a water birth the second time, as first time had gone so well, but the heating/ hot water went off in the hospital (in February!)

Was quite nice for me as I got really hot both times giving birth but not ideal.

Sciurus83 · 04/11/2021 18:27

I would also go ELCS in your position. Having said that a friend just had a successful pretty straightforward induction at 37. Personally if a medical professional tells me the baby needs to come out due to infection risk I wouldn't be pushing back in that.

AHobbyaweek · 04/11/2021 18:35

Why don't you try speaking to AIMS to get all the facts and risks of each side so you can make your own decision. They can also let you know all of your rights and choices you can make.

They will point you to all the research/guidance and balance which might help.

www.aims.org.uk/

TinyCIanger · 04/11/2021 20:55

Thanks for all the responses.

This is going to sound daft, but it hadn’t actually occurred to me to request an ELCS as an alternative to being induced- I suppose because I’ve always thought of sections as being last resort EMCS or planned due to medical need, tokophobia etc. And at no point has any midwife or consultant suggested it to me as an option, even though I have discussed my concerns about induction more than once. But it is definitely something to consider.

I know my reasons for not wanting an induction are largely based around myself - it’s not that I’m not thinking of what’s best for baby, it’s more because the only medical reason for having an induction seems to be because the risk of infection at 37 weeks increases from really minuscule to ever so slightly less minuscule, and everything so far seems to indicate baby is perfectly happy in situ.

I’m trying to compile a list of questions I can ask the consultant on Monday. So far I’ve got:

  • How many inductions at this hospital, at this stage of gestation
a) end up needing the syntocinon drip? b) end in instrumental delivery? Forceps vs ventouse c) How many result in birth injuries to mother and/or baby? Instrumental vs non-instrumental, forceps vs ventouse d) end in EMCS? Awake vs under GA
  • What is my Bishop score? (Have looked through my notes, no mention of it anywhere so I don’t think this has actually been calculated)
  • Aside from losing 40-60ml of what may or may not have been amniotic fluid more than 5 weeks ago, is there anything else that would indicate that induction is necessary?

Can anyone think of anything else I might want to ask or discuss?

OP posts:
Iamuhtredsonofuhtred · 04/11/2021 21:25

Your Bishop score is an assessment of how favourable your cervix is, taking into account position, thickness, dilatation and where baby’s head is; it is calculated after a vaginal examination so won’t be documented anywhere unless you’ve had a sweep or something like that

Iamuhtredsonofuhtred · 04/11/2021 21:25

I would ask for an appointment with the consultant midwife in your position.

whosaidtha · 04/11/2021 21:28

I'd also focus on why it is necessary. What are the risks of not having an induction on baby? On mother? How likely are these to happen? What would the risk factors be if we waited a week? Two weeks? Three weeks? How big is baby- how likely that they may need neo-natal care? How long would I need to stay in hospital post induction? What are the options for a c-section? What are the pros and cons of this? Don't focus too much on your fear of induction and forget to question why they are suggesting it in the first place.
I hope baby comes safely.

wigglerose · 04/11/2021 21:35

I would go for an elective section. I don't know why hospitals are so keen on the rigmarole of induction. Quicker recovery my arse if you end up having an emergency section any way or forceps/ventouse/episiotomy.

Everydayimhuffling · 04/11/2021 22:25

Just to reassure you a bit in case you do end up with an induction: I had to be induced with DC2 at 37 weeks and it was great. They went step by step, breaking waters, waiting, then a low drip which kick-started labour for me. It wasn't ages of waiting for everything to progress and I didn't need an episiotomy like I did the first time. I didn't find the pain more unmanageable than when I went into labour naturally.

Incidentally this was also after failing to get my water birth the first time, and I've subsequently found out that that reduces skin elasticity and can raise the risk of an episiotomy.

NameChange30 · 04/11/2021 22:37

@User0ne

Drs and nurses calculate risk on a population level and base their recommendations on that. It doesn't consider what's best for you (or your baby) as an individual - you are the person who does that.

Maternity care is the same as all other medical care - you can decline it for whatever reason you want. It's perfectly legitimate to say that you don't think that induction is right for you at this point and that you'll let them know if you change your mind.

If you are happy to own your decisions then make them yourself. If you aren't let someone else do it for you. I've declined many things while pregnant/labouring (3dc) - it isn't always easy but they are your decisions to make.

This