To wobble about my birth choice?

[indecisiveaboutbirth]

I’ve had a low risk, straightforward pregnancy and I’m a FTM in my mid 20s.

At around 34 weeks I was diagnosed with gestational hypertension, so I am now under the consultant. I’m on a low dose of beta blockers which are controlling the blood pressure very well and keeping it within normal range. I’m 37+2 today.

I met with the consultant last week who wants baby here by my due date, saying there is no benefit to staying pregnant beyond that time when there are risks my blood pressure could still rise or that it could develop into preeclampsia.

They would induce at 38 weeks if I wanted that. I am very mindful of inductions causing higher intervention rates especially in first time mums. I am worried my body would not be ready. They mentioned sweeps as an option, I asked about the risks of these and they told me there are none which I know to be untrue. Inductions in my trust are more likely to lead to EMCS anyway. I know I don’t want to be on a ward for days, or in pain/exhausted for days on end waiting for the next stage of each induction and feeling out of control.

With all this in mind I have booked in an ELCS. This was originally for 39+6 but they have found a cancellation for 39 weeks exactly which they would prefer for me to have. I had gotten used to the idea of it being at 39+6 and hoped that would enable baby plenty of time to make their own appearance, which is my ultimate preference.

I’m feeling a bit thrown by it all and not sure what to do for the best. 50% of all births in my hospital trust were Caesareans last month so I suppose it’s relatively likely I’ll end up with one no matter what, so maybe I should just stick to the ELCS?

On the other hand, I can’t shake the feeling that I want to try and labour on my own and avoid the need for huge surgery when I might have a really straightforward birth- given my age and no other risk factors there isn’t any other indication for intervention, particularly as my blood pressure readings are currently good.

I thought where better to turn than MN. WWYD? I know I’ve done another thread but hoping to clear it up on here now my dates have changed it makes the situation a bit different.

Listen to the medical experts, on the whole they know what they are doing. They’ve seen it all before many times.

If they advise a planned section, go for it. Be a much calmer experience than an emergency one (on the whole).

No point risking you or your babies health.

I’d just go for the c section. Pre-eclampsia is awful, I’d do everything to reduce risk of getting that

They didn’t advise the section, they just advised about induction being ideal. When I said I was hesitant about being induced and could I have a section instead, they said ‘yes but it will be maternal request’

Honestly there are pros and cons to either approach, so you have to weigh up what's most important to you. I had a positive induction experience with my first baby, but that was after my waters broke spontaneously, so not sure how 'ready' my baby was to come/body was to give birth.

Unfortunately- that’s just not true. The fact that OPs trust has 50% caesareans tells you that their intervention rate is sky high, way over what the WHO suggests. I’d ask for a second opinion- or ask for the C section closer to your due date.

I've had a section and a vb with induction. Vb every time.

This is obviously anecdotal but I’m sharing because it might help - I was induced at 38 weeks (long story) and basically nothing happened (no contractions, no change to cervix). I think my body just wasn’t ready. After 3 nights (!) on the labour ward I had a caesarean. Next pregnancy I chose a caesarean. No regrets here about never experiencing labour.

Good luck whatever you choose xx

Personally I wouldn't take any risk of preeclampsia and would just get baby here before it becomes an issue by the easiest way possible. Preeclampsia is life threatening and can just appear out of the blue so I wouldn't push it on the premise that it's fine currently so will continue to be fine.

I had a planned c section and it was such a calm, pleasant experience with an easy recovery. Don't fear it! It's universally agreed induction is horrendous I think so I definitely think you're wise to avoid that. Also everyone I know who was induced had an emergency c section in the end so you may as well have a nice c section instead without all the crappy induction for three days before hand.

1st babies are usually late so try not to get too hung up on maybe having a natural birth if you had those extra 6 days, it's unlikely it would make a difference. Even if it would make a difference it's not worth the risk to your health.

I really liked knowing exactly when I was meeting my baby and found being able to plan around it really calmed my anxiety rather than not knowing what would happen when so try to take comfort in it and dget excited for your baby. Good luck x

My section was amazing!! Best experience of my life. Recovery was quick, I was walking around the park on day 3. I would definitely have another one.

What you want really doesn't actually matter, giving new mums birth choices is a placebo, those birth plans go straight out the window when health is compromised. Giving birth, even in the UK is still extremely risky and whatever keeps you and baby safe is the best way forward.

I was induced at 37 and a half weeks due to Gestational Diabetes.

I read all the horror stories and had all the concerns about intervention and emergency CS.

It was fine. I had a pessary inserted, waited around for 24 hrs, then they were able to break my waters.i went for a wander round the hospital while the contractions ramped up. 4 and a half hrs after my waters were broken DD was born , with the help of a bit of gas n air.

Have a conversation with your midwife to understand what the various options look like and what the realistic likelihood is of an induction being successful or moving from induction to CS in the event it's not working.

The main benefit to a VB is the recovery time after, there are pros and cons to both recoveries but for me I was mobile immediately after birth, albeit very sore, and I was out walking slowly with DD in her pram the day after.

With DD2, I had pregnancy hypertension diagnosed at 36w. Mine wasn't well controlled - I was being monitored every 2 days and BP meds were being increased at every appointment. My ELCS was booked at 39+5 due to the Easter bank holiday but the hypertension turned into preeclampsia at 39+2, spontaneously went into labour at 39+3 and DD2 born that day. On the one hand, having the ELCS booked so late meant that I had the opportunity to have my preferred vaginal delivery. However, the last couple of weeks, I think I hadn't realised how unwell I felt (put it down to 3rd trimester tiredness / stress but actually it was much worse), plus once you've had preeclampsia you are greater risk of cardiac disease in later life. So I would have preferred to avoid that risk.

If you want complete control over your birth choice, get an ELCS. I would do that at 39 weeks rather than waiting for 39+6. I wouldn’t take the risk with preeclampsia and there is no guarantee that you would go into labour naturally anyway. If you did, your trust had 50% of births end in a section so presumably they are going to a section before interventions like ventouse.

Everyone I know who has had an ELCS has found the experience really great, really calm and because they knew they were having an ELCS had things in place to make recovery easier. They also weren’t knackered from labouring for days. They recovered better.

FWIW, I had an induction as FTM as 38 weeks. I’d had a failed sweep and no indication my body was ready. I had a really positive experience and I only needed the pessary and no further interventions. The only pain relief I had was gas and air. I had a point at which I would ask for a c-section rather than letting it get to the very end with no other option of EMCS. But I was prepared for my birth to not go according to any sort of plan and that I might have no control.

My induction was fine and I still wish I’d did the section. I think you’ve made a fine choice, OP.

My ELCS was a fantastic experience. I was up and about really quickly and able to stop taking painkillers within a couple of days.

I've had a section and a vaginal. I'd do vaginal 10 times on the trot before I had another c section. I really had to fight for mine. Literally up to the last second. DS and I were both much healthier, my recovery from the c section was horrendous.

If your blood pressure is under control with the meds I'd be going with daily monitoring and regular sweeps.

If you're planning more kids a c section affects your next birth aswell. Increases the risks to both of you and increases the lileyhood of another section. I really wouldn't recommend choosing it

It's all anecdotal I know but I have SO many friends who were induced and had week long labours ending in emergency sections, I personally would never choose this.

I had an elective for other health reasons and it was super calm and smooth. If I were you I would choose that every time. Oh and I had mine at 39 weeks exactly and she was 7lb11 and scrummy x

Not induction related but I had a very long and painful back to back labour with DS ending in an emergency c-section. By the time he was born, I was so bloody exhausted and shell shocked over the pain and length of time it had gone on for I didn’t want skin to skin, refused to attempt to feed him and it took a long time to bond. Personally I’d go straight for the section. My recovery was fine and I was back driving within a couple of weeks.

It’s so frustrating to see replies like “listen to the doctors they’re the experts” etc.

OP, be frank with them. In conversations when you ask about risks for induction and are told there are none, tell them you know that is untrue. Tell them you are happy to discuss all options but you want an honest and open conversation including discussion of risks. If you’ve not heard of the acronyms BRAIN/EBRAN for pregnancy/labour, id suggest looking those up.

Yes, obstetricians and midwives are educated and we should listen to them and carefully consider what they propose to be the best options for us. But they are also human. They are working in the NHS which is under huge strain and pressure. They are at risk of litigation depending on their recommendations. They are often extremely risk averse. Women should be provided with facts and be able to make informed decisions about their care.

I’m all about birth preferences rather than plans as we all know you can be thrown curve balls in labour. Having plans set in stone I think can often set us up for disappointment. But it’s not expecting too much for the people looking after you to at least have honest and open dialogue with you when they make recommendations for your care.

One final thing - ask for figures. If they say (and these are examples out of thin air but you get the picture) “your risk of stillbirth doubles if you do/don’t do xyz”, ask for the figures. If the risk is 0.001% and increases to 0.002%, that doesn’t sound as scary or dangerous as the risk doubling.

Obviously anecdotal but i was induced on my due date due to hypertension and ended up with an EMCS 4 long days later! I'd have loved an ELCS.

I ended up having an emergency c section after my labour (and subsequent induction to try and hurry things up after my waters broke) took too long and my baby ended up in distress. I’m 100% going for an elective if we were to do it again. The recovery was honestly nowhere near as bad as I was worrying about- most of my friends who had vb had a much worse of a time recovering. And the induction process, for me, was horrendous. Clinical, rushed, cold and totally out of control compared to when I’d been labouring at home.

Through my work with SANDS, Tommy’s and Bliss I’ve seen too many women bitterly regret thinking they knew better so please don’t trust an online forum over medical advice. Seek a second opinion if necessary but your consultants will have the relevant information to make the right advice for you, because everyone is different.

I've had an emergency section following failed induction and a planned section and I would take the planned any day.

Elective section all the way.

What benefit is it to the consultant to induce you early? Surely they would only suggest it to ensure the safety of you or your baby? There’s no benefit to the NHS for people to have interventions they don’t need is there.