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.

They wanted to induce me at 40+6 for a different medical issue. I was also worried about it often ending in an emergency section so asked for an elective section instead. Luckily for me baby came naturally at 40+3. My health issue was a different one so I'm not sure how I'd feel in your exact position. As they want to do it earlier the chances of baby coming naturally are less. I totally understand wanting an elective section over an induction though. Nearly every elective section story I hear is positive but emergency is negative!

OP, try not to stress about this. I know it is a big decision.

In my trust (I am a midwife), at any point during the induction process you can change your mind and request a section. Lots of first time mums go on to have a lovely labour and delivery from an induction, whilst others don't. I would love to have a crystal ball to be able to tell women what the likelihood would be.

Could you request a plan that leave both options open? Maybe keep the section booked for 39 + 6 (all being well with the hypertension or 39 if thats what the Consultant recommends, but ask for statistics and risks of waiting 6 more days) and then start sweeps from 38 weeks. Your community midwife will be able to advise if your cervix is completely not ready or If things start to change. A more favourable cervix is more likely to positively react to an induction where a completely posterior and closed cervix is unlikely.

Remember though, this is YOUR birth and YOUR decision. Do not let anybody push you into something you don't want and get risk v benefits and stats for all options on the table.

As others have said, an elective section can be absolutely calm and lovely. In my trust we can play music of your choice, immediate skin to skin, your partner can be there and we make it so lovely. Inductions can be very long and slow with lots of delays but can also turn in to lovely births.

Ultimately, yours and your baby's health and safety are the priority but you need to be at peace with whatever decision you make.

Snap!