Any midwives/medical professionals out there - query about induction

[ChocolateBiscuitCake]

No one is listening to me and I know I am not being told the full picture.

Have been offered induction basically from 37 weeks on the condition that my cervix is favourable. This is dc3, I am not stupid, have had countless attempted sweeps with previous births and I have never been 'favourable' before 40+ weeks.

What I want to know and understand is: if my cervix were favourable for induction, am I actually only days from natural labour or can a cervix ever be favourable weeks before due date (both dc1&2 were born naturally at 42 weeks).

Does this make sense?

Please help me, I am very distressed.

Your post does make complete sense - surely if a cervix is favourable you would go into labour naturally anyway?

I would really want to know the point of her recommendation and why she would be so keen to induce a healthy pregnancy early. If she can't come up with a satisfactory answer then tell her to stuff it.

Why are you being offered induction at 37 weeks? Diabetes? Cholestasis? I would want to know why first.

Thanks for your reply. I will try to explain myself better:

I have had two large babies that were delivered in theatre, in stirrups with vontuse. I have spd. Most distressingly after dc2 the spd was immobilising for about 6 months, which was extremely frightening, distressing and painful - I can only assume because of the mode of delivery.

I have had spd since 11 weeks with dc3. Yet no gp, physio or midwife seems to offer any support, recognition or even sympathy. For anyone who has suffered, they will understand it is as physically and emotionally draining as earache/toothache.

So I am now 36 weeks and I am booked in to see a consultant today to discuss birth options. I am very hesitant to go to term and deliver with intervention, which my history suggests is most likely. I am measuring large for dates (as of two weeks ago) so on track for another large baby to deliver. My main motivation is to avoid 6 months post birth spd recovery - I will have three children under 3.5 to care for and bluntly, after the last 18 months of spd issues, I want my life back to be a Mummy.

The consultant, like all medical professionals it seems, thinks that I am making the spd up/that it is not that bad. She clearly has not experienced it herself. It is not considered a medical problem. She won't consider me for ELCS - it is maternal request which the hospital won't support. She gayly said she would refer me to another trust but when I asked who she would recommend, she said no other London trust would consider my case.

However she will induce me at 37 weeks + if I am favourable. But as I understand it, I won't be favourable until I am naturally ready to labour anyway. So she is fobbing me off leaving me to think I have an option. But I don't, do I? I will have to arrange childcare at 37 weeks for possible induction, to be told go home, to come back a week later, arrange childcare, be sent home and so on.

I have no choices and the only person who could ever give me consent and help doesn't care. I feel very lost and distressed.

I was favourable from 38 weeks and offered induction from then, basically my cervix was soft and 3 cms dilated, they would have managed to break my waters. I didnt go into labour in the next 3 weeks and had a sweep at 40 plus 6 which set me off, so if you are favourable you and not likiely to go into labour naturally anyway even with a big baby. Have you had advice re birthing positions

I am not a medical professional/midwife but I do work in the antenatal education field. If someone asked me this in a class I would ask them to think about the following: if you are induced (particuarly with an unfavourable cervix) you are more likely to have an epidural because of increased pain levels. You are then more likely to have further interventions like ventouse, forceps. The position for ventouse with legs in strirrips may well have made the SPD worse. Did you have epidurals with your other births?

It might be because you on baby 3 that a prostoglandin gel/pessary kicks things off well and you can have a straightforward birth although if the cervix is unfavourable this is more unlikely.

The best way to deliever a big baby is to use gravity and help the pelvis open up by using upright, forward and open birth positions, on a birth ball, kneeling, leaning over the bed for example? Would this be possible with your SPD? Have you considered a water birth where you might be able to use open positions for easily with less stress on your pelvis?

If you are really keen for the birth to happen quickly due to your pain, have you considered a caesarean birth?

Oh clueless that is what I needed to hear. Thank you (more tears!). I don't have a fear of labour - I would happily give birth tomorrow (baby already 7lb!) and have already have an independent midwife! I just know my body hasn't been able to do 9.5+lbers and don't want to have another big baby get stuck/need help to get out. The longer I am pregnant, the more weight my pelvis is carrying and I have reached breaking point both physically and emotionally.

I feel so let down.

Thanks wizard - the consultant won't authorise the c-section. And yes, I have had epidurals as I am very fearful of the labour pain. I don't think I could go pain free this time round so epidural is a non negotiable.

what I am upset and confused about is the only option I have been offered is induction of a favourable cervix and I am left feeling that this gives me no certainty or alternative to just waiting...

I feel like I am in a third world!

Hi, it seems you werent getting anywhere with the Consultant, if I were you I would see if you could speak to the Consultant Midwife at the Hospital and she will go to great lengths to help and support you. I have worked with great Consultant midwives and they really do fight your corner. She will look at the whole picture fairly and you both usually come up with a plan thats best for you.

Hope that helps ;

The reason the consultant is talking about induction with a favourable cervix is because there's often bugger all point trying to induce a woman with an unfavourable cervix (the cervix is given a score called the Bishops Score - high, firm closed cervix is less likely to respond to induction, nice squishy soft one is)

I am surprised that no-one has suggested labouring in water as in my local hospital this is what is recommended for women with SPD or pelvic girdle pain, so one option could be to wait for labour to start and then use the pool for pain relief. But you say you want an epidural and I'm afraid making that choice does increase the risk of needing ventouse or forceps to help get the baby born. You CAN birth larger babies because you've done so, twice, so you know you can get them through your pelvis.

You need do decide which risks are acceptable to you - induction of labour and use of epidural make another birth in stirrups more likely, using the pool for pain relief reduces these risks but the pool is not usually available for women being induced. Having said that, I do know a woman who was induced and as her labour then progressed normally she asked to use the pool and was able to.

The other option is to request a c-section, if your consultant does not want to perform one he/she is duty bound to refer you to a surgeon who will.

Best of luck

Sorry you have such unsympathetic people around you. SPD is a valid reason for induction if it is interfering with your life.

Speak with the Consultant Midwife
Be aware that early induction could still result in an assisted delivery
Be VERY careful of movement and positioning if you have another epidural
Know that the SPD could still take time to resolve even after the most normal and smooth delivery.
If your cervix is favourable you don't have to have the induction there and then. You can negotiate a suitable day after arranging childcare.

Good luck!

hi i just wanted to post and let you know my experience, also an spd sufferer, for baby no1 i eneded up hospitalised as it got so bad, i was just in such pain i couldnt move. they tried to induce me at 38wks because of this it didnt work and i nearly ended up wtih Emergancy c section as baby got distressed, luckily they monitered me and he calmed down, they then offered me a c section or to go home and wait. i went back in once overdue and was induced but it took 3 days, had epidural, flat on back, legs in stirrups etc just maanged to avoid forceps and ventouse.

anyway i had months and monhts of pain after that.

it eventually settled, i had physio and i went swimming regularly and also focused on building up my core strength.

i had my pelvis x rayed when not preg and they did talk about pinning it! BUT i was lucky enough to see a specialist in spd! and he recomended taht if i had other children the BEST thing for spd was an upright normal delivery, hands and knees, kneeling etc and he said often a good delivery can help shift the pelvis back into the right position.

anyway i managed to do just that with ds2, kept mobile, used birth ball, laboured in the pool, lots of gas and air etc and i delivered him kneeling up leaning over the end of the bed (some people i know have done this with epidurals btw) and my pelvis was so much better afterwards!

went on to have ds3, same type of labour as with ds2.

then ds4 had in birthing pool, by far the best birth and he was 10lb 13oz!! my others were 9lb+

i think you need to do some research, speak to a midwife, i cant believe they havent referred you to physio!! INSIST and also have they given you a support belt? i have a narrow one specially designed for spd, what size are you? pm me and if i can find it you can have it :)

btw all of my other babies were 2+wks late!! each time i had had a favourable cervix for weeks, had sweeps etc but nothing had happened, in my case i wanted to avoid induction, despite the spd as i am allergic to the prostion gel they give you! i have to have my waters broken and of course this can lead to syntocin etc, i think by waiting my body was ready so after they broke my waters i then went into labour fine without syntocin.

i do really feel for you spd is awful :( but i have 5 now and thankfully most of the time my spd is fine, it seems to flare up when i get my period, i am assuming thats hormone related?

i do think having active births helped tho, so even if you go with the epidural try different postions, the midwives can help with this, also what about a mobile epidural, some hospitals do them?

btw if you are induced, as long as you just have the gel and or your waters broken and then contractions start you can still labour in water, providing monitering shows baby is ok, you are well etc, i REALLY recomend it

I went in for an induction at 38 weeks and she managed to break my waters there and then (which I was not prepared for! After being told I could be waiting up to 24 hours) the midwife said that I was favourable x

Thank you so much everyone for taking the time to respond. I realise that spd is not a life/death symptom but it has really taken it's toll and the lack of support has been extraordinary. I was referred to physio but had an equally farcical session (no history taken, and told that if I stretched every day the pain would stop after two weeks ). I really begrudge the attitude of nhs consultants who have targets to meet and therefore don't give a shit about the recovery of patients...they can pass that to another department with a different budget. Anyway, rant over and thank you again for your quick, kind replies xx

How horrific! Why won't they give cs in these circumstances? - I thought request was available now?

have a looksy here

I can't imagine anything worse than recovering from a section with spd to contend with as well.