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Childbirth

Share experiences and get support around labour, birth and recovery.

Induction and elective caesarian

50 replies

scortja · 19/03/2012 17:00

Does anyone know if its possible to ask for a caesarian instead of being induced? And if its a good/really bad idea?

I have been planning a homebirth but am now nearly a week overdue and the sweeps will be starting soon.. To be honest I haven't really had much in the way of twinges etc so I'm thinking this baby really isn't wanting to come out.. I don't really want to go through induction if the sweeps don't work and if I'm going to have a rubbish hospital birth anyway then perhaps caesarian would be better?!

Is that horrible?! I just don't know...

OP posts:
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nannyn · 19/03/2012 17:19

I'm not sure they would be very keen to give you a C-section, not unless therei s a medical reason. You would be having major surgery & wouldn't be able to drive for 6+ weeks.
What puts you off being induced? I wouldn't be comparing a sweep to induction, sweeps are very hit & miss where as induction is much more sucessful. Depending on your hospital policy you might be able to have a water birth after the induction if it sets everything off.
Failling that loads of fresh pineapple, raspberry leaf tea & sex might get you the home birth you're after!
Good luck.

PeaceAndHope · 19/03/2012 17:34

According to the new NICE guidelines, if your concerns about having a VB in your circumstances are causing you worry and stress, you can certainly ask for a CS and you should get one. Different hospitals will have different policies however and some consultants are completely anti-choice, so you should check into it.

IMO, your feelings are justified. With an induction, you have a high risk of needing interventions such as epidurals, forceps, ventouse and EMCS all of which are riskier than a planned CS.
I wouldn't lay a bet either way on the recovery. I've known people who end up with operative VBs or severe tearing and take a long time to recover whereas others with planned CS are up and running in 2 weeks (I was!).

My colleague did ask for a CS instead of an induction (at 40+ weeks) and her request was accepted. Of course this was in a private hospital, not on the NHS.

Your concerns about a lack of support on a busy NHS ward are also justified.

It's a good idea if you're OK with the risks of a CS as opposed to an induced birth. Make a fully researched decision.

With a CS your baby has a higher risk of developing respiratory disorders. With an induced labour, the risks of an operative/complicated VB are included which can include brachial plexus nerve injuries, brain heamorrheage, oxygen deprivation which can cause brain damage, spinal cord injuries etc.

Your hospital stay with a CS will probably be a day or two longer, but contrary to popular opinion you are not more likely to experience PPH. You are slightly more likely to develop an infection, but that can be taken care of if you take the precautionary anti biotics they offer (like I did).

Look at research papers online for the risks and benefits of both options, don't just go by what people are saying because many people have very biased views about childbirth. Make an informed decision and you will be fine:)

Good luck!!

scortja · 19/03/2012 18:47

Thank you both for your posts - I really appreciate your time! And I'm going to have a thorough look at the options..

For some reason I can't face induction - I've only ever heard horrible stories and the whole point of having a home birth was to avoid being strapped to a bed in pain for an unspecified amount of time, like my first labour...

Oh god - i'm going to be one of those people who need counselling because they didn't get the birth they wanted! How did this happen??!

OP posts:
PotteringAlong · 19/03/2012 18:56

I was induced and, although I have nothing to compare it to as it was my first baby, it was in no way shape or form horrific - even with the syntocin drip and a back to back baby! I didhave an epidural but was up and in the shower an hoyr after he was born. Recovery was a lot quicker than a C-section would've been.

PeaceAndHope · 19/03/2012 19:03

PotteringAlong:

You don't know for sure about the recovery. I was in the shower as soon as my catheter came out and I was almost completely back to normal within 10 days of my CS. My friends and colleagues who had VBs were still sitting on tubes and putting witch hazel on their stitches by the time I was back to work, back to housework and even back to having sex.Blush

Also, OP can't be certain that her induction will be as smooth as yours.

BagofHolly · 19/03/2012 19:18

Pottering, how on earth do you know how well you would have recovered if you'd had a c section, when you didn't have one?

pootlebug · 19/03/2012 19:21

I was musing on this too today. I have gone into labour at 40+7 and 40+0 spontaneously in previous pregnancies and was planning a second home birth for my third child....but I'm 40+8 and beginning to wonder if it's all going to work out that way.

Another option is to be monitored daily (scan + trace) and avoid/delay induction. The policy in my area is that you can't have a homebirth beyond 42 weeks but they can't force you to be induced....they do recommend daily monitoring but I have no problems with that whatsoever. I guess it's just a question of what to do if the monitoring shows placenta deterioration - CS or induction. My preferences are:

  • Home birth
  • Hospital natural non-induced birth
  • Arghhh, don't know between CS and induction
pootlebug · 19/03/2012 19:21

Fingers crossed we both just go into natural labour in the next two or three days!

BagofHolly · 19/03/2012 21:05

I'm firmly in the pro CS camp, but I accept that's quite an extreme view! If you want a fast, safe-for-the-baby, pain-free birth, it's CS. Of course of course of course a non instrumental uncomplicated VB is best for all, but if you're worried that things might not go that way, then ELCS is a very nice alternative. Both of mine were lovely positive experiences. Very best of luck.

Ushy · 19/03/2012 21:45

Exactly my experience Bag of Holly

FlipFantasia · 19/03/2012 22:01

One of my NCT friends had a planned section instead of an induction on the NHS. Apparently her cervix was very unfavourable - sweeps were attempted but they couldn't manage them - and she was 42 weeks so her consultant gave her the choice between induction (which she was told would be unlikely to work) or a planned section. She chose the section and had a positive experience. It was her first.

But I was at the same hospital and was induced at 42 weeks. A planned section instead wasn't even mentioned as an option. So I think it really depends on your obstetrician and how they view induction vs section and your own circumstances (eg your bishops score).

With regards to the conversation around induction, if you want to avoid it then I would insist on seeing the consultant. I saw a SHO for my 41 week appointment and he was very "policy is to induce at 40 + X so we'll book you in on blah day". I was also planning a homebirth, so managed to insist on waiting until 42 weeks to be induced, but the SHO was not happy with it (also mostly spoke to my husband instead of me, and left me feeling angry and patronised!). I think the conversation would have been very different if I had spoken to a consultant (I've seen consultants mostly this time around, as I'm planning a vbac at the birth centre, and I find them much more likely to listen and speak to me as a competent adult!).

The tip my midwife gave me to see a consultant was to just say at reception "i need to see the consultant today" and then say the same thing if an SHO or registrar comes out to call you for your appointment. It pisses off the doctors (registrars in particular!) but it worked for me.

With regards to induction, I think it's valid to have reservations about it. I had friends and family who had positive induction experiences (uncomplicated vaginal births) and less positive ones (two EMCS for failure to progress, one ventouse, one forceps). I very much wanted to try for a vaginal birth, so was happy to be induced (though with hindsight I wish I'd just gone for expectant management!). I did not have a positive experience - I hyperstimulated immediately within minutes of the first pessary being inserted (not a typical experience I might add) and ended up delivering via a crash section.

With regards to the recovery from an EMCS, I found it tough but recovered well. I was up and about 24 hours after my section, home after 3 nights in hospital, and relatively mobile within a week - 10 days. My scar healed well, and within about a month I felt pretty fine (well, I felt like a sleep deprived wreck but that's life with a newborn to some extent!). We had some breastfeeding issues - undiagnosed thrush - but got through it and overall I found my experience positive.

But recovery from a section is major thing, and I do get quite annoyed when people assume it's a breeze (but I also get annoyed when people expect women to recover from all types of births within hours/days - it's a bugbear of mine!).

So I think you're right to weigh up the pros and cons. I really hope it doesn't come to it and that you have an uncomplicated home birth!

Good luck whatever you decide.

PS sorry for the essay! Didn't quite realise I had so much to say on this Blush

scortja · 19/03/2012 22:02

Thanks again everyone - pootlebug my fingers are crossed for you too..

The homebirth naysayers at work will be delighted if I have an ELCS! Its a serious consideration now though.. Will talk to midwife on sweep day and hope she's not needlessly anti-CS..

I'd almost rather just go through a major but often performed operation than deal with the alternative.. I'm already feeling pretty negative and don't want anything to stop me bonding with the baby.. Plus I've spent too much money on the fucking birth pool and don't have enough left for therapy..

OP posts:
FlipFantasia · 19/03/2012 22:07

Scortja I hear ya on the birth pool - we hired an amazing one, and then I just felt it was taunting me as each day passed with no labour! I insisted DH made it disappear before I got out of hospital after the section Grin

And my mother had been very anti my home birth plans all along so she was delighted I had a section (despite the less than ideal circumstances Hmm).

One other thing to add to my mammoth post is that the mode of birth really is a small part of the whole parenting thing. I'm hoping for a vbac but will be happy with a section if that's the safest way to deliver my baby. I know from DS (now 2) that how the baby arrives is really not that important in the scheme of things!

scortja · 19/03/2012 22:19

Oh Flip - my birthpool has been up for the past few weeks - maybe if I deflate the bugger it will all kick off naturally.. Good luck with the VBAC and thanks for your answer - it really is very helpful x

I hate to say it but I always though that it was a bit OTT of people to be upset by how the birth went, or to not bond with a baby because they didn't get what they wanted birth-wise.. (and I'm not even looking at anything extreme or serious) but I do feel angry and upset - its irrational but I feel like he's doing it on purpose! Aaargh!

OP posts:
StarlightDicKenzie · 19/03/2012 22:26

My take on it all is if the baby is in danger, get it out now. If it isn't, bloody well leave me alone.

So yes, I would always go for a cs over an induction.

FlipFantasia · 19/03/2012 22:49

Scortja hmm deflating the birth pool may just work! Can't be any worse than all the other guff people suggest Wink. We had ours up from about 37 weeks until I gave birth at 42 weeks. It was nice to float about in (closest I'll get to having a hot tub at home!) but it did just remind of what might have been...but would have hired it again if we had the space in our tiny flat, despite planning a hospital/birth centre birth this time around (just for that lovely floaty-ness).

Going past your EDD is hard - I found the weeks between 40-42 the hardest of my pregnancy with DS. I thought I'd never get a baby (honestly, thought I'd still be pregnant at 46 weeks!). But it evaporated for me once he arrived (well worth the wait). I'll have to keep muttering this to myself soon, as I'm 39+3 and fully expecting to go past my EDD again!

I really hope it all kicks off naturally for you (or after a sweep). You may still get your home birth!

Flisspaps · 19/03/2012 23:03

what starlight said.

pootlebug you can't be 'not allowed' a homebirth - even after 42 weeks. Its the mother's decision and not something you need permission for Wink

PeaceAndHope · 20/03/2012 07:54

Flisspaps:

Isn't it strange? You can't not be "allowed" a homebirth (which like anything else does come with a set of risks), and yet women are often not allowed ELCS, because of the "risks".

I wish EVERY mode of delivery could be the mother's choice and not something we need permission for.

Flisspaps · 20/03/2012 08:26

PeaceAndHope I'll heartily second that! Smile

StarlightDicKenzie · 20/03/2012 08:52

Agree with that Peace.

Loonybun · 20/03/2012 09:08

I don't want to frighten you because I do know plenty of people that have had positive induction stories (which isn't the same as having sweeps imo) but these tend to be subsequent births. First births tend to take longer anyway so an induced first birth can be even more tricky as baby is just not ready to come out yet! I was induced with my dd 9 years ago and I ended up in labour for 3 days, epidural, ventouse, the works. I found it very traumatic. I am currently pregnant with baby no 2, 11 weeks from a planned c section for these reasons... I discussed things with the consultant at the outset and they said they would be prepared for me to have a c section rather than go overdue or be induced and that's the option I would take - of course now I am going for that anyway regardless. There's no way I'd ever go through an induction ever again and I wish someone had told me before I had dd that an induced labour tends to be longer and more painful - all the midwives and health visitors told me this afterwards. If I had known I would have fought for an elective c section.

pootlebug · 20/03/2012 09:28

Flisspaps - yes, I know they can't stop me. I just find it really hard to know whether to go against it if the advice is 'we don't recommend you have a home birth'....if something goes wrong, then it is all my fault.

It just feels like something isn't quite right this time - I have gone into spontaneous labour at 40 weeks and 41 weeks before.....what has gone wrong this time? Confused

Flisspaps · 20/03/2012 09:39

If something happens, it's not your fault at all. It's just something that happens. If you booked a hospital birth and something happened you wouldn't say it was all your fault! If there are problems from being being over 42w such as stillbirth then these risks are the same whether you give birth in hospital or home at that time, surely? If you have issues in the labour itself then the MWs would be on the lookout for those anyway (whether you are 38w or 43w) and would advise transfer as soon as something untoward was noticed (which, of course you know anyway but I mention this in case someone googles this in the future!)

If you feel something isn't right though, listen to that. Having a longer pregnancy doesn't necessarily mean anything has 'gone wrong' this time, it's just different - but your gut feeling is probably the best tool available to anyone Smile

pootlebug · 20/03/2012 09:55

I guess that 'something isn't right' thing is why I don't want to be induced. I've never heard of anyone who had two spontaneous not-especially-late labours (mine were 40+7 and 40+0) and then was induced post dates for a 3rd at 42+ weeks (as opposed to say induction early for other complications). It makes me wonder if there is a good reason this baby isn't coming out, and therefore that induction would be much more likely to lead to forceps/EMCS/complications....I'd prefer ELCS to those.

Hopefully he or she will just turn up in the next few days so that I don't have to worry about all this...

madaboutmadmen · 20/03/2012 09:56

I was induced and frankly give me that anytime over someone cutting my stomach open. A section is a major
operation, why put yourself through this. I didn't need the drip when i was induced, it was an intense but very quick
labour (3 hours 1st and 2nd stage) 1st baby. I was up and about immediately anf felt well. I had a few stitches which pulled a bit on day 4 but healed well apart from having a new baby for the first time, i was back to normal.

I forgot about the pain of labour immediately and gas and air meant I didn't really care much about it when it was happening Grin

Good luck

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