Induction v c-section - which is best?

[Bethpp]

Hello all this is my first posting on here. Just after some advice really. I've had a couple of growth scans and I'm measuring above the 98th centile for both abdominal and head circumferences. I'm 35 weeks but appear to be carrying a baby of average 40 weeks gestation! It's my first one, and as I'm pretty tiny myself (5ft 0in, shoe size 3.5), I am concerned! I have a midwife appointment next week and she wants to discuss induction. However, I've heard inductions are more painful and are more likely to require epidurals and forceps, and possibly emergency c-section. Due to a blood disorder I cannot have epidurals but I can have a spinal block, which can be used for a c-section. To cut a long story short (sorry) I would like to request a planned c-section rather than opt for an induction and wind up in a lot of pain, without an epidural and ending up with an episiotomy, and possibly an emcs. Do you think that this is a good idea? Sorry for the long post and thanks to those still reading!

Beth

I can understand your fear totally, especially since you seem to have a big baby and you do not have the option of an epidural which most of us get comfort from knowing we can fall back on that if it all gets too much. I think you're being perfectly reasonable in discussing this with your midwife and thinking about a planned C-section. You seem to have some fear and anxiety which you need to discuss with an expert.
Inductions don't always mean a lengthy labour and emcs - it really depends on the person - my best friend had a very easy induction that took quickly and she gave birth within 4 hours with no epidural. Mine wasn't as straightforward but we're all different.

I believe Nice guidelines say you shouldn't be offered an induction for a large baby unless you have diabetes.

An induction can be the start of a cascade of intervention, prostin gel, drip, needing an epidural, em lscs. On the other hand you might find that you only need the prostin gel and never need the drip. Which puts you on an equal footing of a natural labour. But you won't know until/u less you try it.

An elective section is generally safer than an emergency section. But a vaginal birth is safer still. A Section will have implications/risks for future pregnancies which is worth considering.

Having had an induction which ultimately led to an EMCS I would opt for the ELCS.

Inductions (if you need the drip) can be incredibly painful and and the pain is full on straight away. By the time I was given an EMCS I was a wreck after days in pain without sleep. If I had known then what I know now I would never have agreed to an induction and would have headed straight for a section.

biscuitnibbler - totally agree !

Yes, but it really depends on the hospital guidelines. Having an induction that leads to an emcs doesn't automatically mean you get offered a C-section next time. C-sections are offered in very few situations, even twins are not automatic C-sections. I had an emcs after 4 days of induction for my first child and I ended up being prepped for a C-section in my 2nd pregnancy but on the operating table managing to push the baby out (with forceps and ventouse). Even after this I am still having to persuade my midwife to let me go for an elective C-section this time (am 9 weeks preg with my 3rd child). I think Beth is getting anxiety about the birth and this will be dealt with by experts who may offer a C-section if the anxiety cannot be managed. The NICE guidelines on C-sections are very clear - have read them myself for the reasons I've just mentioned.

Thanks all, I do have some anxiety and fear, which I always have had, about vaginal delivery. The macrosomia is unfortunately playing right into the hands of my fear so I will be speaking to the midwife about all of this on Tuesday. Thanks for the advice, it is much appreciated.

Update!

I got my elective c section date yesterday! The consultant was really great and agreed that an elective was the way to go. So pleased!

Cheers all for the advice, much appreciated!

Well done. I read this and thought straight away: that girl needs an elective.
I agree that in general large babies shouldn't be induced but when you are so small it seemed like dicing with a very serious possibility of quite a traumatic induction and in those circumstances, an elective seems best for everyone I think. It would be different if you were 5ft 9 or 10 and broadly built with size 8 feet!

Ooo was coming on to say elective. My DS was a biggie, and I was induced when he was two weeks over. Not a good experience! So much so they won't let me do it naturally this time round!

Beth am glad to hear you got ELCS... I'm also 5"0 and shoe 3.5 BTW!!! I was induced with drip (requested epidural immediately, will never forget the pain if those violent contractions) and 18 hrs later had EMCS. Next time it will definitely be elective

I am inclined to say ELCS having been down the induction route (although for different reasons).

The issue here has to be the relative risks of the two different birth methods. Are there any female consultant obsts at your hospital? YOu never know, you might get a more reasoned and sympathetic discussion with a woman, especially if she's had children of her own :) A good consultant should outline the relative risks of both methods and you should also come away feeling confident that they have taken stock of your particular situation and health/ size issues IMHO

OH duh! You got your elective. That'll learn me to walk away from the screen while mid-read. Good for you.