What would you do? 41 weeks, back to back baby, induction in 3 days...

[politico]

Hi all

The title says it all really. This is my first pregnancy, I am at 41 weeks today and in a lot of pain. I have had SPD since around 16 weeks, so it's been a painful and inactive pregnancy, which is probably contributing to the pickle I'm in.

Went for a sweep this morning, didn't happen, the midwife couldn't reach my cervix and it's not ready. The baby is only 2/5 engaged. He has also turned and is now back to back.

My induction is booked for friday, but I can decline and delay over the weekend if I'm not sure. I'm not sure whether to accept it is going to be awful and get it over with, or pray for some kind of baby-turning and natural labour miracle in the coming days.

I wanted to avoid an epidural because of the SPD, not wanting to not feel anything / be in a bad position which could make my recovery worse. But I fear the combined pain of induction and back to back baby, so am now considering this.

Has anyone been in this position? I'd really, really appreciate it if you could let me know your experiences / hold my hand please.

Thanks.

I haven't been in exactly your position but my first ds was back to back, and I've just found out that this one, who is due on Monday, is too.

For various reasons, I'm also facing induction and, like you, a bit unsure as to what to do. I had acupucture yesterday to try and help things along, and it certainly seems to have brought on lots of tightenings. She said that women usually need a couple of sessions. Could that be an option for you? Reflexology is also supposed to be good for getting things started (I've booked a session for Thursday - am throwing everything at getting things going on their own!).

The acupucturist (who is also a midwife) recommended spending time on all fours to try and turn the baby round. Are you able to do that with your SPD? Spend as much time as possible leaning forward too, as this encourages the heaviest part of the baby (the back) to fall forwards. Someone also reccomended the website Spinning babies.

I was due to be induced last time round because my bp was really high. I had a sweep which the midwife said was unlikely to work but my waters broke later that evening and I had ds the following day. If you can bear to hang on for a few days, you might have some luck getting things more favourable for another sweep and possibly encourage the baby to move position.

Good luck!

Hi Politico
I'm not in exactly the same position as you (yet). I'm currently 38 weeks and baby is back to back, he's been in that position for weeks/months now. I've tried all the suggestions for turning him but consultant said it may be due to shape and tilt of uterus so he may never move. Also been told by mw that he might turn during labour on his way out.
I can really sympathise with you as I've been told I'll be induced at 40w (due to BP), so having read up about back to back labours and induced labours I'm scared!
If you're due to be induced on Friday, will they do another sweep or examination first? Things can change in a few days, hopefully you will have dilated a bit more then. If you really feel at the time that things will be better if you delayed it over the weekend, do that. For me, at the moment I'm thinking this baby's got to come out, the sooner the better, hoping for the best sort of labour but accepting that doctors/midwives will do what's necessary.

Hopefully things will happen naturally for you over next couple of days!

I'd get down on my hands and knees with my bum in the air and try to get the baby into a better position. Although I appreciate with the SPD that may not be the easiest of options for you. I used to use a pile of cushions so would sort of lie my arms and head on those with my bum higher than my head whilst watching tv.

As for whether to delay over the weekend, if it was me I'd just wait and see how I felt on Friday. I was induced with DS, and after I still hadn't gone into labour with two overnight pessary's I refused to go on the drip when offered in the morning, but then took them up when offered again later that night, rather than going for more pessaries. Each time the decision I made, after a bit of discussion with DH, just felt like the right thing to do at the time.

Also remember that whilst there are plenty of negative induction stories out there it isn't always that bad. I was on the drip for 6 hours from start to finish and whilst it wasn't the most pleasant 6 hours of my life, it was nowhere near as bad as I thought it was going to be.

Good luck, you're nearly there, and it is honestly amazing how quickly pregnancy conditions receed into the background once the baby arrives. I had sciatica when pregnant with DS and the first twinge I felt after giving birth to him was 8 months later when I got pregnant again!

I have had two back to back babies, if this one turned/is back to back I will be refusing all types of inducement and insisting on an ELCS.

It may not help, but I was in a similar situation re induction last year. I wanted a waterbirth and hung on and on to avoid induction. Induction eventually booked for 42 weeks but I went into spontaneous labour that morning. I went into the mlu but because I was so late and so large I was checked by a consultant who said no waterbirth and decided I should be moved to the consultant unit next door.

Eventually I was moved when I was fully dilated (just as well or I'd have been on a drip to speed things up; our mlu is more relaxed about progress than the cu).

DS wasn't quite back to back but he was a lousy presentation and he got a bit stuck. He's fine now but had to be resuscitated and was sufficiently squashed that he spent a bit of time being monitored in scbu.

Despite this being my second, I really didn't know there were any risks with delaying induction and therefore didn't ask any of the right questions. with hindsight I wouldn't have delayed so long. Had he been earlier and smaller I think a lot of our issues could have been avoided

My first son was back to back, i was induced at 41 weeks, wasn't really effective, he was progressing to slowly - in the end was rushed to theatre to have a cesarian. They offered me one in the first place but refused as i believed it could have had a natural birth. Looking back on it would have gone for cesarian straight away - so i could have avoided all that pain.

i would be spending my days on my hands and knees, and if that didn't work I'd look into acupuncture / moxibustion / whatever to try and turn him/her.

Have to say my first was a back to back labour that ended in a section. When I went into labour with my 2nd and she was also in an awkward position I opted for an ELCS. I would do the same again.

Thank you all for sharing your experiences, I really appreciate it.

coconutfeet I will look into acupressure / reflexology and check out that website, thank you - there are a couple of places near me which offer it I think.

pickledpeppers sorry to hear you're in much the same boat. There isn't another sweep attempt planned before friday, they are really shortstaffed and even though I'm overdue I've had to fight for an appointment. I have worked my way through a big bar of chocolate in the past two hours and am feeling a bit like you at present, i.e. let's just get it over with. It being my first labour, I don't have anything to compare it to, so perhaps the worst of it is in my head.

thefurryone thanks for that - right, I will just wait and see how I'm feeling on Friday. Right now I'm feeling that while there are some things I can do in terms of positioning, on a birth ball etc. I appreciate that some people have more positive induction stories so it isn't necessarily the end of the world (I have just been fed horror-stories by my MIL (a nurse) about inductions, really not helping me in the circumstances!). And at least it would be over with and my baby would finally be here!

Babieseverywhere, welovesausagedogs and Casserole thanks as well - I've been keen to avoid a C-section, as my SPD has put my abdominal and pelvic muscles in so much pain for so long - I'm worried major abdominal surgery will only delay my recovery from this. My family and my DP's family also live in a different country so I won't have any support after he returns to work after two weeks. But I do accept it's an option and may happen, like it or not, so I'm going to read up on it, so I can at least make an informed decision if it comes to it in the next few days.

golemmings thank you for sharing your story, that must have been so traumatic. I'm so glad to hear your son is ok now. That's helped give me some perspective. Our antenatal teacher told us about the rates of stillbirth increasing after 42 weeks, so I accept it's medically necessary to get the baby out safely; at the end of the day, the safe delivery of my baby is all that matters, right?

Right, I am off to do some crawling / bum wiggling / googling of reflexology practitioners! Thank you all so much for getting back to me, I feel a lot less alone than I did this morning.

Swimming is good for encouraging a baby to turn because your belly can hang in the water and they have maximum space.

Also, don't sit back on a sofa (pretty harsh when you're 41 weeks pregnant I know!)

I had two back-to-back babies, neither could be induced to turn by any of the usual wiggling-around-on-all-fours methods recommended.

I had them both naturally (no epidural/pain relief, obviously no c-section, though I did have episiotomies) but for the first I was mainly on my back due to doctor's insistence on continual monitoring - partly because he was a big baby, but also they kept losing the heartbeat due to the baby's position. The labour was very slow, I dilated unevenly, and it was not a great experience.

So with the second one (9 days late, back-to-back, also expected to be big) I refused continuous monitoring and insisted on being as upright and mobile as possible for as long as possible. That labour was much faster and easier - obviously second babies often are anyway, but I certainly avoided a lot of the back pain and uneven dilation of the first time.

politico I was induced at 39 weeks because of severe SPD with DD2. She turned back to back at the last minute. I also never had a successful sweep with DD1, my cervix was always too far back and they just couldn't reach it, and I was induced at 42 weeks. So I understand how you feel.

Tbh, I found induction quite unpleasant, but my local hospital isn't very nice, which probably contributed. Also, having had no experience of going into labour naturally, I have nothing to compare it with. Maybe I would be lousy at labour regardless :)

The labour with SPD was painful, I won't lie, but it was quite quick, and apparently this is quite common with SPD as the increased relaxin levels in your body help things along. I had ventouse deliveries with both of mine, the second time because I couldn't get my knees apart to deliver naturally because of the SPD. It wasn't nice as I hadn't had an epidural, but I survived.

All I would say is that (IMHO) labour isn't great, but it is just a means to an end - becoming a parent. It's a bit like a wedding is just a step in the grand scheme of marriage. Does that make sense? If you are in pain with the SPD, do consider the induction, because once you have had your baby, you will be so much better (though don't overdo it and do have physio afterwards). The back to back thing may change, or it may not. You may need an epidural, or you may not (make sure you tell everybody plenty of times about your SPD if you do have one). But your baby will come out, one way or another, and you will feel amazing for having done it.

Good luck and un-MN hugs x

Fruitsaladisnotpudding thanks for the tip. There are no pools near me but I will have a bath and see if that helps!

exexpat thanks for sharing your two birth experiences, that's really helpful and I'll try to advocate for as much mobility as possible. Hard with the SPD, but lying on my back with the SPD isn't going to be fun either, so that's really useful.

BigBadBear thank you for the hugs!! Your perspective is really helpful. I'm hoping all this relaxin is going to be good for something! I totally agree, labour is a means to an end, and one/two more bad day(s) after several bad months, but then it will be over and the whole reason for going through this will finally be here!

Thanks so much all! x

I was induced at 40+14 with a back to back baby.

I did have an epidural, which was sited at the same time if the drip and I can honestly say that it wasn't that bad! My active labour was 11 hours (he was born exactly 20 hours after the first gel was applied) but the epidural meant I got some sleep overnight, I could feel to push and was in the shower an hour after he wax born but I think that's relatively unusual.

I delayed my induction for a few days but he wasn't even slightly engaged by + 14 and I was very fed up! I've no useful advice, but I see my birth as a really positive one!

My birth experience - not my actual birth!

OP I could have written your post! I am pg with dc4, and all if mine have been back-to-back, and I've had SPD with them all too. The last 2 were also very overdue (14 & 16 days) so I can imagine the same happening for me this time...

One sweep managed to bring on labour with %231&2, but I had FIVE sweeps with %233 which didn't work.

Dc1 was born face up (difficult birth) but dd2 & 3 both turned during labour. I spent a lot of time on all fours. I remember clearly feeling dc2 turn and drop down and engage while I was in labour with him, it scared the life out of me (literally felt a 'thud'), but I went on to have the most wonderful, positive birth experience.

With dc3 my cervix was also not ready, even at 14 days overdue (have you been given a Bishops Score? en.m.wikipedia.org/wiki/Bishop_score%23section_2
Mine was '1' at 14 days overdue, so I was so fed up thinking that even an induction was going to fail. (and very upset that my home water-birth was going out of the window).

I opted to go past 14 days overdue with daily monitoring. They scanned me at 15 days over to check if the fluid levels had depleted (can happen when overdue and is dangerous) and discovered that my fluid levels were three times MORE than they were supposed to be (no wonder I suddenly got huge ) so I had to be immediately induced.

I had to go through all of the staged of induction - pessary overnight (I really didn't like this, placing it was difficult with my awkward cervix,and it felt like I'd been kicked in the fanjo), then I had my waters broken (this was fine - although GALLONS of water!), and finally as nothing had started by this point - the drip.

I was so scared of that drip. Was so upset when they attached it. It brought on contractions and dd was born 4 hours later. In comparison to my non-induced births, yes the contractions were definitely
more intense, but I would say it was only the last 10 minutes before she was born that I felt I couldn't cope with (I had gone from 7 to 10cm in that time). But I managed with G&A and breathing (did hypnobirthing) and didn't have an epidural.

Looking back it was actually fine, so much better than I had feared.

Make sure you get on all fours as much as possible before and during labour, also draping over a birthing ball is good and is also lovely relief for the SPD.

Good luck OP, let us know how you get on!

Sorry for the random %223.,; in there! They are mean to say DC2 & 3...

Hi OP, I was induced at 40+12 with a back to back baby but no SPD (first baby). Had two days of pessaries with mild contractions which tailed off on the second night. On the third day the consultant offered that I either go home for 24 hours or have another pessary. I went for another pessary - wanted the baby out as I felt he was ready! That night my waters broke spontaneously and my contractions started from 1.30am lasting to 4 am and I tried to be as active as possible using the techniques from Juju Sundin's Birth Skills book. At this time was still on the ward rather than the labour ward and when the contractions started coming on top of each other I asked for some pain relief but when the nurse examined me I was 7cm dilated and they moved me to the labour suite and after half an hour I had a powerful urge to push and the pain of the contractions stopped. Then I got onto all fours and pushed. However my urges to push slowed down and they had to start an oxytocin drip. DS1 then turned on his own but the second/pushing stage lasted from 4am to about 8am and was very tiring and I think it took so long because he was turning. But I had a great midwife and the Sister also came in to help with the birth - got me out of bed so that gravity would help which I know would be difficult for you with SPD. DS1 never was in any distress. Also I had none of the severe back pain that you can read about. And I delivered without forceps or episotomy. Had some small lacerations which needed stitching but compared to the crowning it was nothing!

I am now 40+3 with another back to back baby (DS2). Argh! Just wanted an experience where it was quick and hopefully no induction but there we go. Try to stay positive and think how you will cope with the pain especially with your SPD.

Good luck!

My first baby was a week overdue and I began labour with him in the back to back position and he hadn't engaged at all.

I had a sweep and my waters broke later that day, maybe my body wasn't ready yet though and I should have waited and tried to get the baby in a better position.

Personally I wouldn't go for induction, try to turn that baby as people have suggested - nobody told me to try and turn my baby and I ended up with very strong contractions early on in the labour (my body's attempt to engage the baby?) and was exhausted, went to hosp to find I was only 2cm dilated! Nobody told me to try and get that baby moved! I wish I'd spent my labour on all 4s, but I was naive! By 5cm as had the premature urge to push, I was exhausted and my baby in distress. This led to en epidural, a very long labour and eventually a 3rd degree tear! Granted we were all fine in the end with no long term damage, but I just wish I'd been armed with the knowledge I have now.
I'm expecting my second in a month so it obviously didn't put me off, but believe me I'm spending a whole lot of time on my knees! Got to see a consultant on Friday do discuss a C-section after 3rd degree tear, but I'm fighting my corner on the normal delivery with no epidural this time!

Good luck and reeeeelax! Contractions hurt a whole lot less if you can relax and breathe.

Hi politico I thought I'd share my 3 experiences. I have had severe SPD and PGP in all three pregnancies and all 3DC were back to back so hopefully it'll be useful for you.

DC1 back to back 38 weeks midwife checked me on the Friday saying he was still really high and not engaged at all and I'd probably go overdue. I had him that Sunday at home in the bath with the whole thing start to finish being 1hr 51mins. We called the hosp when my waters broke after about 40 mins of contractions. They said get in the bath and we'll probably see you tomorrow. DH ended up ringing an ambulance that didn't get there in time! I had a 2nd degree tear which healed well.

DC2 planned homebirth arrived at 40+1 again born before the midwife got there in just under 45 mins. She was back to back and the MW was amazed she was so quick. Again 2nd degree tear but otherwise fine.

DC3 was a different matter. I was in hospital from about 7 months as I had multiple pulmonary emboli and I was induced at 38 weeks. I was very high risk but they wanted to avoid a c-section so I had a full works induction with synt drip etc. I couldn't have an epidural as I was on blood thinners. All the mw were very busy telling me how painful the drip would be and as dD2 was back to back that it would be a nightmare. Well I managed with half a chocolate orange and no other pain relief at all. So it can be done.

I think it must be something to do with my wonky pelvis that all mine were back to back.

So to summarise. It might be horrid but it may also be not to bad. Good luck!

Hi politico I thought I'd share my 3 experiences. I have had severe SPD and PGP in all three pregnancies and all 3DC were back to back so hopefully it'll be useful for you.

DC1 back to back 38 weeks midwife checked me on the Friday saying he was still really high and not engaged at all and I'd probably go overdue. I had him that Sunday at home in the bath with the whole thing start to finish being 1hr 51mins. We called the hosp when my waters broke after about 40 mins of contractions. They said get in the bath and we'll probably see you tomorrow. DH ended up ringing an ambulance that didn't get there in time! I had a 2nd degree tear which healed well.

DC2 planned homebirth arrived at 40+1 again born before the midwife got there in just under 45 mins. She was back to back and the MW was amazed she was so quick. Again 2nd degree tear but otherwise fine.

DC3 was a different matter. I was in hospital from about 7 months as I had multiple pulmonary emboli and I was induced at 38 weeks. I was very high risk but they wanted to avoid a c-section so I had a full works induction with synt drip etc. I couldn't have an epidural as I was on blood thinners. All the mw were very busy telling me how painful the drip would be and as dD2 was back to back that it would be a nightmare. Well I managed with half a chocolate orange and no other pain relief at all. So it can be done.

I think it must be something to do with my wonky pelvis that all mine were back to back.

So to summarise. It might be horrid but it may also be not too bad. Good luck!

This website is good op for tips for turning babies www.spinningbabies.com/more-info/for-pregnancy

At 40+11 I saw the midwife for her to try to do a sweep. She couldn't do it because she couldn't reach my cervix as it was too high. Baby wasn't properly engaged. She was back to back. In the words of the midwife there were no signs at all that my baby was going to arrive any time soon.

My daughter arrived of her own accord 13 hours after that midwife visit. Admittedly she was my 3rd and came a lot quicker than the previous two once she decided to start on making an appearance.

Personally I would decline induction as long as sensible. But I didn't have the SPD issues that you have so I don't know how much difference they make.

Both my DC were back to back babies (when I was told about the second pregnancy I was gutted to find out that I was carrying another back to back baby!). Both births were not the easiest. Found both very painful. Sorry I'm not making my experience sound very positive!! In saying that, they were both natural births (no CS for either birth) and no major complications (well, except for the third degree tear after DS1, second degree tear after DS2).

I did not get an epidural both times because of staffing levels in the Dept, so I had to just get on with it (had diamorphine and G&A).

Good luck with your birth, you may find your baby will just turn for you. I tried all the techniques shown to me but it made not a jot of difference both times. Hope you're more successful!

Both of mine were overdue. 40+11 with DS1 and 40+10 with DS2. Needed a sweep both times.

Both were long drawn out labours.