Induction or C-Section?? & SPD

[babylily]

I had severe SPD with my first pregnancy from early on (crutches/ wheelchair/ etc etc) and consequently had an elective c-section at 39 weeks.
I'm now 19 wks pregnant again and meet with consultant next week and I need to make a decision about what I want to do this time.
I like the idea of trying to do it myself, depending on how bad the SPD gets (crutches at the moment), but as my dd was a 9lb-er the weight of her made the last few weeks unbearable last time I wondered about being induced at 39 wks rather than having another section.
I'm also a bit concerned about ending up having an emergency caesarean as my elective had complications due to undiagnosed placenta praevia and I had to have a blood transfusion.
I don't even know if hospitals generally allow induction early (although it was an option for me last time)
Also - anyone know if it's okay to use a birthing pool during labour if induced/ and if have had a previous section? With the extent of my SPD the hospital birth plan for me would be an epidural as soon as I was admitted and a ventouse delivery - and I'll need an alternative plan to argue at my meeting next week.
My main reason for not wanting a section this time is seperation anxiety over the hospital stay- I don't want to be apart from my dd for a week, but I was unable to walk for 5 day after because the SPD got worse before it got better.

Did not mean to go on this long - sorry. Probably very garbled too -I'm in pain!
Any advice/ experiences would be really helpful...

thanks
babylily

babylily I think it's a bit early for you to be able to be definite about what you want - I think you will have to see how it goes with the SPD. You sa you couldn't walk for 5 days after your section because of the SPD - have you a guarentee that this wouldn't be the case if you went for the induction? I think if medically required inductions are allowed early - my SIL was induced at 38 weeks because of a liver condition.

Yes, hospitals do induce early for some medical conditions (eg pre-eclampsia) but I don't know if your SPD would qualify.

You won't get a water birth I'm afraid. If you're induced you can't have one (at least in my local hospital) and the same applies to VBACs. The reason is the need for frequent monitoring.

Can you make an appointment to see your consultant now? It's obviously playing on your mind a lot at this early stage, and it might put your mind at rest to know what the options are.

babylily - sorry about your SPD, sounds grim - they are unlikely to induce you (esp early) if you have had a previous c section due to risk of uterine rupture (the drugs used in induction can cause very intense "man made" contractions). Also, if you are induced it is more likely that you would need other types of intervention, an assisted delivery (forceps/ventouse) or an emergency c section.

With a previous placenta praevia they may well want to be doing lots of scanning and monitoring towards the end of your pregnancy, but if all is well you can have a normal birth.
You would need to go into labour on your own though! I have seen many women who have had vbac's and used water.

My advice would be to talk to a strong midwife or doula, or even a female friend/relative that can boost your confidence in your body's ability to birth and then take them with you when you see your consultant.

I would be challenging a plan of epidural and forceps for a woman who has SPD - makes no sense to me, and arm yourself with the info you need to do this and make your voice heard. Don't go on your own though.

hi all,

just wanted to add that i was induced, and it was totally premature. They told me that i had gestational diabetes, after a blood test , before hand i had a bottle of lucozade which in my opinion would greatly increase my sugar levels any way!so, daft consultant booked me in for induction on my due date? i didnt even have the leisure of the waiting game of 5 dyas pre induction. inductions didnt work and then bubs heart rate went down, reluctantly agreed to c-section as they said bubs could die, still feel cheated out of natural birth and dont even know what a contraction feels like..so....sometimes go with what you feel and i know the doctors are experts but i feel in my case they made a bad call.

I was induced at 38 wks because of SPD - had been bedridden in hosp for a month beforehand. Had epidural soon after first (and only) dose of Prostin, was able to deliver without any further intervention and was able to walk relatively normally 3 days later. Hope you get the birth you want.

I am 33 weeks and due to go to the hospital at 36 weeks to discuss this with them as they won't discuss it before then. Seeing as though I have been off work with SPD since beginning of january and like to I have been on crutches since February I am pushing for an elective.

Unless they can guarantee me (which they can't)that with an epidural (bearing in mind I wont' be able to feel anything and they can't feel for me) that i will not do any damage by pushing with my pelvis how it is then I am going to fight tooth and nail for it.

I had SPD with dd although not as bad as this time and was induced but I didn't dilate and ended up with an emergency c-section. I am not going to go through this again.

With the c-section last time my SPD cleared up almost straight away.

I posted this in another thread:

'I had very bad SPD during my pregnancy and my consultant said that delivery would very likely make it worse, as labour itself puts strain on the ligaments and the actual pushing the baby through the birth canal would stretch the pubic bones even further apart, which could result in them separating (if that happens you have a real problem you'll need surgery and will probably end up in a wheel chair for a good while). However, that's quiet rare. He suggested trying to stand or kneel during delivery and KEEP THE LEGS together as much as possible (which made me lol). He warned against lying on my back and said that I must not be put into stirrups as that can also lead to the pubic bone separating. However, I then wondered how to avoid stirrups if they need to pull the baby out via ventouse or forceps, so he said that should that scenario occur it would be wise to ask for a c/s.

In the end I was very very lucky as my baby turned herself breech and I got a scheduled c/s, so I didn't have to worry about the delivery aspect.

However, and I know this next comment is very controversial (but that's what my physio explained to me) is that breastfeeding prolongs SPD because the hormones keep your ligaments soft for as long as you produce milk, so although your SPD is going to get a lot better once the baby is out it will not dissapear until you stop breastfeeding. I still chose to breastfeed because I believe it was the best for my baby girl but I did struggle with my SPD for the whole time. My decision to stop breastfeeding after 6 months mostly had to do with the fact that I wanted to get rid of the pain and now, three months after stopping I am almost pain free.

Anyway, this is just my experience. Good luck, and you have my full sympathies for you pain !'

Rochwen -thanks for this. I will use some of this when I see my consultant next week. I hope the SPD will clear up quickly as I do bottlefeed and therefore shouldn't have prolonged agony!

Helsi, here's my two cents: SPD is a very debilitating condition and for some women it never really goes away even after their children are born. I personally didn't want to risk anything that could make the condition worse and affect my well-being for the rest of my life.

Good Luck and I really feel for you !

i had spd, and was only crutches and wheelchair from 6 months. i was induced and was allowed to go in the birthingpool, though at my request when the drip kicked in i came out and had an epidural. i kept my legs relaxed and they were placed slightly open and held by bolsters.

sadly my dd got stuck, and in an emergency while trying to prep operating room. ( latex allergy so takes a while) they had to put me in stirrups and use assistant.

it took 30 mins with the cap on and they still had to break her shoulder. but i can honestly say apart from being bloody stiff, not so much painfull, i was walking 8 hours later when epidural wore off.

i have only suffred from it on random occasions since.

my aunt had spd mildly, had a c section due to other reasons and she still suffers from it now 15 years on. she couldnt walk for a month and getting in and out of a car took 5 months.

she was taken home in an ambulance and had physio.

so i really think each case is diferent.

so sorry its long!!!!

I had SPD badly and had a successful sweep at 40 weeks and an easy delivery. I was advised against a section as it cuts through the muscles that you need to strengthen after the birth to support your pelvis. I still have occasional twinges and I don't think it will ever be totally right, but I walked out of the hospital and after some intensive post baby physio I'm doing OK.