Can you induce a baby who won't engage?

[MrsJSC]

This is my 3rd baby & she needs to be delivered early. Midwife found baby not engaged & chances are baby won't until labour starts as no.3 so how are you meant to induce?
Will be 38 weeks on Friday which is when consultant wants baby delivered. Help

None of my babies (4) engaged as all were back to back. I was induced successfully with them all.

I went for a sweep on Friday and because her head wasn't in my pelvis Midwife couldn't do anything and offered no advice. I was so upset.
If you don't mind me asking how did they induce you?
Thank you so much

Hi MrsJSC, my understanding (and I'm not a midwife or a doctor, just a doula so this is just my understanding) is that midwives don't like to perform sweeps when the head isn't in the pelvis just in case the waters were to break accidentally. When the waters break without the head engaged in the pelvis there is a higher risk of cord prolapse (the cord coming out partially with the waters which is an extremely urgent emergency).

When I've been with a couple of clients in for induction with the head still high they have asked for the doctor to to the sweep/break the waters and just been on standby in case of cord prolapse. I believe they aren't happy to do this at home or in a doctor's surgery as they don't have access to theatres for an EMCS should a prolapse arrise.

Would it be worth speaking to your consultant and/or midwife to reassure you? They can talk you through why she declined to give you a sweep and whether they would be happy to give you one if you came in to hospital for it. They could also explain what is/isn't possible in terms of induction in your specific case.

In the meantime many women find bouncing on birth balls great for bringing the head down, though as it's your third baby it might not engage until labour itself.

Just to reassure you cord prolapse is pretty rare, but serious so they take precautions because of that.

Thank you.
I was just so upset because for the last 9 months the consultant team had lead me to believe I had the option of being induced as I just don't want a c-section. I felt so sorry for the midwife as she was apologetic & it's not her fault. Just no one had thought of the baby not engaging.
Though people say c-section is fine in my heart of hearts I just don't want one. Just can't feel fine with the idea of it. Going to be an emotional consultant meeting on wed. x

I only had a sweep with my last baby (which was horrible and did nothing except give me period type pains for about 12 hours).

My first baby was gel on my cervix (several doses) and a drip once labour started,
my second and third were both started with the gel only (but again took several doses) and
my fourth was straight to the drip (waters had broken on their own already).
Didn't have my waters broke by anyone with any of them. Don't know if it was for the reason given above, nobody said and I didn't ask.

Can't see why they can't induce you rather than do a C section. Although induction with a drip is unpleasant, I agree with you in that I would much rather that than a C section.

Good luck on Wednesday.

Thank you. Going to try & stay positive. This is our last baby x

Prostaglandin pessary or gel is how you induce if had not engaged. This is not that likely to work at 38 Weeks. Why can't you wait for normal labour? Prostaglandin can be quite risky for people who have had babies before. Also re 3rd degree tears, I would say if they were 3a tears (ie only just 3rd degree) and you had no major healing problems then it would be worth going for it, if they were worse tears than that or if you have had continence issues then I would suggest a section. A big part of why your cons is suggesting a section may well be because you are 38weeks and he/she knows that induction at this stage can be unsuccessful.

I was induced at 38.5 weeks and DD wasn't engaged (via prostaglandin pessary), the first round didn't work but the second one did (6 hours later I think), contractions kicked off, waters went about 30 minutes later which lead to a cord prolapse (dd still hadn't engaged) and a crash section.

In retrospect the consultant said I probably should have gone straight for a section (I was given the choice) but that said the hospital were amazing, I was monitored very closely during the induction and the risk of prolapse was fully explained to me (its not actually that common but obviously more common if you are induced when baby isn't engaged) and they checked me for prolapse pretty much as soon as my waters went (I can now laugh at how ridiculous i must have looked on all fours with a midwifes hand up my vagina trying to hold the head off the placenta as i was wheeled to theater, although it was very traumatic at the time). We had a happy ending as both DD and I are fine, I don't think I'd consent to the same again though.

I don't want to scare you and I'm sure you are aware of the risks, what happened to me isn't common, but yes, to answer your question they can induce without being engaged.

i was induced at 35 weeks with ds (due to IUGR). head not engaged, the hospital tried the gel, 3 doses later still no labour but was taken to the delivery room where the consultant managed to break my waters was given 2 hours to see if i would go into labour naturally or need the drip nothing happened so the drip was started and ds arrived back to back 3 hours later.
my drs never mentioned prolapse.
good luck!
HTH

Thank you. The gel sounds good. Feeling the pressure to make the right decision! x