Is it possible to refuse induction and opt for c/s instead?

[143b]

I wonder if it is possible to refuse induction of labour point blank and ask for an ELCS instead?

I have researched the risks for both and i am much more comfortable with the risks of planned calm c-section rather than an induction with a very unpredictable outcome. Even nhs website admits that your have less than 60% chance to avoid instrumental delivery or EMCS if you are induced.

ELCS seems to be safer for the baby statistically if compared with induced labour.

I am planning to have a hypnobirthing course soon, and in the best scenario would want an unassisted birth with minimum intervention. But if it comes to induction - just not comfortable with the idea at all!

Please share your experience!

Thanks

yes.

guidelines have changed and you should be able to request a ELSC if you want one even if there's no medical reason to justify it.

Induction is a process with several stages. Usually starts with a sweep. Then a hormone pessary (may be several administered over a couple of days) to start you off. During either of these stages you can carry on to labour with no intervention - so pretty much a kick start to natural labour (albeit with the MWs keeping a close eye on you).

The syntocinon drip is a bit more intense and I think this is where people are more likely to get into the cycle of intervention.

Would you refuse a sweep or pessaries, or is it really the i/v syntocinon that you want to avoid?

sweeps are not always successful for first time mums though and only offered after 40 weeks.

it is worth asking for it though!

Unless you are offered and given them at 37 weeks.

MrsCakes really? where?

I was given a sweep at 37/38 weeks. Didn't work but they where happy to give it a go as They had just booked me into be induced early anyway. Both pregnancies i did ask about c sections when my early inductions were being booked but it wasn't considered an option. This was 4 and 2 years ago though.

I had a 41 hour labour with my induction & at about hour 30 I was pleading for a c section, they said no but at 39 hours my contractions were still give minutes apart even though I was fully dilated so they decided to take me into theatre & prep me.

As a long shot they tried ventouse quickly first no thinking it would work but it did so I ended up avoiding one at the very last min.

I have to say in retrospect I'm glad I didn't have one but at the time I REALLY wanted one instead of the extra 11 hours of labour I got.

Yes, I am not willing to go with the drip route really. I understand that the natural labour is a very complicated process, where the series of hormones are being produced by your body and released at certain stage. And having the synthetic hormones messes the whole process up. So it is not that much of a natural thing, in my opinion.

I am a bit of a control freak and prefer to know all the risks and benefits in advance if possible, so cannot really understand the idea of having an induced labour with its risks for both mother and a child.

I am aware of the benefits of natural labour over c/s for both mother and a child and I am definitely going to do everything I can in order to have my baby naturally.

But when it is really natural at least from the outset, ie my body kick starts the labour etc. I understand things can go wrong while you are in the process, which is obviously out of anyone's control. But not sure about starting with the induction and messing it up from the feet beginning..

The question is, if I go overdue and start being pushed into induction, can I refuse it at all and insist on a planned c/s unless the labour starts naturally by certain date? I read here on mumsnet that they can offer expectant management and basically monitor you every day. But it does not sound the safest idea either. I would prefer a section instead.

I know if you do it privately this scenario is very acceptable (my friend had it and was very happy). But what about nhs? I cannot go private unfortunately as cannot afford £20k at the moment

You can refuse any treatment, so yes, you can refuse induction. I imagine that if they were so concerned about the baby that they needed to get it out now, then they would offer a CS.

I was induced at 38 weeks due to my own health problems.

I was given 2 lots of the pessary, I can't remember the exact time spacings but i think 12hrs apart.
This got me to 1cm. I was fed up and in pain (my condition, not really labour pain) and so refused a third dose when the mw came round to give me it.

When that happened, the consultant came to see me and said that by refusing the 3rd dose I wasn't really leaving any other option than a c-section and would leave it to me to think about what I wanted to do.

Anyway, I decided to give the 3rd one a try (I was v scared of c-sec, not against it, just terrified!) which got me far enough along to break my waters.

I was prepped for the drip but refused it initially and mw agreed I should see how I progressed without it.

In the end DS was born 3.5hrs after waters breaking, no interventions, no stitches etc and everyone agreed it was a good job I had refused drip or he would've been too quick.

Anyway my point is, induction isn't always a terrible thing with lots of intervention, at least it wasn't for me.

But mostly what I'm trying to say is, I was given the impression lots of times that I could refuse whatever intervention I wanted, that was my right.

If I'd point blank refused the 3rd pessary I believe I would've been given a c-section. Equally I refused the drip and everyone was ok with that.

Have a think about whether you are totally against induction AT ALL or whether it's just that there are some parts you don't want?

Happylittlebear, thanks a lot for sharing your experience!

Looks like there is some form of flexibility at least in some hospitals.

I guess everyone reacts to the unknown in different ways- I would definitely prefer a more controlled route approach, even though maybe a harder one.

It's just I know if my baby got stuck, distressed or needing intensive care after instrumental delivery or emcs I would hate it knowing that it could have been avoided and I didn't do anything!

I know they the recovery for a mother is harder and longer after c/s and you are left with not a small scar, but I would still prefer it to the unknown outcome of an induction.

I once spoke to a friend who is an obstetrician registrar, and he said even though it is still relatively safe to induce etc and he would push for an induction for his patients as per nhs practice, for his wife he would do a c/s to be on a safe side.. I know its just one doctors personal opinion, but that tells me a lot.

I can understand wanting to take away the uncertainty, my friend was induced at 41 weeks and after a long labour with no progression, she ended up with an EMCS. She is now pg with her 2nd and is having ELCS as she said the worst part of her 1st labour was being so utterly exhausted from labour but ending up with a c section anyway. It was like having the worst of both worlds.

Ultimately, whatever anyone else tells you about their own experience (positive or negative), your birth will be unique to you and there is no way of knowing for sure how your body will react and if you are someone that doesn't like uncertainty then I think you're kind of answering your own question really.

Only you know what you're scared / unsure about or what your gut feeling tells you, for me I was scared of a c-section, I don't know why (but then fear isn't always explainable!) so I was willing to try other things and go with the flow but if I wanted certainty then my choices probably wouldn't have been the right way to go!

Glad you posted this 143b as I was wondering exactly the same thing. I want to try for a natural birth but am not prepared to go down the induction route either.

My friend keeps telling me to stop trying to take control, be patient and see what happens, but I am also a control freak and cannot stand the thought of being induced and going through a traumatic time, only to end up with a c section anyway.

I have had a really difficult, horrid pregnancy and don't want anything else to go wrong, so am going to speak to my obstetrician next week about trying to go natural, but skipping an induction and going straight to a section if I go overdue.

Fingers crosssed neither of us will have to go down this route anyway!

I had an induction at 40+1, due to high blood pressure and I got a sweep a few days beforehand which did nothing. I went into labour after 2 doses of prostin, my waters broke on their own after that and then it was only a few hours until he was born but the pain was very intense and sudden. I got an epidural quickly, fortunately, as I was in a lot of pain. My son had meconium 2, likely because of the induction, and required suctioning and CPR because he inhaled it. The suctioning was of course essential as it was an emergency but I think very likely lead to our consequent breastfeeding problems but of course I have no proof of that!

In hindsight my outcomes were probably pretty average/normal for an induction. I pushed him out in 55 mins and narrowly avoided ventouse. I had quite a bad second degree tear - I sort of split when he crowned. He was pretty lifeless when he came out which was scary for me and DH.

For a second child I would not be scared of induction because I know what to expect and that it won't automatically lead to instruments etc.

HOWEVER if due to being overdue or some other reason I am staring down the barrel of induction again, I will ask whether I can have a scheduled c-section instead. Mainly because induced labour was so intense and because of DS becoming distressed/having meconium issues. However I would prefer to go home from hospital ASAP after birth so that is something that wouldn't be possible with a c-section.

In terms of being a control freak - I was like that. Please be aware there is a lot about birth you will have no control of....and that's not even covering the first few weeks of being a new parent, which are like being on an out of control roller coaster. I know it's hard but you have to prepare to let go of control and accept the unknown. Reading up about everything is not always helpful. I speak from experience..... I am an organised control freak and labour, birth and the newborn phase knocked me for six. Less organised people seemed to take it all in their stride a bit more!! You will be fine but please realise you can't control what happens when it comes to birth and babies!!

This is exactly what I've done. I'm currently 40+3 and if this baby has not appeared naturally by Monday then I'm booked in for a c-section on Tuesday. I have refused all induction options and, thankfully, my consultant has been very supportive of this.

It's your body and your baby - good luck.

Ladies - thank you all for sharing a your experiences! This is very helpful.

Italianbride - how did you convince the consultant? Was it hard?

Best of luck with the birth and hope everything goes very well for both you and your baby!