Can I ask for a planned C section rather than being induced?

[LisaAYarrow]

Hello there, this is my first time posting here :) I just have a question about something that's bothering me! I've just had my first baby 7 weeks ago and I found the labour really horrendous. I had to get induced after being 13 days overdue, had a 14hr labour with forceps delivery and a 2nd degree cut. I only had pain relief for the first 4 hours and had the rest with just gas and air. I know that might not be as bad as some other people but I just found the whole thing quite upsetting and disturbing.

I wanted to know if I became pregnant again could I explain all this to my midwife etc and say that I'd really want to have a planned C section rather than go through the induction process? I am 34 just now so I am secretly hoping that my age would also swing in my favour! It's just that I'm so nervous about having to go through induction again it's actually making me not want to have any more children. Thanks very much for your help.

Hi Lisa, congratulations on your baby!!!

I'm pregnant with my first and due in 6 weeks - I am under Consultant care due to two health conditions I have. My two labour options were:

1. Come in and be induced with an epidural put in place straight away. There would be a time limit on the labour and if I don't give birth within 'x' amount of hours I'd be taken for a C-section.

2. Have a planned C-section and cut out all the faff.

Me and DH researched all the pros and cons and have decided to go for option 2.

My argument was that if I was having an epidural from the very start it may slow down labour, there's usually a need for assisted delivery and more medical intervention and there is a higher chance of foetal distress. Me and DH explained that if there was a good chance it would end up with me needing a CS anyway I would rather just go straight for ELCS as opposed to risking my health or the baby's by choosing Option 1.

My Consultant was more than happy with this and my ELCS date was booked when I was 28 weeks pregnant.

I was induced with my first at 39+4, due to pre-eclampsia. DS was very ill when he was born - he didn't breath for 10 minutes and there was a long (as in months) wait to establish whether this had led to brain damage, so that put us off having any more for some time.

Anyway, long story short, he is now 3.4 and absolutely fine, and I am expecting DC2. Because of the difficulties we experienced last time, we were put under consultant and midwife led care. When we saw the consultant and discussed what had happened then he said that he would be supportive if we opted for a planned C-section.

We have since done more research and discussed with various professionals and decided to aim for a natural birth as plan A, but to refuse induction if that becomes an option (e.g. if I have PE again, or if baby is overdue). So if they want or need to get the baby out then they can do a c-section.

I also have a friend who had a traumatic birth the first time and gained (written) support for an ELCS before even TTC #2.

I'd give it a bit of time, your DD is still only tiny (congratulations, btw ), and you may feel differently in a year or two, but you can always refuse induction even if you aren't planning a c-section.

Aah brilliant :) thanks so much for your replies! I know, I actually want to wait at least a full year before I try again so maybe the horror is still too fresh in my mind, lol. But it's good to know that they might be understanding with me and let me have a planned C. I don't mind a natural birth but I just really want to avoid induction. Thanks for sharing your experiences with me, totally appreciate it. x

I had exact same experience as you op (though I haemorraged too!) -but i had epidural so I had substansial pain relief! It is very traumatic none the less. No way would I go through thst again. If I am over due with next one I will demand a ELCS ! ( well, beg lol)

Oh god a haemorrhage as well, poor you! It's just mental, I mean I think women do try to subtly warn you how bad it's going to be but your brain goes 'that'll never happen to me!' Next time, forewarned is forearmed!

Haha- I def was not prepared for that! Or the after math recovering from it all. Yep, next time we will be ready at least :)

I know exaxtly how you feel. Was induced with DD, spent four days in labour begging for a c section as it wasn't progressing and told not to be 'premature about it'. Ended up with distressed baby and emergency C section. Now pregnant again 3 years later and am seeing the consultant in four weeks time to ask for elective section. Never going through a week like that again. Also have two health probs and had recurrent miscarriages.

Yeah that sounds awful, good for you for asking :) I think we all just need to be firm about it, that's the key.

I had a difficult birth (3 day labour, no progress, late induction, failed forceps, fetal distress, clips on baby's head etc!!) ending in emcs with my dd, and am now 40 weeks with no. 2. After lots of thought, I have decided that I want as natural birth as poss with an active labour and just gas and air pain relief. However, if things look like they are going wrong during labour, I don't want any instruments (forceps, ventouse) and would opt straight for cs. I also don't want to be induced, so if baby is late, I'll opt for elcs rather than induction. I have been totally supported by my MW and told by the hospital that this is completely fine. Have app with consultant next week where we can discuss it if I've not given birth by then, but I am told it is totally fine to specify this so don't worry. Stand your ground and lay out your plan firmly and clearly. No one can force induction or anything else on you if you don't want or need it!

I'm expecting my first baby and have the same thoughts about induction. After extensive research I am definitely not comfortable with the idea of induction and all the risks associated with it, including pretty much 50% chance of ending up with emcs or forceps..

As a topic starter, I wonder if I can just refuse being induced and ask for ELCS?

Surely this is not an irrational fear, and if compared to the risks and probability or these risks materialising to those of an ELCS, ELCS sounds like a safer type of intervention?

I know there are stories of people being induced and still having a straight forward birth, but even nhs own statistics indicates that the chance for unassisted birth with the induction is just over 50% (not exact figures, but close)

I wonder if anyone had any experience of such conversation with nhs health professionals and how far they got with getting their preferences heard?

Yup - I've been told I can opt for a cs as opposed to induction, no problems whatsoever. I have had a previous cs though so don't know if it would be the same if I had had a vaginal delivery first time round.

Similar to you, my first DC was induced (ending in EMCS after 3 days of failure to progress).

With DC2 (now 2 weeks old) I had a ELCS - but had to jump through lots of hoops, see consultants, consultant midwives etc and only obtained agreement at 36 weeks: there was a lot of pressure to go down the VBAC route. My ELCS was a very positive experience - I didn't need anything more than paracetamol and diclofenec (sp) for afterwards, my scar is healing well and I am not utterly exhausted as I was after DC1. I recognise that I am one of the more lucky ones as regards recovery but I feel so much better this time..

When an ELCS was looking unlikely I took comfort in the fact that they cannot force you to have any intervention if you go overdue - eg consultant midwife said it was now policy to have 3 sweeps (rather than the 1 I had with DC1), community midwife said they would try to turn the baby with ECV if he was still breech ( turned by himself in the end) and that they would only me on the drip for a shorter period of time at a lower dosage.

I just smiled and nodded at all of these comments - I knew that if it came down to it I was just refuse to allow them to try ECV/give me sweeps/induce me and the only option would have been for a section. Happily it didn't come to that, but you do have some control of what they can and can't do to you.

Incidentally, there were a number of very useful threads on here which I mined for information and tactics when putting my case together. Good luck!

But if you had emcs previously, I think it is nhs policy anyway that they should not induce you as it puts additional pressure on the scar tissue?

The topic starter had a vaginal birth if I understand right, so the doctors may not be that agreeable..

Congratulations on the birth of your baby Lisa, and I'm sorry that the birth was traumatic.
I had an appointment with the registrar on Monday at 35 weeks, where I was hoping to discuss the possibility of CS rather than induction, for all the reasons you and others above have stated. Her introductory comments to me were not promising - "Do come in, this should only take 2 minutes. Have we got you booked in for induction yet?" I had to push to have a conversation about my preference for CS as opposed to induction, and she made it abundantly clear that she was not in favour of, or particularly willing to discuss CS with me. This is despite the fact that they are not willing to let me go past 40 weeks as I am over 40 and this is my first baby, so there is a slight increased risk of stillbirth. To be honest, I was made to feel like I was being unreasonable and demanding and simply trying to duck out of labour. I made it clear to her that my preference is for a spontaneous, natural labour with minimal intervention, and that I am not afraid of the pain, but I am afraid of being hooked up to a drip and monitor without the use of my legs because I have had an epidural to manage the pain of a heavily induced labour!
Anyway, I stuck to my guns and she went off and discussed with the consultant and has recorded in my notes "can decide not to have syntocinon if she likes" though no mention of CS.
I was not happy with the consultation, and really disappointed that I had to fight my corner, and even then only got half a result!
Now I am just praying that I go into labour spontaneously before 40 weeks, or that I will have a reasonable Dr in charge of my induction when the time comes who will listen and be willing to consider CS.

143b, they were definitely prepared to induce me this time if I went down the VBAC route - just that the induction would be strictly timed, lower dosage of drugs etc. They would also carry out continuous monitoring if have epidural etc in order to monitor stress on scar. That really put me off, as did not want to be stuck on my back, fail to progress again and end up yet again with an EMCS.

I've just been told they'll discuss induction with me, I've said no thanks, I'd rather have elcs if vbac doesn't happen, and everyone seems fine with that. Different trusts have different policies I guess - can only offer my experience as I have had the conversation again with my MW this week! Incidentally, a friend had a very difficult vb first time round, and had a very straight forward elcs second time after refusing induction. I think she had to be pretty tough with her consultant but she got her request in the end! Congrats on your new baby op!

Thanks everyone again :) Yep I'm willing to have a normal vaginal birth no problem but just do not want to be induced into it. The contractions through the drip were so strong my husband had to tell the midwives that I wasn't coping, and that was only 3hrs in :( which is when I asked for morphine (something I absolutely didn't want before I got there, ha!) It was all very medical and scary, not the 'beautiful experience' bollocks that I'd made up in my head it was going to be. If I'm going to have something un-natural happen I'd rather have a planned C than hours and hours of agony! (Apologies to pregnant ladies reading this, although to be honest it probably won't sink in as it didn't with me beforehand)

I wonder what the doctors could do if you say a point blank NO to induction? Printing out their own statistics from NHS website should surely be enough as it is clear that the potential risks of induction are higher than ELCS?

They can't make you have an induction if you don't consent.

Yes, I did. I very much wanted a natural birth the 2nd time round. But when it didn't happen at 43 weeks I went straight to CS vs induction.

It's really up to you if you want to plan for a C section beforehand. I understand how you feels about induction and natural birth but the disturbance that natural birth can give is short-term compared to the long-term effect and scars of C section.

It's really up to you if you want to plan for a C section beforehand. I understand how you feels about induction and natural birth but the disturbance that natural birth can give is short-term compared to the long-term effect and scars of C section.

My concern was that for me, induction isn't natural birth. I very much wanted a natural, non-intervention birth. I really, really, really did not want a CS. But I'd had both a failed induction and a CS before. And to me, the risks of an induction, and then potentially an emergency CS were worse than a CS by itself. But my situation was probably different, and I'm not much of a fan of inductions, even less than CS.

Yes I found induction really un-natural too. I was hooked up to the oxywhatdoyoumacallit machine (they took 4 attempts to get the drip in me by the way. The midwife tried once, a Dr tried twice then the anaesthetist managed it. I was covered in raised painful bruises for the first week afterwards, and it made upset and nervous before I'd had a single contraction!) Then each time the midwife shift changed, they would come in and jab the button that sped up my contractions. I just found the whole thing like a scary horror film. I actually cried a bit when I put this post up because I realised I'd tried to push down and normalise the whole labour even though I was so upset about it. Ooh and I had to be wheeled back to my room after the post birth shower because my drip came out and started to haemorrhage blood all over the floor...but to end on a positive note, MOST of the staff were absolutely fantastic and kind and I couldn't fault them. But anyway yes, I'd rather not have any more children than being induced ever again.