Induction questions

[MuddyWellyNelly]

Basically I'm trying to decide whether to go for induction at term or not. This is due to being 40. No other risk factors at all, have had an easy pregnancy so far.

There are two or three main deal breakers for me. The first is staying overnight in the early pessary stages. I've been told it will be an inpatient induction but I'm not doing that. What reasons am I likely to be given for having to stay? I know I can do what I want but would rather have the consultant on my side. What compromises are possible? I don't want to be apart from DH and want to be able to relax at home if it takes a long time.

Secondly can I stop after pessary/gel stage and give nature more time to work? My leaflet says breaking waters would be next but didn't make it sound optional.

Finally can I insist on a section at any point instead of further intervention? I don't want the drip.

Libraries that's a good point re the induction stats, thank you. Yes I've heard mainly horror stories about the drip.

Burning, I know DH could stay during the day but have been told overnight you have to be on your own. That bothers me a lot, not because I'm a needy person generally (he often gets irritated by my complete independence!) but because this is our journey, it's been a long traumatic one to get here, and we are in it together. I guess though they can't actually force you to stay. Maybe I will just get up and go home anyway .

Bored again a good piece of advice, thank you. I think I maybe already said this up thread but the leaflet I got given suggested breaking waters was an automatic next step after the pessaries and gel. But again I've heard this can be incredibly painful if you aren't ready. My fear is exactly as you say, at 40 weeks I may well be nowhere near ready hence why I'm concerned it will be a long, drawn out, painful, medicalised intervention.

I was induced for ds1, pessary and breaking my waters didn't do much so I was put in the drip. nver was mentioned nor occouredto me to go home.
May I ask why you would prefer CS to the drip?
Not saying that the drip was easy, it was annoying to be in the bed being monitored rather than the hoped for pool, and when the contractions finally came it was 0 - 100 faster than a Ferrari, no gradual build up. As I wasn't dilating much I then had the epidural the midwives had been recommending, and from then it was fine. had a snooze. couldn't push hard enough when the time came as couldn't fell anything so had a ventouse.
For me all that was preferable to CS as quicker to recover from.

DidIreallysaythat, sorry you didn't have the best experience in the end. As you say you may have been lucky with how quickly it happened; but I think induction at 42 weeks is far more likely to be effective than the 40 they want to do. I'm now wandering if I should just say I'm adding a week on. They also "want" (ie have told me they will ) to do a sweep at 39 weeks but that also feels too early and probably unnecessarily painful!

Bumper it's a fair question. I think mainly because I prefer the relative certainty of both the process and the recovery from a CS vs the unknowns of the drip and instruments. Ironically I was going to say I also really really don't want an epidural, but I do realise that's part of a CS! Hard to articulate but there is something about the idea of pushing and labouring when you can't feel it that really upsets me, whereas it is rather more acceptable when it's surgery.

probably doesn't make sense but it's just something I feel, really.

I found it helpful to think of it as being done for me and my baby, not to me (sometimes difficult to match to the experience).

I have never found sweeps painful, bit like a smear really.

There is a medical reason why they want to induce you at 40 weeks. It's your choice to refuse or take up the offer. FWIW, monitoring the babies heartbeat every day or so for 30 minutes to an hour isn't monitoring the condition of the placenta.

I had an early induction. Couple of pessaries and that was enough for me, I do realise that isn't the case for everyone. I did have a private room though. There were a few available for induction. Does your hospital offer something similar? Sometimes they are free (mine was). Would that help?

Congratulations

I was induced. I was anti c section, but if I could have the chance to do it all again Id take the section in a heartbeat.

I guess it's different hospital's policies, but my husband stayed overnight with me while it was happening. I had previously been admitted for monitoring at about 36 weeks and he slept on a camping mat at the side of my bed! Perhaps the key thing was that we didn't ask, just did it and no-one said anything?

I've had two inductions. Both led to baby/ babies being born within 12 hours despite an unfavourable cervix.

My situation is different as induced at 35 weeks due to preeclampsia (after birth also discovered placenta had failed and was in an awful state hence why DS was so small at that gestation but scan the previous day said it was working well).

After overnight monitoring for preeclampsia they induced in the morning and I went straight to the drip.

DH was phoned to come to hospital and I was taken to a private room in labour suite the minute decision made. Nothing started until DH arrived and drip started about 10am.

I had my waters broken a few hours later which was an odd sensation but completely painless.

I laboured lying down due to monitoring as they weren't happy with DS movement by this point and DS was born at 330pm with no intervention and just gas and air.

He was my first and to be honest I'd not been to any classes yet as he was early and i didn't research the process at all so was possibly naive and just knew it would get DS out quicker. I'd also agreed to be induced on due date due to history of recurrent mc but obviously didn't get that far. However, having been through it I'd happily do it again if needed.

I know it's different circumstances but thought it might be helpful to have a positive induction experience incase that's what is decided on. Good luck and I hope you get to choose whatever makes you most comfortable.

Thanks all. Interesting about husbands being allowed to stay in some cases. A private room would help a bit but doesn't take away from my caged tiger reaction. Or the drip/intervention/instruments part.

Tilder there isn't a medical reason for induction for me and this baby, only a sweeping generalisation for all woman over 40. I'm also having weekly scans now which do look at the placenta, and would expect if I refuse induction they would want to increase their frequency.

Bumper - it isn't a given that you will have quicker recovery though is it? My massively long labour and forceps still has effects 6 years later.

My understanding is that the risk applies at a population level and that it isn't possible to say which individuals are actually at risk and who is not. So the risk for all is managed by induction at 40 weeks, effectively removing exposure to the risk.

As with all these things, the number of individuals that might be affected is small (hence people saying 'well I went over 40 weeks and I'm ok').

There is no test to see who is actually at risk. Monitoring will show some things up but not all.

I guess I would just say, try to go for things with an open mind. You are 37 weeks (from memory) so plenty of time for things to kick off on their own.

Congratulations again - waiting for the birth of any child is exciting, nerve wracking, frustrating etc but a first baby is truly a wonderful thing.

Good point Libraries. Before the day came I was adamant that a c-section would be the end of the world and recovery would be dreadful. Quite the opposite, I was up and about within 12 hours, using stairs, holding my son, breastfeeding, off pain meds within 48 hours. All totally fine.

It's not a medical reason why they want to induce at 40 weeks, it's based on some research that, as far as I could find, states that the increase risk of stillbirth is 0.3 %. If you ask hcps what the actual risk is they often don't know, it just gets banded around as fact. And I'm not sure if they separate known medical conditions from the figures.
Muddy, sweeps don't work if your cervix is still too high up. I had 3 and they did nothing because they couldn't reach. I wouldn't bother next time (if there was going to be a next time!)

Why is a 1% risk of miscarriage deemed acceptable when carrying out a amniocenticis but a 0.3% risk isn't accepted to medical professionals?

Well it isn't 1% often.

But taking those stats I would guess they don't see the upside of waiting as as valuable as the upside of amniocentesis (and that's actually speaking as someone who had amniocentesis but would not agree induction ).

I was induced with both mine at 39 week due to high blood pressure during pregnancy.
I had 1 pessary only each time and straightforward vaginal births each time with gas and air.
I am a bossy cow though and made sure all MWs and registrars knew who was in charge.
DD was 8lb 13 and I had a tear which was stitched in theatre. Glad I wasn't full term when she wouldve been bigger! Made a great recovery from the tear and I was back to normal sooner than if I had had a section.
Good luck!