C section or Induction with preeclampsia?

[possum18]

I am 36 weeks pregnant with DCDA twins and been in hospital for the last week with moderate preeclampsia. Both babies are absolutely fine and have been monitored closely, no concerns about their wellbeing at moment.
Been let home now, with monitoring every 3 days.
I have a consultant appointment on Thursday (7th) when I will be a day or two off 37 weeks, if I haven't gone into labour naturally by then they want to discuss my options for getting the ball rolling the following week, either by induction of ELCS.
If the preeclampsia gets worse before then they will intervene sooner.

Both twins are head down and we have been planning a vaginal delivery throughout, so I would prefer to be induced.

Does anyone know if having preeclampsia will change my consultants preference towards either induction or ELCS?

I was in your position and had an induction and I really wish I'd just had a nice, planned c section.

I won't mince my words when I tell you that induction is very unpleasant. It's painful and involves loads of drugs and doesn't even work for some people....didn't for me so I had to have an emergency section which is far more stressful than a planned one.

In the end it's nobody's choice but yours though...I hope it all goes very smoothly for you though.

By the way I subsequently went on to have a planned section with DC2 and it was wonderful. So nice to be awake, aware and all organised because I knew exactly when the baby was coming.x

I waa only pregnant with one, and started contracting naturally, but after a couple of days of on/off contractions they induced me with syntocinon and ARM, which didn't work and I ended up with an EMCS. I had another baby 6 weeks ago via ELCS, and it was great 😃 I know this doesn't answer your question at all but just wanted to flag up that a section isn't necessarily a reason to panic, or worry, or feel like a failure at all (as so many people seem to think.) I'd have another one in a snap!

Do remember that your consultant cannot force you into anything, and you have the right to ask for an appointment with the Supervisor of Midwives if you're not 100% happy with his or her advice.

This woman's blog describes her birth story with an induction with twins, she is a midwife as well gasandairblog.com
Both induction, c-section (well birth) carry risks and unless your medical team recommend one course over another I would go for the one with the least intervention- personally.

Thank you ever so much for your input, I think from a planning point of view an ELCS has its benefits!
Fingers crossed I go into labour naturally before any need to intervene.

I'm just going to correct a part of MattDillonsPants's post: "induction can be but is not always very unpleasant."

I've been induced a bit early (with one baby) because of complications with the baby. It was all very smooth. I was too dilated for the pessary so they went ahead and broke my waters. Nothing happened so they started the drip. I did like the epidural I got a couple of hours later, and then DD was born a couple of hours after that, unassisted delivery, tiny graze.

I recovered really quickly and felt far more normal far more quickly than my entirely unmedicated home birth a couple of years before.

If it was me, I think I'd want the decision to be made based on how ready my cervix seemed to be, with perhaps a plan to start induction but to switch to a semi-elective section if things didn't look like they were progressing promptly.

Some useful links for you to read through before seeing the consultant are:

NICE guidance on hypertension in pregnancy www.nice.org.uk/guidance/cg107

RCOG patient information leaflet on pre-eclampsia
www.rcog.org.uk/globalassets/documents/patients/patient-information-leaflets/pregnancy/pi-pre-eclampsia.pdf

RCOG page (and links) on elective sections
www.rcog.org.uk/en/patients/patient-leaflets/choosing-to-have-a-caesarean-section/?gclid=CjwKEAjwuPi3BRClk8TyyMLloxgSJAAC0Xsjs4RlxAsDUZ1wT5VqURSJAlIvGw_8Mhepnlzg8_ZR8RoCpHPw_wcB

Been trying to find if there are RCOG/NICE guidelines on mode of delivery for DCDA but can't find anything, I'm afraid.

Hope all goes well and those babies decide to make an appearance soon!

I had an emcs because of severe PE at 31 weeks, baby was considered too small/weak to consider induction. Not that it made any difference, but a midwife told me that women induced because of PE often had very quick labours.

However 2nd baby was induced at term because of high bp (not PE though). It was fine, pretty easy/quick as labour goes, so it isn't true that all inductions are awful. Maybe there was something related to bp that meant quick labour (like midwife at first birth mentioned)

Good luck btw

Countess thank you so much that's really helpful info I'll make sure we read through before seeing the consultant, I want to get the most out of the appointment so really great starting point!

Thanks for that Countess I shouldn't let my experience colour the facts.

I've been induced twice with single babies due to pre-eclampsia (looks like I will be this time too) and honestly it was fine. Obviously I can't compare my inductions with going into labour naturally but both were manageable with gas and air and pethidine. Personally I'd always rather avoid a section if possible, especially with twins to care for after.

One thing I've discovered is a csection is far more risky for baby. They aren't prepared for birth and there is more chance of infection. If I had my time again I'd be induced and be as active as I could through labour. Everyone is different tho, I'd read up pros and cons for both and see what your consultant says and follow your gut.

I was induced at 38wks last time due to preeclampsia. Had the pessary, spontaneous rupture of membranes, put me directly into established labour - DD born 12hrs later with no interventions.

It's really not always bad.

I had an induction which worked very quickly. I was 41+ weeks with reduced movements and decelerations on CTG. I was in active labour the next day after contracting on and off for 18hours. I did end up with an EMCS at 9cm the following morning but glad I laboured. Bodes well for next labour hopefully.
I certainly wouldn't say I had a bad induction experience

I was induced at 35 weeks for preeclampsia.
Once my waters broke on their own after two pessarys active labour was 3 hours including pushing stage. Midwives also told me women with pre eclampsia often had very quick labours as the body just wants to heal it self as quickly as possible

Also contractions started within minutes of waters breaking as well.
It was in no way traumatic but I have to be honest and say it was very intense once it got going.
Baby was fine though and so was I. Normal vaginal delivery and 2nd degree tear which felt sore for a week or so but no pain since.
Baby was 5 pounds 1 ounce with a 48 hour stay in scbu

Thank you so much for sharing your experiences, looking forward to seeing my consultant Thursday and finally getting a date to get these babies out into the world! Super uncomfortable and no sign of them coming on their own.
New BP tablets seem to have helped a lot with that aspect of the PE but my protein levels are continuing to rise.
Not long to go now.

Induction booked for Monday (37+1)! Consultant said he is 50/50 about it ending in C section. I have told him I am happy with either, which ever is deemed safest for babies.

Good luck possum. You've got the right mindset, whatever is best for you both.

Oops forgot! Whatever is best for you and both babies xx

I've been induced twice. The first was ok and the second was something I could certainly do again. Neither was terrible.

Thank you - I just want to meet the baby possums now and squidge their little faces

Thanks all for your thoughts!
Was induced Thursday lunch time, had my waters broken Friday lunch time, 18 hours of established labour until Saturday afternoon when I got stuck at 9cm for a few hours so ended up with an emergency C-Section!
Horrible experience all in all but two perfect babies have made it all worth it

Congratulations possum!!

Rubbish that you had the worst of both worlds but you're all through it safely, that's the main thing.

And so in love