Were you informed of the risks of induction?

[minifingerz]

RCOG has done an audit of birth outcomes at hospitals across the U.K.

The national induction rate for first time mums is now about 33% and about a third of these will result in an emergency caesarean, with about another third needing forceps or ventouse.

Wondering how many first time mothers are told that the most likely outcome for an induced labour is c/s or instrumental?

Was anyone here actually given these figures when they discussed induction?

Do you think women should be told this?

The women in my NCT group had 10 babies between us (4 women). Only 2 matched the NCT "ideal", with no drugs or interventions so I do feel they have a part to play in this.

No I wasn't told of the risks. Took their word for it all and ended up with a c section after a horrific long labour. Awful. This time I am refusing induction under any circumstances (36 weeks pregnant now) due to the awful traumatic time I had with my first.

I refused induction for same reason as FATE. I knew I was only 5 days overdue and not ten. Ds was born healthy after I went into labour naturally.

Big guilt trip about how I was putting him at risk. Nothing about the risks of instrumentation and cs.

I ended up with augmented labour after labour completely stopped.

Isn't there also increased asd risk for induced babies iirc?

This is a pretty timely thread. Im 31 weeks with twins and have been told if i have them "naturally" ill be induced at 37 weeks. So far I've tried to ask 3 different consultants about the risk of interventions as opposed to a planned section and am being totally fobbed off. No chance of active birth at all and i basically have to have an epidural. From what I've read all of this just increases the risk of forceps. Id rather have a planned section than forceps but getting anyone to actually talk to me about the pros and cons has been impossible so far.

No - they thought increased add risk in 2013 but now seems there isn't:

www.hsph.harvard.edu/news/press-releases/autism-and-induced-labor-oberg/

Sorry neon, that was meant as an add on to my earlier post and not directed to you.

Nope have been induced six times and I made sure I informed myself but the consultants didn't like that at all. They were very keen to write on my notes PATIENT HAS BEEN INFORMED OF RISKS IF STILLBIRTH DUE TO REFUSAL TO induce, this was when I wanted to go 14 days over rather than ten. The irony when by my next pregnancy they wouldn't induce till 14 days over as standard.... Policy change.

Anyway it was always about risk of stillbirth, not Ince did they mention increased risk of c section etc and didn't like it when I questioned them on it.

They basically tried to scare me into induction each time and it was always presented as a done deal 'we will/you are booked in for induction on. ' rather than you are heading towards being overdue/past 42was so we should discuss your options. But lots of medical care is like that in pregnancy, can't trust women to make an informed choice now can we...

It's 10 types of wrong that women are led to believe they have a good chance of a straightforward birth then subjected to procedures which make it unlikely, in settings where physiologically normal birth is like hens teeth.

I don't understand what you are trying to say there (sorry!). But it raises an interesting thought that hadn't occured to me.

After 3 normal virginal births, upon agreeing to my first induction with dc4, it didn't occurs to me for a single second that I might actually have a c-section. I had definitely been led to believe my induction would lead me to a birth just like my others.

I knew the risks. I understood that I might end up with assisted or c section deliveries. But I didn't believe I really would. This was my fourth afterall.

I'm done having children now. But if I had another I would either refuse induction (and deal with the daily scans/pressure) or skip straight to c-section.

I was 44 when I had dc2 and due to my age was told I had to have an induction at 40 weeks exactly. Because that must be what the guidelines say for geriatric moms. Like others was told nothing about risks of intervention.

I got to the hospital and told them I couldn't go through with it. Tut tutting all around. Luckily an older wiser midwife was on hand who gave me a seep instead and I gave birth the next day.

Glad I didn't have an induction but v cross that it's become such a default mode in maternity care.

That's meant to read 'sweep' not seep!

Socks - NCT would have told you what a normal physiological birth involves. A physiologically normal birth is often couched as 'ideal' by women but it is simply a physiologically normal birth. Like having a shit without needing laxatives is a physiological shit, or conceiving without needing assisted conception is a physiologically normal conception.

It's only because interventions in birth have grown so much more common so quickly that normal physiological birth is now seen as a fancy and unattainable ideal, rather than just a normal physical function.

NCT will always have a high percentage of clients who have complicated births because they have very high rates of inductions - maternal age related often. Their clients also tend to have more than the usual number of scans and tests (again related to maternal age) and this in addition leads on to more interference in birth.

It's a pisser for NCT. They have clients who want natural births who have an unusually low chance of achieving it.

FATE I'm just saying that women are led to believe that normal birth is the norm. It's not any more - at least for first time mums who choose a hospital birth in an OU.

normal physiological birth is now seen as a fancy and unattainable ideal

You believe normal births are rare amongst the general population of the UK?

No nothing at all. But plenty on the risks of not complying. I had a sweep that nearly took my tonsils out & went into labour 12hrs later. Another 24hrs later, after being off my face on pethidine, failed epidural, failed forceps, baby in distress, consultant was called. I witnessed a stand up row between registrar & consultant about the former not calling her sooner, before scribbling my consent for a crash CS under GA. I had no idea what I was signing or the risks. We both came out OK and i am eternally grateful to the consultant and anaesthetist who was so kind but will never consider another child. Reflecting, i think I had PTSD or PND afterwards.

No. have made a formal complaint.

"Proportion of spontaneous, unassisted vaginal deliveries:

45% first time mothers
58% other (multiparous) mothers"

indicators.rcog.org.uk/results/indicators

Around 50% normal (ideal?) births is not an "unattainable ideal".

FATE - the likelihood of a normal birth depends on

• your age

and

• whether you choose a OU for your birth

and

• which hospital you're at.

The normal birth rate varies from 32% to 62% for first time mums depending on which hospital you're at for a start!

Induction rates for first time mums - lowest 16%, highest 43%

Episiotomy - lowest rates 16.2%, highest rate 50%

I think women should start choosing hospitals to give birth in the way they choose a school for their child.

Look at the data!

that's still depressingly low though
be interesting to see what that those figures look like if you exclude maternal issues (high bmi, diabetes etc)

I know this is a slightly different scenario but reading this brought so much back. Ds was born at 34 weeks. Doctor tried to stop labour with drugs but all they did was slow it down. I was given steroids for his lungs and then induced, all in the space of 12 hours.

I was strongly advised to have an epidural. I was made to wait for 2 hours when fully dilated then spent just under 2 hours pushing. In the end I was rushed to theatre and ds was delivered by forceps.

He was struggling to breathe and suffered horrific bruising, he had been back to back and no one had known. His bruising added to his gestation meant he had prolonged jaundice(10 days of double phototherapy) and concern about his long term liver function.

The pain I still suffer daily thanks to the forcep delivery really pales into insignificance. Had I know what I do now I would have asked for a section as soon as the labour slowed enough to warrant induction. I never talked it over with anyone really. Could I have insisted on a section?? Probably not. Our lives were in their hands and as a first time mum you do as they say.

here

Birth outcomes for low risk women by parity and place of birth.

(scroll down)

68% for low risk nulliparous women who choose and OU for birth
80% for low risk nulliparous women who choose a free-standing birth centre.

"as a first time mum you do as they say"

I think that all first time mums should be made aware of the range or normal practices and protocols across hospitals.

So often they're presented with the idea that 'we need to do this to keep your baby safe' when what is meant is 'this is our protocol to increase your chance of a safe birth, however the hospital down the road may have a different protocol as the clinical evidence isn't as clear cut or as worrying as we've encouraged you to believe in order to get you to comply and not inconvenience our staff.

I was told. Midwife chatted to me and I was also sent a letter informing me of risks. The letter also mentioned that I could refuse if I wanted.

Why are NCT members more likely to have intervention? My group weren't in any 'risk' groups (except one ivf and older mother)

A number of medical professionals scared me shitless about the risks of stillbirth / placenta failure if I refused to be induced at 40 weeks because of my age (pregnant at 40). This was from medical professionals who knew my history of multiple recurrent miscarriages.

Luckily I had a midwife who was very supportive and had done at lot of studying into stillbirths / induction etc and was able to share a lot of information. I argued to wait until 41 week and reassess with the consultant with daily monitoring. But I was put under constant pressure for weeks to just agree to the induction, with no description of the risks of induction.

In the end I did not go over 40 weeks and I was the only one from my antenatal group not to need any intervention/pain relief. Again I was supported by a fantastic midwife.

Reading this thread has made me cross - I was made to feel like absolute shit for sticking to my guns, and was given horror stories not impartial advice and no real information about risks of induction.

In fairness to the medical professionals, they have to tell you about the increased risks of declining a treatment or intervention that they are recommending - if they didn't and you or your baby died, they would be liable.

However, they should also be completely clear about risks incurred by accepting a treatment or intervention, including the need for further interventions.

I have just had my first baby. I am 33 so a slightly older first time mum. I was very keen to have as natural a birth as possible but I knew I would accept necessary interventions. Throughout, when any intervention was mentioned, I asked: "What are the risks? What are the risks if I decline?" That way the HCP knew that I knew that I could decline. They used the language of "done deal" but I never felt like I had no other option, because I know that they need my consent for any procedure whatsoever and I am within my rights to decline.

I was only told if the risks of going overdue. Nothing was mentioned to me at all about increased chances of assisted birth. I had a horrific induction resulting in an infection and EMCS that left me unwell for a while after. My second was a planned c section as my consultant said they'd rather not induce me again based on the previous birth. I was very grateful!

I think HCP have a duty of care to tell you how hard induction can be as I would have put mine off for another week if I'd known then what I do now!