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?

My SIL was induced with her first child on her 40w due date, which surprised me as I had my 2 at the same hospital and there wasn't a notion of inducing me until 40+ 10 (I went into labour naturally before then). I've since established it was because she was carrying an IVF baby. Imo she was not informed of the risks and she is not the sort of person to read up about it herself. It was a big baby (9lbs) and was not engaged and it took a full 24hrs on the drip to get into established labour, then a couple of hrs later she had an epidural. It ended with an emergency c section approx 48 hrs after the induction commenced. As far as I am aware there was no actual 'need' for the induction, it was just a risk profile and she went along with it because she wanted to have the baby earlier in December so she'd be ok for Christmas. You can't ever tell I suppose, and I'm not a HCP, but my gut feeling is had she been better informed, or had opted for monitoring rather than the induction, things would have worked out better. She is really struggling as the birth experience was not at all what she expected

minifingerz thanks! I can see rates of induction at section 2, rates of EMCS following induction and section 3b and 3c, but section 4 on forceps/ventouse gives a single rate for FTMs of 24% and doesn't split that into rates for induced vs spontaneous labour?

The only UK stats I could find on rates of instrumental delivery following induction were at www.nhs.uk/conditions/pregnancy-and-baby/pages/induction-labour.aspx and over a decade old! They show much lower rates of EMCS than the new RCOG stats you linked to, unsurprisingly since the rates have risen over time!

Sorry to chase, I just do love a good stat

I was aware that there was more chance of needing a section/intervention. Can't remember whether midwife told me or I researched myself. Probably both. I had two successful inductions though.

Following this thread
First time mum and I have been trying to inform myself.
Friends are midwives/ doulas and got lots of books and research.
I am also a scientists and understand how to interpret statistics and risks.
I am refusing a sweep based on the data and preferences and I know this wont go down well.
I have to write my birth plan with midwife next week and I know I dont want to be induced just based on dates, decided based on the research and my personal preferences. This wont go down well.
I will be told that I am accepting stillbirth risk and my placenta deteriorating and all. Yes. They will scare me with that.
But what is the raw data for that??? How many stillbirths on a woman my age that knows when she conceived and can be monitored daily? Have had perfect bloods, BP, measurements all along.
Yes there are risks.
What are the risks of me accepting the induction???
Plenty!!
A person is not just body anyway, we are body and mind and I can see how all this affects me and will affect me if I dont deliver by 40 weeks.

I have been given ZERO information on inductions apart from this at my NHS antenatal classes:

"Take your due date. Add 2 weeks. That is your induction date"

That said to a group of 13 women all with different circumstances. As a blanket rule.

And I am sorry but this "ideal birth" and how people shouldnt think they will have an "ideal birth" is very annoying.

I dont want or even know what an ideal birth is. I do want to be empowered to choose and have a say and what it will be one of the most important moments of my life.

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.

Sorry but statements like this wind me up. If we're quoting stats, how about how many births ended in maternal and/or infant death before the advent of modern medical interventions, any numbers on that?

A 'normal' birth in the way you frame it would have been an inattainable ideal for me: my pre-eclampsia might have killed me. My induction process was lengthy and far from perfect, but I'll take my heath & the health of my DS, over the notion that I should have felt entitled to a 'physiological birth' any day.

I 100% believe there's issues around consent & autonomy in the way pregnancy & childbirth is dealt with by HCP in this country, but I don't think an increase in 'physiological births' is the way you'd map improvement in this area.

I had inductions with DS2 and DS3 at around 37 weeks - I was aware of the increased risks of further interventions but can't remember how how much this was discussed with DS2. I got an information leaflet with DS3 rather than the doctor discussing the risks.

However. Both times there was a clear medical reason for induction - DS2, waters broke and I hadn't gone into labour spontaneously. DS3, we'd been having regular growth scans, and the last growth scan suggested that he hadn't grown at all in 2 weeks.
So the emphasis from the doctors and midwives was very much "this baby needs to be born very soon because xyz", with the reasoning and the risks to the baby of not inducing being made very clear to me.

As it turned out, DS2's birth was, other than the drip, a normal vaginal birth. DS3 was an emergency c-section, but this was needed because he'd got the cord wrapped around his neck, so I'm guessing chances are we'd have wound up with an emergency c-section however I went into labour.

Although DH did comment that he felt the informed consent for the c-section was seriously lacking. C-sections weren't discussed at all before things started going wrong. And when things did start going badly, I was very much "just stop talking and get the baby out NOW" when the doctor got called in for the c-section. I wasn't really in any frame of mind to be wanting to waste time listening to talk of risks when I was aware that they were worrying about losing DS3's heartbeat.

Evergreen I think I love you. I also refused a sweep at 39 weeks and made it clear I wouldn't be thinking about induction at all until 42 weeks, and then I would be requesting expectant management. Again, based on my individual circumstances. Went down surprisingly well in my case, but my son was born bang on 39 weeks so I was incredibly happy not to have to go through all the pressure that surely would have followed.

Induction and CS rates in this country are a national disgrace, as is the postnatal 'care' which follows and routinely chucks traumatised women out to deal with the consequences.

Yes, I was informed. In my induction appointment a registrar told me I was putting my baby at risk by inducing early (38 weeks) and she could die. Obviously he hadn't read my notes as my consultant wanted me induced early for the onset of pre eclampsia and a previous late miscarriage consultant ripped him a new one apparently.

As it stands apart from the pessary I had two intervention free, drug free natural births that took under 4 hours.

I had meconium in my waters with dd and had to be induced because I was not contracting at all.

I don't remember being told those facts but it was almost 4 years ago. I wouldn't have cared about risks to me anyway, I just wanted baby to be ok. Dh did the worrying about me! (Bless him.)

I was induced with my first DC at 37 weeks. I didn't feel I had any other choice as was being monitored for low growth. I found the whole think extremely traumatic and frankly didn't want to fall pregnant again. I sit her now at 34 weeks and again having to be monitored as baby measuring on the 10th centile. I am DREADING being induced again. Part of the problem last time is that I was begging for epidural which they wouldn't give until 4cm - by the time they did it I'd gone to 10cm and the anaesthetist was standing behind me shaking his head to DP basically saying it was too late. He was still trying to convince me it was working, I was made to feel like I was going mad. ECS was mentioned but I just pushed and pushed ended up with a 3rd degree tear and surgery. Infected stitches so recovery was quite bad for first month or so. This time I have considered planned CS which midwife has pretty much tried to rule out. All they did was tell me the cons of CS and painful recovery etc. Does anyone have any pros or positive experiences of planned c section I'm really confused and scared. X

Nope, no info given 7 or 5 years ago respectively.

I found the info out for myself, planned 2 home births but caved and was induced with DD in 2010.

Forceps, 3rd degree tear, PPH and retained placenta. Really regret not sticking to my guns.

I stuck to my decision like fucking superglue with DS in 2012.

And yes, women should be presented with this info - how the hell can they make an informed decision without it?

Uninformed consent is not really consent - how can you agree to anything if you're not fully sure if what it entails?!

"the bottom line is that safety must always come first. Over birth trauma, injury and everything else - life is still more important."

This may be true for you personally (and perhaps most people), but in consent terms this is bullshit. Anyone of sound mind can refuse any intervention, even where it might result in harm to them or even death. Railroading women into accepting induction, without willingly discussing risks of both acting or not acting is unacceptable.

I was told nothing, all I got was a text when I was a week overdue saying I'd been booked in for induction on X date and the hospital would call me in at 7am.

I tried to call my midwife to talk about it and was told she was 'off shift' so couldn't possibly go through it with me and I'd have to ask the midwives about it when I got to maternity ward.

I spent the next 5 days shitting myself because all of the information I could get was from google and was horror stories about needing forceps / ventouse / c section.

On the day of the induction, the hospital didn't call me in, I had to chase them. I spent the whole day calling and asking them when I would be called in as no-one had explained the process to me and all they said was they would contact me when a bed was free. That was finally 11:50pm and by the time I was induced I was 40+13 and a bloody mess from not knowing what to expect.

I ended up in labour for 24 hours before an emergency c section. I didn't fully understand the consequences of the epidural or the c section, I just had a clipboard and a bit of paper/ pen shoved in front of me to sign. I could have been consenting to giving my kidneys for all I know.

I have complained to the hospital they are 'taking my comments on board and will speak to the midwife who had no time for me'

I really do believe you should be given the full details so you know what the risks are and what to expect but unfortunately my requests for this were denied and Dr Google made me more anxious due to number of horror stories so nothing actually helped when trying to search myself.

Ime most women don't know that most inductions end in fc/cs.

We have legions of women sleepwalking into automatic 40+10 inductions without being given the opportunity to weigh up the risks.

It's a western version of fgm.

It's a western version of fgm.

Jesus Christ, making a comparison like that is horrendous. We're not being fucking tortured and mutilated with no pain relief or choice.

After 3 normal virginal births

Well, THAT sounds like a story we have to hear.

Very interesting discussion. I think the mere fact that stats vary significantly based on where a woman chooses to give birth shows some interesting stuff is going on. That and hospital staff have different incentives and perspectives to women, and after you make an intervention for the woman or baby's "good", anything that happens will serve to reinforce that decision. If baby and mother are fine the intervention was clearly a great decision; if baby experiences further distress clearly you went in just in time.

Sorry I haven't read this thread fully but just a couple of points.
Please, please anyone who is looking like they might need to be induced read the IAIMS book Inducing labour-making an informed decision. It is so helpful. All women should have access to it when being offered an induction.
Secondly all inductions are not the same. I had an induction for DS and DD2. Despite having a synto drip both times they were entirely different experiences. For DS I was on my back with continual monitoring and no pain relief. Resulting in an episiotomy, venous delivery and serious birth trauma. With DD2 I had a truly mobile epidural (I delivered standing up) a whiff of synto and I was monitored via a clip on DD's head and it was the most positive untraumatic experience. All down to an amazing midwife, really flexible anaethetist and empathetic consultant.

febmumtobe I was offered a planned c section instead of the induction by the consultant as I was so terrified by the prospect of an induction after my first. We came to the conclusion that we would try the induction and at the first sign of things not progressing positively I could go for a c section. I think just knowing that I had that option and that people were recognising my fears as valid was the game changer.

Nope-- absolutely nothing. I did do my own research though. However what they didn't tell me and I didn't know is that you're supposed to take out the tampon - thing (can't remember what is was called) as soon as contractions start or it can cause problems (and it did )

Nope-- absolutely nothing. I did do my own research though. However what they didn't tell me and I didn't know is that you're supposed to take out the tampon - thing (can't remember what is was called) as soon as contractions start or it can cause problems (and it did )

Nope-- absolutely nothing. I did do my own research though. However what they didn't tell me and I didn't know is that you're supposed to take out the tampon - thing (can't remember what is was called) as soon as contractions start or it can cause problems (and it did )

raaaaaah thank you for sharing. Can I just ask, was there any particular reason you chose not to go for c section!? I'm so torn. I understand the severity of operation with c section but actually the consultant said in all honesty it's easier for them to do c section but not for the person recovery. The midwife in the room made a loud gasp and said "just think of your bikini body with a scar" - that thought couldn't be further from my mind.

feb honestly it was a mixture of fear of the csection and having to be able to look after our three children afterwards. I was utterly torn too. Our midwife was very pro 'natural' childbirth so she was encouraging of giving the induction a shot. If you would really prefer a c section (completely valid and understandable) then push for it. Good luck xx

Im going to be induced sat if no baby nothing has been explained to me about risks