Planning to refuse induction in favour of c-section?

[Decaffstilltastesweird]

I am in the early days of pregnancy with dc2.

I have requested to be referred to a consultant, due to a traumatic birth after being induced last time. I have spoken to two midwives, who both said that, if I requested a c-section, they would think it was fair enough. Obviously they can't tell me if the consultant will agre or not, so who knows?

I am considering whether to go ahead and request a cs, or to say I would be happy with a vb, but refuse an induction in favour of cs? It particular I would not agree to having the hormone drip again.

I will obviously discuss all this when I see the consultant, but wondered if anyone else has planned to do this and what the reaction from the consultant / HCPs was please.

Any advice greatly appreciated.

I was induced with dc1. Not a great experience but nevertheless she came out with forceps and I recovered very quickly.

Just had dc2 via emergency c section. Actual process of having a c section seemed as enjoyable as these things can be. However I am finding it really difficult looking after dc1 following the surgery.

Totally understand your motive for not wanting to be induced - really do.

But I'd Def consider the impact of the recovery time of a CS when discussing with your consultant etc

Good luck to you and hope dc2 arrives safely

Thanks floppy. I would have minimal help at home after DH goes back to work, so recovery time is a consideration.

Hope you're on the mend now and congratulations on the new arrival .

I've had two sections, EMCS following failed induction with DS1 then elective with DS2.

The recovery from the elective was so much better as I wasn't exhausted going into it. I did have lots of help from my mum, MIL and DH though. I did nothing but feed and cuddle DS2 for a month but it paid off.

I had a tough first birth after induction. Forceps and the recovery wasn't too bad but labour long with many very hairy moments and a super distressed baby. When pg again (and DC1 only 12 months at the time) I started a conversation about elective c section, was just too terrified. I found midwives to be pretty dismissive of my experience, and they made it clear that I'd have to jump through a lot of hoops to get an elective section. Was pretty annoyed at the attitude. Was told had to have essentially a counselling session with midwives, which was useful in helping me address fears. I should add that the hospital local to me has great stats for natural birth versus c sections and they seem to want to keep it that way.
In the end I opted to try naturally again. Labour was under ten hours, no pain relief and a water birth. There's no guarantee at all that a second might be easier but what convinced me to try was the thought of managing a toddler after major surgery and two weeks of paternity leave! My recovery was so fast this time. I'm so glad I gave it a go. If you want to go down that route you may need to be forceful, but remember you do have a right to be heard!

Thanks, that's good to hear.

Yes, DC1 and I were both exhausted after the very prolonged birth, and then became seriously ill a few days after getting home. Ended up being readmitted into separate wards . DC1 was recovering when I fell ill; I genuinely (drama llama) thought that was it, I wasn't going to live to see my dc grow up and how unfair it was, as she was just getting better and I was definitely going to die. Thank hormones for that one.

We were both fine eventually, but dc had a week in hospital and I had three days. Fucked up feeding of course and was generally a massive mess.

That's what I want to avoid. The actual birth, though long, painful and scary, I could have lived with if we'd been ok after we got home.

I refused induction but was told by the consultant that she had no reason to offer me a section. So I waited, and DD came without mishap in the end.

Thanks intra. I wonder if we had waited a few days if she'd have come out on her own. We had shoulder dystocia though, so suspect had we left it any longer she'd have been too big to come out on her own? She wasn't exactly massive (8lbs), but a mw later said she may have been a little big for my body?

Excuse all the question marks! Shows how little I understand about what happened and what it means for this time round.

I had a birth debrief with a mw, but it was so long ago and I wasn't thinking about the next birth at that point.

I had a long and traumatic induction with DD. Took me ages to get back on my feet.Was seriously considering section when I fell pregnant with DS.
I knew I would have minimal help after birth and my consultant said there was no reason why I couldn't have a normal natural birth.
I put my trust in him and also did lots of research about 2nd births after induction.
Need not have worried, DS arrived 3 weeks early, extremely quickly! Couldn't have been more different.
I felt great afterwards compared to the first time, and although I had a week in hospital due to DS being in SCBU for meconium aspiration, i coped much better second time around.
I would voice your concerns to your midwife and see if you can speak to a consultant midwife also. I did this and we went over my previous birth notes, discussed what went wrong and what could be done this time to make me feel more relaxed and not anxious.

I had an induction with my first and it was quite an ordeal. Not due to induction I don't think but due to stressed baby and long first labour.
Second labour was long but natural with gas and air. Felt totally different.
Personally, I always want to avoid c section to avoid the long recovery you can sometimes have after them

I vaguely recall being told (your midwife could confirm the evidence basis) that the risk of shoulder dystocia increases with induction as the baby doesn't always have time to turn properly and gets stuck.

Both DD1 and DD2 were very late, and DD1 had quite a sideways squashed head - my midwife said they were probably just taking their time getting into position and if I'd had an induction it may not have helped to get them out faster as they might have become stuck. I don't know for sure, obviously.

Expectant management past 40+14 is no picnic though. If you do think that's a possibility for you I recommend you write down all your thoughts and the evidence basis for them in advance - there will be a lot of pressure to go with policy (i.e. induction).

Thanks all for comments and advice.

I'll see if I can ask to speak to a consultant midwife, if they have them at my hospital, (the mw who booked me in didn't know if they have them at the hospital where I've chosen to give birth - it's a different one to hers). I'm down for consultant referral anyway. Not sure if that means consultant midwife or obstetrician...

I was in exactly your situation. The midwife thought it was a reasonable decision. I had to go through a process (VBac clinic where senior nurse talks through the risks with you) agreed that c section sounded best. Then my DH and I went to see a consultant. 30 mins discussion. They agreed to a c section. I think it was a well informed discussion where my wishes weee respected. They agreed to c section at 39 weeks.

Thanks olympic.

And yes intra, will definitely try and clarify why they think she might have got stuck. It was resolved easily enough, but there was a herd of HCPs round me by then, so I was in particularly safe hands I think.

The mw at my debrief said that I may not be advised to go so far overdue with another pregnancy, as she said dc might have been too big for me, but it's interesting to hear that the opposite could also be true - she wasn't ready to come out.

I'd been in stop start labour for days beforehand, but nothing came of it. The same thing after the pessary - contractions for a few hours which just fizzled out. They didn't believe they would fizzle out when I said to them that I'd been experiencing exactly the same feeling for days now. When nothing happened, they decided to hurry things up with the drip, but by the time I wasn't fully dilated, dc was distressed and heart rate dropping etc. She was in a funny position and not turning properly, so what you said about them not being able to turn in time after induction makes sense.

*was fully dilated

I was in stop start labour for six days with DD1 and for three days with DD2. Both ended up (eventually) as straightforward births without intervention.

My first came 13 days late (was going to be induced on the following day) and I had no complications. 9lb 5oz.
I was induced on my due date with my DS as I'd had a very complicated pregnancy. The induction was horrific. 3 days in and we got to 8cms before discovering baby was back to back. I was swollen off the medication, in agony and was then rushed in to have an EMCS after my heart rate dropped and my son's was up and down. 24 staples later I wish I had just had a ELCS because the induction for me was horrific.
I dunno what I'd do if I was to have another baby.

Thanks again for posting. It's really helpful.

I don't know if this would have made a difference as well, but my due date was moved forward 4 days at our 12 week scan. This time, I am pretty sure I can't have conceived before a certain date as we were not actively TTC, just using one of those period tracker apps. We only dtd (sorry tmi) after my fertile window. So if they want to move my due date and therefore induction (if I go overdue) forward this time, I don't think that would be right? But don't know. And I know I would not be able to possibly risk the health of the baby, by going against doctors' orders if it came down to it. All worth discussing with them though maybe.

You're entitled to request anELCS and if your consultant refuses then you can ask to be referred to one who will do it. Ask them to explain all the pros and cons and make a decision. I researched this at length when pg and decided that i would opt for a c sec rather than induction due to the increased risk of intervention with intruments. To me forceps are far more risky to both mother and baby than an ELCS. I ended up with an EMCS and if i have any more ill opt for CS again.

Thanks, I had a letter with the pack I picked up at the GP when I was referred to the mw, from the original hospital, basically saying they don't abide by the NICE guidelines on CS. I've chosen to give birth in a different hospital, (not because of the letter, but because it's easier to get to despite being further away), but I'm not sure what their stance will be. I'm not hell bent on a CS, but it would be preferable to an induction with the hormone drip.

My ideal situation would probably be that I could be booked in for a late CS, after my due date, when they would want to induce me anyway. That way, I would hopefully have a good chance of going into labour beforehand and might be able to avoid induction, but without going overdue by more than the recommended 14 days.

I had a very long and very traumatic induction with DC1. My consultant was more than happy hat if I got to the stage where induction became necessary I could opt for a c section then. As it happens I had to have a c section for other reasons in the end but my recovery from that was extremely quick. I am 4 weeks post partum now, I could barely notice I had had c section after the first couple of days (which were excruciating) and was driving after 2 weeks. Probably could have driven before but didn't need to. I have been very lucky on that front I realise. I don't know whether it made any difference to my recovery but I MADE myself get it of bed as soon as the catheter was out 12 hours after, despite huge discomfort, and then regularly got out of bed to mobilise myself and use toilet etc. I really struggled with that but glad I did it. And I am a massive wimp with pain normally. Good luck

Thanks for that LeSquigh. Hopefully the consultant I see will feel the same as yours. Glad to hear you've recovered so well. Congrats to you too on the new arrival !

The midwives will encourage you out of bed with help asap to help prevent blood clots forming.

Let us know what happens as I have just had a forceps delivery after 15 days overdue and would like to elect for c section next time.

I had a very very traumatic first induction (massive tear, hyperstimulated contractions caused by bad reaction to the drip and leading to foetal distress, very long physical and mental recovery with surgery etc). I thought I was genuinely going to die during labour it was so awful.

However.

I ended up opting for a second induction for baby 2 rather than section (my tearing meant I was borderline for compulsory section) but I refused the drip and had my waters broken in hospital. We had agreed that if I didn't progress from there myself that I would go for a section. As it was I went into labour myself after my waters were broken on the ward and I ended up with a very quick and straightforward normal delivery of a 10lb baby with a few puffs of gas and air. It felt so very easy compared to first time. I had to have a very small episiotomy to preserve the scarring from first time but that was very minimal in terms of recovery and I was home 6 hrs later.

So just to say it isn't all or nothing. I'm glad I tried the gentle induction with the section as back up but then my consultant was very supportive so depends on your hospital really.