Likely to fail induction or elective caesarian?

[Aw12345]

I'm being induced in a week as consultant concerned about babies growth. Went for a sweep today... Baby nowhere near pelvis, midwife couldn't feel cervix at all because it's so far away still. I'm 39 weeks (being induced at 40).

Assuming baby doesn't get a real wriggle on... Shall I attempt induction or just go straight to caesarian?!

Any advice welcome!

I would go straight to CS.

Three years ago I was induced when I wasn't ready. Five gruelling days later DC1 was delivered via EMCS. Because it was an urgent rather than planned induction I hadn't realised I didn't have to consent to it. I'm still angry about that now.

The CS bit was great though so I opted for an ELCS with DC2. No regrets there!

Another vote for the planned section. They attempted to induce me two years ago due to my blood pressure and after 5 days and nothing happening I was booked in for a section. The section was a breeze compared to the induction process and I'm currently pregnant with baby number two and recently told my consultant that I want another section.

I would go for the c section, personally.

I was in a similar position but in my case was overdue by 12 days. My bishops score (readiness for labour) was 0 - no dilation, cervix hard and long. I considered a section but went for the induction and in the end just needed one dose of gel, went into labour a few hours later and the labour lasted 3 hrs start to finish. So it can work out ok. Think my baby needed a final nudge!

In your position I'd really probe why induction is necessary- none of the people I know induced for growth issues actually enddd up with small babies. The longer you can wait the more chance your body and baby will be ready. Also things can change very quickly. But if you're not opposed to a CS (I wanted to avoid it if poss) then yes, just go for that.

I'd always opt for a elective c-section over an induction if by induction they mean putting you on a syntocin drip. I had a drip for dd after my waters broke and I didn't go into labour and it was awful (very painful contractions didn't actually seem to achieve anything and I had a c-section anyway) , but the gel induction is quite different I believe. However it doesn't sound as if you are ready for labour at all so if the baby really needs to come out a c-section seems like a better option as it does seem likely that you'd end up with one anyway. ds's birth (he was an unplanned c-section but no labour was involved) was very civilized and untraumatic.

I was induced.
Bishops score of 1, cervix was 1 dilated and long and hard.
Over the week before the induction I had 4 sweeps to see if I could just go into spontaneous labour. And acupuncture and lots of clary sage and raspberry leaf tea!
Then I had a 24hr pessary- checked after that and I was exactly the same as the week before. I was very despirited

Then I had a gel inserted. 6 hrs later another check and I was still the same. No progress.

I had already made the decision that I would give my body a chance to go into spontaneous labour after a drug-kickstart but that I would make a call whether to have an emergency caesarean early on, if for example, it was all going super slow and I needed the drip.
When the 6hr gel didn’t work, I told the hospital I needed time to think and I considered just refusing the induction so I went to sleep in my bed on the ward. 2 hrs later my waters broke. Dilated to 4cm in timescale they wanted and then dilated to 7cm four hrs after that and then 3hrs later baby was born. I declined an epidural as I feared slowing down and them therefore insisting on the drip.
I was very worried about the ‘cascade of intervention’ associated with inductions but mine just kicked my labour off and I just went from there.
There is always risk of emergency caesarean ie. too much meconuim in waters etc, baby’s heart rate dropped etc and that you can’t control. But for a caesarean related to ‘failure to progress’ you have more control. You could make a decision earlier if you get to a cartain point and aren’t happy with your own progress.
I had a very clear conversation that I agreed to induction on the basis they would support a caesarean if I asked it for it during the process.

what is the growth concern with your baby? I would really check the basis for their induction recommendation:

C section. Without a moment's hesitation.

I was induced with DD1 and the entire process I personally found horrific. Culminated in a forceps delivery in theatre, and it took me months to recover from physically (with 2 ongoing issues 2.5 years later) and mentally I was still having trouble right up to DD2s birth this week.

DD2 had suspected growth restriction and abnormal dopplers, so I opted straight for c section. I'd already requested an elcs but they did ask if I would be induced as I was 37 weeks on the dot. Honestly, it was bloody amazing. Her birth was a far cry from DD1's and the recovery has been so straightforward. I'm 5 days post CS now and I can't believe how good I feel. I did have some bleeding from the incision so it was not entirely straightforward, but even with that, it has still been an overwhelmingly positive experience.

Good luck OP!!

I was induced at 39 weeks for the same reason. Induction failed and they recommended a c section. I refused, saying I would return at 40 weeks and attempt the induction again. Second induction was successful but I still needed an assisted delivery with forceps and ventouse. Baby was a perfectly healthy weight and I do feel that my birth was complicated in ways it didn't need to be by an induction I don't believe was necessary. I don't know your specific circumstances and I'm absolutely not suggesting you go against medical advice or take risks of any sort with your labour, im just sharing my experience (for context I was a medical student at the time so felt fairly confident asking questions and being a bit pushy with my birth choices, but as a scared FTM I do still think I let the doctors walk over me a bit). Basically I was classed as "suspected IUGR" but my scan didn't show any actual signs that my LO was too small. My consultant later admitted that I just got caught up in a new initiative they were trialling at my local hospital to induce everyone that fell within certain parameters (I fell within them by about 0.1%) with the idea that although 99% wouldn't actually need it, it would help them catch the 1% who did. So don't be afraid to grill your consultant a bit on the extent to which an induction is actually clinically indicated. And if you haven't already, it'd be a good idea for you to read the NICE clinical guidance surrounding inductions. The better informed you are the easier it is for you to advocate for yourself. Good luck 🙂

www.nhs.uk/planners/pregnancycareplanner/documents/nice_induction_of_labour.pdf

I was induced with my first and it was horrific.
For various reasons they don't want me going over 39 weeks this time so I'm booked in for section on Tuesday.
(I have had a section already though(

I had an induction first time round pessary water broke and drip failed to progress at 6cm stayed there for 4 hours then emergency section.
I was 37&5 was induced for ketones and liver problems.

I have the same decision to make in next few weeks for this pregnancy so this thread is helpful.

I would like a third child too.

I refused induction, too many indicators which suggested it would be a very difficult birth. A registrar even promised me she would be there with forceps... went straight to planned C section. It was absolutely the right decision, I'd do the same again.

Thanks so much for your replies. I'm going to talk more to the consultant about whether she thinks it's absolutely necessary and if so then go for caesarian.

Thanks so much for you help!

I was induced with my eldest at just before 35 weeks because of pre eclampsia. And I wasn't "ready" for labour at all. Still had a quick vaginal delivery with no other interventions. So I'd probably be more likely to go for induction as I don't think they are always the horror stories that you read about on here.