Please advise, nearing day 6 of induction.

[Rosley]

Came in on Monday at 3am with complications of OC and reduced movements. Had an emergency scan that showed baby is big and has increased fluid. Sonographer did not pick up baby moving on the scan but said heartbeat was fine.

Monday night the doctor said I would be induced Tuesday morning (when I turned 37 weeks). Had propess in Tuesday morning and had it in 24 hours. It did not work, told by midwife that doctor wanted to try a foley balloon.
11pm Wednesday balloon was fitted and removed 12pm Thursday afternoon. Was told it had not really worked.

I was then left all of Thursday and saw no doctor. This Friday morning (10am) saw the Consultant on their rounds. Begged them for a CSection, told them I am exhausted barely getting 2 hours of sleep each night.

Consultant told me they would not give me a CSection. Allowed Consultant to examine me and they said they could break my waters. Asked me to let them try, I agreed.

I am now still waiting for someone to come and break my waters. Women have been coming in for induction, taking to the propess and are being taken up to the Labour ward. I feel like because i am not progressing they are just leaving me here?

Tonight will be 6 days I have been here, 5 days after they told me my baby needs to come out for it’s health.

Can someone please advise me what they would do in my situation please? I am a first timer and just so exhausted and mentally drained.

I feel for you OP. It is dreadful being in hospital and feeling you might as well be at home because you aren't being treated.

They need to tell you what's happening.

Just another thought if you want to get the chief execs name google your healthcare trust chief executive, they may have an email address online.
Just may be helpful to drop it into the conversation that you will be contacting the most senior named person in the trust with how distressed you are, even if they don’t pick it up until Monday morning it means you are starting an audit trail with evidence about the way have been treat.
This is really shocking I’m so sorry for your stress op.

Gosh OP you poor thing. My 5 day induction was bad enough. It's because it's the weekend. Bastards. Contact PALS.

Best of luck with your delivery. It's shit now but will all be worth it when you have your baby x

Seriously this is standard at induction and I had OC too and I was 37 weeks. OP - listen please. If they break your waters you will still end up with a section I’m sure as 37 weeks is too early I think for an induction to work. I tried all your methods - then my waters were broken with gas and air as my cervix was horrendously pulled down. So traumatic. In the end I had a level 2 emcs. The massive massive mistake the doctors made is at 37 weeks they should have given me steroids for my baby’s lungs. They didn’t. My baby was born and within a few hours developed respiratory distrsss was taken away from me to another hospital and intubated. If you are going to have a section ask and push push for steroids. They feel like you’ve been kicked in the arse by a horse!!! But please ask for them.

Don’t let them fob you off on the steroids. I never sued my hospital but sent them a lenghthy letter and they changed procedure as a result. In my next birth I was given steroids. Similar pre birth issues OC etc. The new hospital couldn’t believe I wasn’t given steroids.

Your partner needs to go make himself a pain. Go and ask every 15 minutes what's happening. Hopefully having your waters broken will really start things going - it did for me. My first induction was 4 days - not too dissimilar from yours.

I'd be asking to speak to pals

OP you need to be very forceful, you do not fuck about with obstetric cholestasis, they've let this go on long enough now

Midwife here to add another perspective (hopefully not too controversial a one).

It’s very common that we offer an induction and explain our rationale for it (in your case, getting your baby out sooner rather than later may reduce the complications of OC and a large baby. These extremely unlikely complications include a shoulder dystocia or a stillbirth. You say that to a couple and I guarantee the message they take away is “my baby needs to come out now or else they’ll die”. That really isn’t the case, you will have been (I hope!!) monitors via CTG so staff can be sure of your baby’s wellbeing, and are proceeding in the way that, in their professional experience, is safest.

Delays are frustrating, for us as well as you. If your unit is anything like mine then the reason for your delay will almost certainly be labour suite capacity issues. We all want more rooms and more midwives, but hats not a change that can be made in time to help you this pregnancy. Ask yourself why the delay might be: my educated guess is it relates to midwife/doctor unavailability because they’re rushed off their feet on labour suite with genuinely urgent cases.

Obstetrics is a sliding scale of risk and a constant reshuffling of priorities. We just cannot continue an induction if we don’t have the resources to cope with the intended outcome (I.e. you labouring). If they’re telling you they haven’t got capacity to do an elective section - believe them. I know, it’s headbangingly frustrating. If significant complications arose with you or your baby, you would become a higher priority. In the nicest possible way, please don’t harass staff to speed things up any more than offer to because they’ll be rushed off their feet, doing the best they can, and very well aware that you’re contemplating PALS.

Its not that I’m unsympathetic to your situation, but they really are doing what’s best for you and your baby with the resources they’ve got. By all means highlight the lack of staff/space with the Chief Exec (we’d love something done about that too!) but please listen to the advice staff give you and remember they haven’t forgotten you, they’re just st dealing with a LONG list of priorities which unfortunately you’re not (yet) at the top of.

@MooFeatures

I don't often argue the toss, but this made me a bit cross:

they really are doing what’s best for you and your baby with the resources they’ve got

Like myself, you're not there. Unless you work at the specific site that OP is on, you can't possibly know that they're doing their best, just like I can't be sure they're not. I love the NHS, but am aware of its failings, and given some worrisome news stories regarding maternity units recently, it is disingenuous to suggest OP should effectively lie back and think of England instead of advocating for herself and her baby.

But moo if she wants a c section instead of continuing with the induction, why can’t she have one?
Even if she was told she could but wasn’t the top priority so would have to wait a bit longer.
At least she would know what was happening and would have her preferred delivery option.

I agree you have to be very forceful. I believe there is little evidence for breaking waters to induce labour - in fact I'm sure it's against guidance (I'll be back after I've googled) I remember I refused. My Inducton didn't work and took 5 days before they agreed to a c-section. Unfortunately you just have to continue being really firm. I assume they're monitoring the baby throughout this?

Just remember to ask for steroids for baby lungs please.

Sorry I can't find the evidence I used when I was induced but I'm adding these screen shots in case they help at all

Bumdiscloths you’re right, and maybe I would change that sentence to “the best they can”. However, I’ve often found that even in exactly the same environment the staff and women have differing perceptions of what “best” is. On the balance of probabilities, I’d like to think staff really are trying. The staff at OPs unit will be highly trained professionals who are very well aware of what could go wrong if OP is delayed any further and, surely, will be as keen to avoid that as she is. No-one opts to provide crap the care the OP is getting, but I can’t imagine a scenario where the OP “advocates for herself and her baby” and informs them of something they don’t already know and are already trying to resolve. It sounds like a situation where communication could definitely be improved (as PPs have said) but again ask why isn’t that being done - most likely because the people with decision making capabilities are busy with those with the highest clinical need.

Again, I don’t think your situation is acceptable, I just think understanding and patience may be a better approach than PALS and grey rock-ing.

Sourpatchkid OP has already has Propess, therefore an amniotomy wont be the primary mode of induction.

I hope things are improving for you, OP. My first was induced at 37+4 due to OC. I just wanted to give you some reassurance that, as Moo said, though there is an elevated risk of complications with OC I understand that the absolute risk is still low. A pp mentioned the need for steroids- I had some at 32 weeks when my liver was very weird, but not when eventually induced after 37, and baby was fine. I don't know what the official guidance is.
It's exhausting and distressing to be constantly worrying about your baby, and it sounds like the staff haven't communicated adequately with you. I think it's perfectly reasonable to be assertive and threaten complaint
at this point.
I hope things get moving very soon. I remember being frustrated at how tired I was from being in the ward before even having the baby- is there anything they can do to help you get more sleep? I don't know whether this is realistic, but could they move you to a cubicle?

I know Moo - that's why I said I couldn't find the evidence I'd used

We have spoken to the midwife in charge and have voiced our concerns. We still have not spoken to a doctor but I genuinely believe it is because the ones on call are dealing with emergencies.

The midwife is going to speak to the doctor and proceed with prepping me for a C Section (Cannula, Ranitidine, Bloods ect). As if I am not taken up for waters breaking tonight I will be further pressing for C Section in the morning.

Baby has been put on the CTG and is fine. I am showing up as frequently tightening on the TOCO(?) - going up to the 40s but not in any great deal of pain just pressure down below. Midwife didn’t really seem like it was all that important, so not got my hopes up.

I am so anxious and tired, I need sleep. But just don’t know when someone will show up. I just want my baby here now.

RE: being moved to a separate cubicle, partner and I offered to pay for an amenity room just for some sleep. However they are so busy there are none available.

RE: Steriods - baby’s lungs were something I raised concerns about on Monday night when induction was suggested. I was told baby would be fine at 37 weeks. I definitely think this is something else now that the doctor needs to clarify.

They told me all would be fine at 37 weeks too. If I had a natural birth maybe that would have been the case. C-section raises the risk of respiratory distress - please push for steroids. I was told at my second birth it was fairly standard up to 38 weeks with a section. The first hospital amended its procedures. Sleep tonight OP and handle in the morning. But I would not have a section at 37 weeks without steroids.

Seriously put your foot down on steroids. It’s not a new thing. You need them. Good luck OP

The midwife upthread is right. As long as baby is ok on CTG, you are not a priority and baby is best off where they are. I recently had a second induction at 37 weeks. No need for steroids at that point, just a long wait and an hour on Synto to get going after waters broken, which they won't do unless they have staff available to see you through labour. Hang on in there. I was in for 10 days with first baby and 14 with second.

Help you had a natural birth. That’s different. A section this early needs steroids.