Is induction right for me

[Amelia910]

Hi all

I am 41 +1 so midwife attempted a membrane sweep at my appointment this morning

She said only the bottom of my cervix was open so she couldn't perform it and has booked me in for an induction on Saturday

If my cervix isn't favourable should I be having an induction?

My vaginal examination info is on the attached if that helps at all?

So, on Saturday you'll be 41+5? I'd say that's about right time-wise. The placenta tends to begin to loose efficiency past 42 weeks, and inductions usually take a couple of days.

Obviously, you can absolutely refuse and request regular monitoring instead.

Tbh, you have a good chance of going spontaneously before then!

Hi Spaneroo, yes I will be 12 days overdue by that point. Fingers crossed it does happen naturally before then I just really don't want to be induced. I think I would have said no to induction but then scared myself by ready about the rates of still birth etc and figured I'd rather have a horrible birth but have my baby at the end of it x

Only you can decide if you’re happy with an induction but can I ask why you are thinking you don’t want one?

So I have only ever heard bad stories about inductions so I decided to do research beyond anecdotal stories. It does appear that in the UK that intervention leads to more intervention. So higher rates of assisted deliveries and c-sections. I worry about the fact they have been proven to be more painful and I also really don't want to spend hours having to labour on my back/on the bed if I do get put on the drip. I'm also scared about having to labour on my own at the beginning if my partner cannot be with me. I would have to be in a delivery suite rather than a midwife led dept too which puts me off. I'm a low risk pregnancy so just seems like I will have to have a lot of things I don't want just because my baby is late.

I was late with my DS and really didnt want to be induced but the midwife was quite insistent as there is a risk of placenta starting to fail. Being induced was fine , intense but less than 4 hours long.( Have you tried skipping ? That brought on labour with my DD.)

I went 12 days over and didn't want an induction either. Can they not offer another sweep and monitoring if they are concerned about the placenta?

Maybe you’ll find my experience reassuring then?....

Induced at 40weeks, I admit I was bored for 24 hours with the pessery and remained at 1cm. MW checked and I was still only 1cm but she was able to break waters. Baby arrived swiftly 3 hours later!

The pain was bad but not unbearable - I elected for an epidural only because a MW assured me the pain got worse and would last for atleast 8 hours. It didn’t! Baby arrived less than 40mins after I requested epidural (so it was actually dangerous to have one) and the epidural didn’t get into my system until baby was actually out ! But it did help with after birth pain. If I’d not panicked I’d have coped fairly well with the pain but it’s all subjective.

The risk to me and baby was too high for me not to go for an induction and we held off as long as possible for a natural birth, had several sweeps in the week before.

It’s obviously your choice but I’d not say every induction is negative and results in intervention. Congratulations on your pregnancy and good luck!

Given a lot of inductions are due to potential issues for baby/mum, or just late (so baby not well positioned for just starting labour) you'd expect more interventions regardless of induction. My 2nd was induced at 38+3, birth experience was pretty well the same as my first spontaneous labour, including the ventouse when both got slightly stuck just short of the exit. Epesiotomy was better than tearing by my non induced birth.

I honestly don't think induction is necessary the cause of the issues, but induction is often required in situations where other interventions are more likely to be needed...

I do understand what you're saying Random. My baby has been in perfect position since they started measuring me he just doesn't seem to want to come out yet!
I guess like I said I will have one because of all the reasons given I just feel really disappointed that it's going to be the total opposite of what I wanted.

I understand exactly what you mean about feeling disappointed, but really do try to let go of the idea that you could ever really have any control over how your birth is! Thinking like that will only lead you to feel terrible afterwards because inevitably it won't be how you imagined or hoped. I hope whatever happens for you that you and the baby are safe and well and that the birth is not traumatic.

My DSis was desperate for a home birth and refused induction until she was 41+5 at which point monitoring showed that the baby was showing signs of distress. And she admits that actually, induction was fine and she delivered fairly quickly without needing instruments or an epidural.

Given that the risk of stillbirth rises after 42 weeks I’d be really wary of delaying beyond medical advice...

What “random” had said above is true. Just because two things happen, it doesn’t mean that one has caused the other. A poorly positioned baby will not be putting sufficient pressure on the cervix to begin labour, so induction may be recommended. Then the same poor positioning might mean the baby needs to be adjusted hence forceps, or cannot be delivered, hence a c-section. So in this scenario, declining an induction will do nothing to reduce the chances of section or instrumental delivery.

You should also remember that your risk status is only ever assessed at a moment in time. You say you are a low-risk pregnancy, but get sufficiently overdue and you are not low-risk any more. Your placenta is getting older and more worn out each day, the longer you go overdue, the greater the risk of the placenta malfunctioning. So you may have been low-risk at 39 weeks but you are definitely not low-risk at 42+ weeks. It’s not an exact science and of course it’s possible that your baby will be just fine if you wait it out but they don’t have a crystal ball for exactly your baby, all they can go on are the most reputable medical studies which shows that induction before you are severely overdue results in a reduction in stillbirths.

I’ve had two very positive induction experiences myself.

No experience on this myself but am currently reading the Siobhan Miller hypnobirthing book at the moment and in the induction part of that she suggests that a lot of the cascade of intervention on inductions could be down to other factors present when a woman is induced - e.g. staying on her back, bright lights in the room, more clinical setting, etc. I don't know if you've done hypnobirthing but there was a positive birth story from one of her students where the woman was able to keep some of these other factors under control and got through it without further interventions. Good luck OP!

Another positive induction here with no interventions. I was done in 4 hours from the start of the drip and also used hypnobirtjing techniques to get through the contractions. Wouldn’t change a thing.

There is zero evidence of a cascade of interventions at all, let alone one caused by bright lights. Seriously, how could bright lights affect labour? How? I’ve seen this claim made lots that things like lights or a doorbell ringing or even speaking can slow down labour and it’s all such nonsense. Wouldn’t it be wonderful if they did - then we could massively reduce premature births by flicking a switch on. Please apply some level of logic or critical thinking.

Seriously, how could bright lights affect labour? How?
Environment influences the production of hormones. There is plenty of evidence and studies.

I refused my induction. Low risk pregnancy, knew my dates perfectly and disagreed with their EDD which is based on measurements on a scan and does not account for longer babies than mine.
I informed myself of the risks associated with having an induction or waiting.
I met the consultant and gave her all my reasons and agreed to monitoring.
I went into labour spontaneously and my placenta was as good as any.

This was for me. With my knowledge of myself and the scientific research I read.

I am a scientist as I evaluate my decisions case by case.

I am pregnant again. We shall see but so far their dates are wrong again... oh well.

Longer babies *like mine not than

That's interesting dancing robot. My original EDD was actually a week later but they moved it back a week after my 12 week scan, even though I track my periods and they are the exact same length every month etc I often wonder if the original date is right which would make me 40+5 on Saturday

Hi @Amelia910
I completely understand why you are fed up. I was induced as well (ds is seven months old) and it was also not what I wanted at all.
However, having been through the induction I would agree with what @diddlediddle says. You really have no control as to how labour goes. Some people go into labour naturally at 39 weeks and then end up with intervention, some people have induction at 42 weeks and the pessary does its work and they end up having a completely straightforward delivery. It really is luck of the draw.

The reason I am writing this is because I really hoped I could have a certain kind of labour, and I didn't, and if I had just let go of the idea of control and just gone with the flow, I would have been happy with what happened. Because although my induction did go a bit off piste (not because I was induced - basically when I went into labour from the drugs at 40+14 some other complications arose that would have arisen even if I had done into labour naturally) I was well cared for, I made a relatively good physical recovery and, most importantly, my ds was healthy, well and very happy.

I suffered from PND afterwards and my GP said a good thing to me - that too much is made of the birth. The birth is just an event that gets the baby out healthy. Some women have a really easy time. Some women have a difficult time. But doctors and midwives are there to ensure that you and baby are ok at the end. I know some posters have recommended hypnobirthing etc but personally I would treat with caution - yes the techniques are useful but the whole 'cascade of intervention' thing is a bit outdated and also there is NO evidence that giving birth in bright lights is a problem. In any case if you ask them they can dim lights in the labour ward - they did that for me for a time when I asked.

Sorry for the essay. Basically, I feel for you. I hope you go into labour naturally but if you don't you will meet your baby soon and you will love him/her so much and that is the most important thing - just remember that. The whole 'birth experience' thing is massively overrated, in my opinion!!

@Amelia910 LMP dates still might not be right, depending on when you ovulated - if you track ovulation then you're likely to be more accurate than scan dates. As @dancingrobot says, scans assume average size to determine a date (which clearly not everyone is going to be on the 50th centile!). My scan date has me down as an immaculate conception currently (and 4 days ahead of when we know I ovulated) 🙄...

I’ve had 3 babies, 3 inductions. The first lasted 36 hours, and I had the drip and all the pain relief and a retained placenta and big pph. This one was for being overdue.
The second lasted about 12h, I had a placental abruption, was not allowed pain relief as baby was in distress, had even bigger blood loss. Almost lost my life and baby’s life. This one was 4 weeks early as my pre-eclampsia had gone out of control.
I had my third 2 weeks ago, offered to me and not pushed, because baby was measuring large. I took it with eyes wide open. It lasted 57 hours, and I sobbed through a lot of it due to previous trauma but at no point did I feel unsafe or that my baby was unsafe. I was confident and comfortable with pain relief options too and felt assured in my choices. After what happened in my second birth, I knew nothing would be worth that pain of not knowing if either of you will make it. A natural, intervention free birth is a lovely ideal but it has never been an option for me. Once risks come into play, I’m happiest in the most knowledgable hands!
(Times are from the start of ‘induction pains’- the actual labouring was never longer than 8 h.)

Induced at 41+5 went home nothing happened back next day at 41+6 broke my waters, drip etc. It was fine, quick, intense, but baby arrived safely. The labour room I had was lovely to be honest, I had just gas and air, but did need ventouse, baby was big due to being overdue. Which if you were in a midwife unit they would move you for ventouse anyway.

Don't get hung up on a dream labour, you just don't know what might be needed.

Thank you everyone for taking the time to reply to me, I feel a lot more comfortable about having an induction now. Blue your kind words/post has particularly helped me.xx

While there were no signs of trouble for me or the baby, I'd refuse induction too. Bright lights and other environmental factors do impact labour. Every other mammal goes to a dark, safe, warm place to give birth usually on their own. We go lie on our backs in a brightly lit hospital room not because this increases success but because of historic factors. We then end up with interventions to save us and the babies, like csections. Women don't tend to grow babies they can't give birth to and babies are born when the mum is relaxed and ready and not flooding their bodies with cortisol.

Hi OP. Another vote of confidence for the induction process here. I’ve also had three inductions. First at 40+2 (suspected ruptured and leaking waters, nope, just fanny sweats ), second at 40+4 (repeated reduced movement, consultant put the fear of God in me) and third at 38+2 (baby measuring huge + v late GD, again, nope, baby my smallest).

Each induction went absolutely fine, with just a pessary needed. First labour lasted 6 hours from pessary going in to big fat baby in my arms. Second - took about 12 hours for anything to happen after pessary went in, but after first contraction, baby was born an an hour later. With my third baby, pessary went in at 9pm, contractions started the following morning at 10 am, waters broken at 4.20 pm, baby arrived just after 5 pm.

With each labour my waters were broken and that’s when the pain really intensified, but also, the babies arrived super quickly too.

I second the PP who talked about active labour. Loads of ball bouncing, walking around, staying on your feet, squeezing a stress ball, visualisation exercise, breathing through the contractions etc, helped keep my labours as “natural” as possible. I only had gas an air, and in the second labour that constituted around two puffs, as baby arrived so quickly!

Aa Machiavellian as this sounds, when it comes to it, the end justifies the means.
Good luck with your labour, OP.