induction vs planned c-section 1st baby pros and cons?

[islawhite]

HI all

Any comments welcome - my planned homebirth has been nixed.

Hate the thought of induction due to the 'cascade of interventions' which according to one consultant leads to a 1 in 2 chance of a c-section anyway (although this was disputed by the consultant midwife at the same hospital).

Thought I'd skip the trauma and go for something planned and manageable (but with it's own risks) instead.

Be interested to hear from you all.

Thanks

Are you going private then?

What makes you think you will be induced?

islawhite: I had to be induced at 37 weeks with my first baby for medical reasons.

I don't know what your situation is, but if you are ill in some way (like I was) then the induction may succeed even if your cervix is shut. Sometimes your body knows that it really does want the baby out!

The cascade of interventions is not always terrible. I had prostin gel, then had my waters broken, then syntocin drip, then epidural, then episiotomy and forceps combined with continuous monitoring. I can honestly say that I recovered from all that with no problem at all, very quickly (much quicker than a c section).

I think if you know what is coming and you are prepared for it, it is not so bad, and certainly if you have an epidural, it is pain free!

I know other people who have had failed inductions - with 5 or 6 prostins, or made it into labour, but labour did not progress and ended up with a c section.

Try not to worry about it, the doctors are there to look after you and I would go down the intervention route again.

Just to add that the majority of people who go on the syntocin drip need an epidural as the artifical contractions can be extremely painful. If that is your situation, just go with it.

Having had a failed induction followed by cs, if you decide to go for induction:

(1) Have the epidural to start with
(2) Refuse ARM (it bloody hurts) unless you have epidural in
(3) Bear in mind you will have to go pee every hour so wear something you can comfortably and decently shuffle down the corridor in (or you'll be in a gappy surgical gown!)
(4) If it isn't working after say six hours, you are free to call a halt to things (seriously I kept going for 13 hours when it was clear after four that sod all was happening except pain).

Having said, if you can get things going with the gels it's much more likely to succeed than syntocin apparently. Because it means your body was pretty much ready anyway.

If you decide to go for a scheduled section, write a section birth plan to decide how you want to do it. Personally I found there was very little recovery from my section - much less than others who have torn during vaginal deliveries.

Good luck

Is the reason you're being induced medical or because you're overdue?

I was induced at 38+6 for medical reasons and it ended up in a cs.

The factors you've got to consider are you and the baby.

I was encouraged to have an induction because it helps the babies lungs - more fluid is expelled when being pushed out.
Also it can help breast feeding as your body is more attuned to the idea it's had a baby and will be quicker to produce milk than if you don't have any signs of labour.

As for you a cs is hard to recover from. Elective is meant to be easier than emergency ie once labour has started but even so it's still a major operation with the added bonus of not being able to sleep well after it because of a demanding little person.

If you're scared of any of the other interventions aside from a cs then a cs is tempting as you're more in control. On the other hand you've got to bear in mind that having a cs for the first one will mean it will be much more difficult to have a VB with any future children.

I was induced, first gel worked, my waters broke naturally and then I discovered that I really couldn't deal with the pain after 3 hrs, had an epidural and stuck at 8cm when they realised ds was OP (back to back). Eventually I agreed to a cs to get him out. I don't know if the induction didn't work because ds wasn't ready to come out or because of the epidural and therefore sitting on the bed for many hours. Either way I don't regret my decision and would do the same again.

Some people are induced and it goes really easily. You might be one of those.

I've no idea what the statistics are but they will vary depending on other data. For example with my condition I found out afterwards that the cs rate is 67%! So there are other factors to consider when someone says 1 in 2.

Good luck with your decision.

whomovedmychocolate is right - get that epidural in ASAP!! Don't wait until the pain becomes too much, with inductions it does become too much very very often!! I made this mistake.

Plus, if you end up with a section, it is helpful for them already to have an epidural in. Don't know why, but that's what they told me.

HI all, thanks for your replies, makes for interesting reading...

Consultant insisted on induction at 40 weeks due to mild gestational diabetes.

Got so stressed about being a week away from my due date with no further info/ differing opinions that I spent yesterday pm arguing for a planned c-section date, after lengthy discussion with the consultant midwife about what induction might entail.

My negativity about it stems from the fact that I have only ever heard bad reports about induction, so wanted to see if anyone had anything else to say about it!

From a head space pov, I am just concerned that the baby comes out ok, and I'm not sure I could handle the trauma of lengthy induction followed by emergency c section...

crokky - its because they then don't have to wait 90 minutes to find an anaesthesiologist, get the epidural in and wait for it to work. They just top it up and install the catflap

LOL at catflap...

Ah see, the epidural thing asap is what bothers me.... it's just a step away from forceps...

Islawhite there's a thread on here somewhere about positive induction stories, I found it before mine. From people I've known, one was induced twice early for PE and she had very quick births 7 hours for the first. Another was induced early with both for medical reasons and with the first she had demanded an epidural after ARM but by the time they got the needle in and then checked she was fully dilated.... It can be done.

Part of the reason for demanding an epidural quickly is it can take a long time for an anaethesist to come. When you're in agony you don't want to be told there's an hour and a half wait (he made it in 45 mins in the end).

My only regret is that I didn't try hypnotherapy. I saw a thread on here from someone who said she was induced and used it effectively.

have you got time to get hold of a copy of "the caesarean" by michel odent?

i would say though that induction - if you need to have it - and they can't MAKE you be induced, still gives you the chance of having a perfectly straightforward natural birth. which an elective section doesn't. and a caesarean is an intervention in any subsequent birth that you may have.

islawhite - with respect - bollocks - epidurals are nothing like having oversized salad tongues shoved up your fanj!

Epidurals can be really light so you feel 60% of the sensation but not the 40% that makes you wish you could smack yourself on the head with something heavy to render yourself unconscious.

Don't get me wrong, I found labour okayish for the first ten hours of contractions every minute for 45 seconds, but then it got a bit ouchy and a bit tiring too.

I developed T1 diabetes during my first pregnancy and was induced at 40 weeks for that and my subsequent baby.

The gel wasn't enough to get me going either time so had to have drip, I also had my waters broken both times - which I didn't find particularly painful. I did choose to have an epidural both times once contractions really kicked in.

Both babies were born with no further intervention, and no tearing...hurrah!!!

I presume you've had an extra growth scan, unless this suggests a very large baby, I would go for the induction - it didn't feel overly "medical" and was next best thing to "natural" birth to my mind.

OK - I have had two very positive induction experiences.

Ist time around was 4 days overdue - hindwaters broke but no contractions hence the induction. Was given prostin gel at midnight, no monitoring or anything. Was 9.5cm dilated by 9am after an night of pacing around my room and just breathing through contractions with just my TENS machine. Started pushing at 9:30am with assistance contractions wise from a syntocinon drip but dd got a bit stuck and therefore I pleaded for a ventouse. dd born at 12 noon - no extra pain relief but an episiotomy and stiches.

DD2 who was 13 days overdue hence the induction. Went into hospital at 08:30, ARM done at 10am (and it was not painful at all) and hooked up to a drip at 10:30. Was allowed to be mobile throughout in spite of monitoring. Was considered to be in established labour at 2:45pm on TENS only. DD2 was born at 4:15pm after only 10 minutes of pushing, gas and air only as pain relief and no stiches required.

So......induction is not necessarily that bad!

Good luck with whatever you decide to do.

Oh and another thing slightly off the subject, have you discussed what will happen to the baby after the birth? I know at the moment the most important thing is how to get the baby out but once it is out if you have GD the baby is at increased risk of having neonatal hypoglycaemia which hospitals treat differently. Some routinely take them away to nurseries others leave with the mother unless intervention is needed. It's worth finding out now rather then when you are completely exhausted and hormonal following the birth.

islawhite, honestly, the epidural is no problem. you can still feel your muscles etc and you can still push as the epidural is taking away the pain, leaving behind sensation.

Part of the reason for my forceps was that my baby urgently needed to be delivered. I had been pushing under 1 hour, but he really did need to come out so they pulled him out! You don't feel the forceps with the epidural and they did not damage me.

Given the choice between epidural and forceps OR a c section, I would go with the epidural and forceps. Plus they are cutting you to get the forceps in and baby out so I think you'll be less likely to tear.

I had a wonderful induction with ds1.

I had gel overnight, started a drip at 8am and ds was born at 8:12 pm. There was no pain medication, and no other interventions. In fact when I compare births I would take the experience of my induction over my natural labor with ds2.

both of which had the same pain, neither with pain relief. The induction wasn't more or less painful than my natural labor and birth.

crokky I am wincing at your blase mentioning of an episiotomy - at least with a catflap you can sit down afterwards without wincing!

adding this to my threads so i can come back nad have a read later

If your baby is at risk of hypoglaethingummy its worth going through a bit of labour to make your milk come in a bit earlier (unless you don't mind giving formula, see millions of threads on bf'ing topic)

How good is your birth partner going to be at getting attention / info / decisions? And generally pressing for a cs if it all goes on too long?

On the one hand, you're right about 1 in 2. If your cervix is "unfavourable" (not doing anything at all towards labour) and its your first birth, induction has a 50% chance of ending in a cs. Which is just the worst of both worlds, isn't it.

On the other hand, if you have a cs, there are a load of things that can go wrong, and a load of consequences for future pgs.

How traumatic is induction if you get the epidural in first? (genuine question, I've no idea)

whomovedmychocolate
aren't you high on morphine after a c section and therefore cheating with the sitting down ?

I didn't have an epidural and I didn't think it was traumatic at all.

MKG, I think you must be a very brave woman!

Oh I meant no disrespect there on the forceps front!

Um, did hypnobirthing, and am ok with the thought of natural labour (I hope!!) - will be getting some acupuncture to see if that can start me off - but what bothers me is that going from 0 - 100 in terms of labouring, but the reports here are quite varied and very helpful, so have given me some more things to think about over the weekend.

Baby's size is a little on the heavy side, but head size is ok, and bub is definately engaged (which gives me hope!).

On the hypoglycemia front, one consultant said it would be a one in a million chance for this to be likely due to my blood sugar levels being only slightly over.

Will be mulling over the weekend, but true to form, Mumsnetters have supplied some fab info again! Thanks everyone!

Thanks . . I don't think I'm brave, I think I just handle pain well.

If I had had an induction that lasted for days and I had contractions for hours I would have had an epidural-- no lie.

But I've been lucky to have very quick and trouble free births.