C section or balloon induction at 38/39w - what would you choose?

[fool11]

This is my second pregnancy, , ivf baby and i'm 45..consultant wants me to deliver baby at 38/39w - at the latest. I'm going to try a sweep at 38w, although not sure it will work so early, it worked with my first at 39w and baby was born next day, although this time i also have anterior placenta..not sure if it makes any difference.. If sweep doesn't work, they said they would try a balloon induction (they are currently not doing gel/pessaries because of covid situation), i would need to come to hospital in the afternoon, they would insert the balloon, stay there till morning, if nothing happens they would break my waters, wait i think for 4h, if nothing happens would have to go on a drip for up to 12h..I read lots of horror stories about induction, heard balloon insertion can be painful (i'm def not good with the pain) and nhs web says that one in three inductions will end up in emergency c section..so would you try to get induce (which might end up in c section anyway) or choose a c section from the beginning - i know the risks, major surgery, recovery time can be long etc..I'll be honest i'm not keen on induction or c section and really hope that a sweep might work..don't want to stay in hospital for long, especially as partners cant stay with you and want to get home asap. Anyone else had to decide between these two and how did it go? thank you.

I'd go with the section.

I’d go with the section too. 100%. I’ve had a failed induction (drip) followed by an emcs. It was a pretty painful and stressful experience right up until the section. Section was great and such a relief. My two subsequent deliveries I opted for elcs. Really positive by comparison. Very calm and safe. I’ve also had very easy recoveries from all 3 sections.

I was induced via balloon at 36w. It worked for me (first baby) but not sure how effective it is overall; are you able to ask your consultant?

I had balloon induction and all it did was give me a few hours of contractions but somehow I didn't dilate any further. I ended up having the drip induction which resulted in a c section. After my c section I was exhausted from being awake for so long following the induction so I wish I'd just gone for a c section to begin with. My c section was fine and I didn't feel anything. I'd already had an epidural prior to the drip induction and the epidural was the hardest part as I had to sit still for ages as they struggled to get it in. Gas and air helped though. The only downside to the c section was I was in a bit of pain for a couple of weeks after when getting in and out of bed and I needed help but paracetamol and ibuprofen helped a lot. Good luck!

C section. Loved mine, would 100% choose to go that way if I had another baby (unlikely).

It's difficult currently really to talk to them, everything is over the phone and my consultant is not very 'pleasant', unfortunately. I'm down as high risk, due to age, ivf and my first was born very small, i think 2 percentile, so that's why they want baby out earlier, other than that i'm healthy, and my first labour was a precipitous labour, went from 1 to 10cm in 2.5h (was ignored by midwifes and left in pain, also i asked for epidural, they just said..it will take hours as it's your first.. wouldn't even give me a gas), really horrible experience..they say you will forget the pain once the baby is born..well, 5y later and i still remember it and don't want to go through it again. Don't want to sound like a wimp, just don't want to go through induction for maybe 36h and then end up in c section..i know induction might work but 1 in 3 dont...consultant just said that the c section has much higher risks of complications, gave me all the stats but wasn't really helpful.

was the balloon insertion painful for you @Wolfgirrl?

Not at all. Hand on heart, I asked when they were going to do it and they said it was all done already!

They gave me gas and air which helped, but I didnt feel a thing.

C section. Induction was awful for me while the ELCS I had with dc2 was much more positive.

I've had two inductions. The second was a balloon induction. Second induction was by far smoother. Neither induction ended in c section. To be honest the idea of a c section freaked me out more than the inductions ever did.

After four days of failed induction (pessaries) I insisted on a section, and it was the best decision.

Calm, pain-free and controlled. Much better than the risk of a crash section when even more exhausted.

I’d go c section too I think.

@fool11 I second what Wolf said. Balloon didn't hurt! I'd built it up in my head to be horrendous but it wasn't bad at all! I didn't even had gas and air as at that early point I was scared to have gas and air. Further on I went I had gas and air and I bloody loved it! My husband said I was saying it was better than wine! Anyway, the only thing with the balloon catheter is it's bloody annoying as you have these things hanging down and they wouldn't tape them to my leg so when I went for a pee they would hit the toilet 🙈 take masking tape and tape them to your leg! I did this myself in the end!

I would say the stats on c-sections are very misrepresented by the NHS. They compare emergency c sections to straightforward, no intervention, low risk ‘natural’ births. You already don’t fit into either category. Ask specifically about the risk profiles of planned c sections vs inductions in high risk pregnancies at that specific hospital. Then ask specifically about how they would work with you given the trauma of your first birth. Then make your decision. And don’t let the not pleasant consultant put you off. Have an advocate with you if it will help. Ask your midwife for help if you feel pressured, uncomfortable or worried. Did you have a debrief or counselling after your First birth? It might be worth investigating if it might help.

You aren’t a wimp for not wanting to be in pain. That is a normal, sensible choice. For any other medical procedure it would be a basic requirement.

Hi OP, I’m currently weighing this up too, although likely to be induced a bit later at 40 weeks (I’m 40; it’s a VBAC). The decision feels complicated by the fact my baby has been back-to-back since 28 weeks.

I think(!) I’ve decided to do a balloon insertion as a trial, but not let them break waters or go to the drip due to the baby’s position & high risk of instrumental birth or EMCS. If the balloon doesn’t kick things off on its own I’ll ask for a ELCS. Really hoping labour starts naturally.

Good luck to you!

If you've already had a vaginal birth, the chances of a successful induction are higher this time than the stats for induction overall. I've had 2 (though not with the balloon) and both went smoothly.

I've been induced and had a section (not the same pregnancy by the way) the induction was fine but if I had to choose I'd go for the section as it's more convenient to get it done and dusted and I found the whole experience fine (even thought it was an emergency). Recovery was also good for me.

Thank you all for your time and responses. I had a growth scan this morning and the baby's growth dropped fair bit in last 4w , so need to go for another scan in 2w time..same grumpy consultant (head of department) who doesn't say anything, and you feel like an idiot asking any questions and you are kind of dismissed the minute he finishes the scan..doesn't help that partners can't come in for some support..I've asked a midwife after the scan about the risks of planned c sections vs inductions in high risk pregnancies at our hospital - she had no clue...

with my first I didn't have any debrief..after i screamed like somebody was murdering me (baby was ready to come out), the nurses and midwifes suddenly popped in, all busy and said oh my god, that's so sudden, we didn't expect that etc etc, ignoring the fact they ignored me for 2.5h, we made them actually give me a spinal and then epidural at 10cm (i honestly thought i'm going to explode inside and wanted to die), i was exhausted from pain by then, and after she was born i just wanted to go home...then i just wanted to forget about it all..

Last time i spoke to a consultant from the birth choices about the induction and asked her if i'll try the balloon and it doesn't work, can we maybe switch to a c-section, and she kind of dismissed it saying that she doesn't see a point to try balloon and not go ahead with breaking the waters and drip, if needed..it sounded like if you try a balloon first you should do the 'full induction', whatever is needed before you have to go for a c-section..

I would go for C section. I was induced & in labour for nearly 3 days only for the induction to fail & needed emcs, I was hallucinating from lack of sleep & it made everything feel worse, if I had gone to emcs instead of induction, I probably would have been home before the date ds was born.

That’s interesting, @fool11, I did wonder if I’d get that feedback about not much point in the balloon without being prepared for having waters broken etc. I’m due that conversation in a couple of weeks.

I think I’d be less afraid of the induction scenario if my baby wasn’t big and back-to-back; I also had a prolapse last time that took a couple of years to resolve so am anxious about instrumental birth.

Is your main fear about progressing to EMCS?

I'd go for elective section. My elective section was great and I recovered far better and faster than I had from my previous very traumatic vb. I really wouldn't want to go through a possibly traumatic induction which may well end up as unplanned section anyway after being in labour for days.

You could ask PALS to get involved. I know most people think they’re just for complaints but my understanding is they can help with situations like this too.

Personally I’d go for the c section but it’s a very individual choice.

please keep me posted what they tell you @fretnot..

I'm worried about the instrumental birth.. 1 in 3 births do end up in instrumental births, 1 in 3 induced end up in emergency c section according to nhs web, if i read it correctly..i really don't want an instrumental birth..and just thinking whether i want to put myself through induction which might not work, baby might get distressed etc, and have then emergency c section, which would prolong the whole stay in hospital etc, or just go for a planned c section , which would be prob organised etc and next day if no complications i would be home probably..but i understand the recovery is much longer etc. If i get induced and will need instrumental help, that can cause so much damage as well, stitches are not pleasant either, i had a 2nd degree tear with my first and took a while to recover, and still suffering from post birth stress incontinence..with planned c section it can be done and dusted and prob less stressful..there are some risk for future pregnancies as i was told, but this is our last chance to have a baby, i won't be doing another ivf and we don' have any embryos left/frozen..i'm not looking for an easy option, just really scared of induction and possible instrumental birth...i can only pray that a sweep might work and baby will decide to come out kind of naturally..
will see how my scan goes in 2w time, things can change so quickly...

from your responses it looks like most of you would go for a planned c section, based on your experiences..

Go for the c section. Save your pelvic floor. TBH if I were still having stress incontinence after my first, I'd be going for a section for my second regardless of anything else!

I had an induction at 38.1 (donor egg IVF) they couldn't get me going after trying for 3 days so I had a section. Had DS2 the year after and I snapped their hand off when they offered an ELCS

So balloon induction is mechanical so chances of going into labour from it is minimal. It will stretch your cervix to enable your waters to be brokeN. The fact you have had a Vaginal birth before means it would be very likely you would have a successful induction. I think it’s absolutely acceptable that you have a plan to have a balloon followed by Waters broken, if not contracting in 4-6hrs, CS.
Sorry everyone appears to be dismissive. Can you request to speak to your trust consultant midwife to discuss further and make a birth plan?