Induction with second baby after spontaneous delivery with first

[Magpiefeather]

Hello, could anyone help me out with their experiences of induction with second babies after a spontaneous labour with their first....

My First baby Dd was 3 years ago, went into labour spontaneously which was a long old 36 hour slog (only 30 mins pushing though and sadly a third degree tear) she arrived at 40+8

I’m now 13 days over “due date” with DC2, induction booked for tomorrow.... I’m still undecided whether to accept the induction or to wait it out a bit more with monitoring. Anyone got any wisdom to offer to help me decide?

Things influencing my decision:

• have had two sweeps, cervix is definitely doing something, is dilating but still not all the way effaced
• Lost mucus plug yesterday after second sweep
• I’ve had weeks of “niggles” - contractions which seem to be building but then peter out. Worst was last night, they were definitely proper contractions, regular, getting stronger, quite long, for hours! but then I decided to try get some sleep and they’d stopped by morning again
• At dating scan my due date was moved ahead. Going by LMP I’m only 40+2 so I have a feeling baby might not actually be “late” yet
• We are an hour away from the hospital so daily monitoring would be a considerable faff
• I feel physically fine and not too fed up. A problem-free pregnancy. It’s literally just the dates making them want to induce
• Midwife thought yesterday baby had turned back to back again. I’m wondering whether his position is holding up labour getting going (and that induction wouldn’t help this, he’d get stuck and need forceps etc. This is my main worry)
• Head is engaged, 3/5this palpable

I’ve done and am doing all the spinning babies things to get him into a good position. Have been doing ALL the labour inducing things - sex, regular and pretty committed nipple stimulation, bouncing and circling hips on birthing ball, long walks twice a day, visualisations.

Anyway, this is very long winded but I feel a bit lost as to whether to go for induction or not.Anyone have any stories of a second time labour being induced when the first wasn’t? How was it?! Even more interested to hear of anyone else who had been having stop/start contractions and then went for induction!

Thanks in advance!

Bump?

Hi
I don’t have the answer but will be facing this choice... my first came spontaneously at 42 weeks, very long labour, ended in ventouse & 3b year.
This time I’m over 40, so they want me to be induced before due date due to risks of going overdue as I’m now ancient. My concern is due date discrepancy by 4 days, & also my body being completely unready so early.
If your signs are already looking like your body is prepping for labour, then an induction would hopefully not fail/be too slow. What are they suggesting? Can you have the 24h pessary as an outpatient? Or how do you feel about staying in hospital?
How sure are you of your dates? Have you discussed the due date with your midwife?
If I were you I’d go with some more questions about risks of waiting, due date discrepancies, perhaps they can do the maternal Doppler for placenta function? Then make a decision. If I was sure of my dates, I’d perhaps look at waiting a few more days, especially if you’re having some labour symptoms.
Not sure if that’s helpful at all but I totally get what a massive decision it is. I’m really not keen on induction, but it’s hard to make a clear decision with weighing up the risks too. Good luck! x

I've only ever been induced (4 times)

The more overdue I was the faster/less intervention was needed. My Bishops Score was awful before the fist pessary - absolutely no signs of anything happening.

I never needed the drop and all 4 deliveries were unassisted.

What early scans did you have and after which one did they want to change your due date?

Thank you both for your replies, it has helped clarify things a bit in my mind.

@tmc14 it’s really tough to weigh up the risks and benefits isn’t it. They haven’t even laid out what they’re suggesting yet, I’ve no idea if they’d do gel or pessary, both were mentioned in the leaflet and unsure how they decide which one, then breaking the waters then to drip if needed. It’s the drip that worries me to be honest. I feel like maybe I’d consent to the first two bits but if it’s still not happening after breaking waters go straight to c section as i really want to avoid it all spiralling out of control. I mentioned this to my midwife and she said it’s not usual but they can’t do any part of it without your consent obviously so if you got to the drip part then said “no” they’d have to do a c section really.

Since we are an hour from the hospital my midwife has said they’ll want me to stay in, too much of a risk in case things kick off quickly to try and make it home then all the way back in again. I feel ok about staying in, slightly weird in these COVID times and I know dd will miss me hugely but other than that I’d be ok. A bit worried about dh missing the birth if it goes fast and he has to get all the way back.

Yes to be honest all the things you mentioned were what I was going to ask before (potentially) consenting to the induction. I think I will specifically ask if there are any medical indicators that it would be dangerous to continue a few days, or is there an obvious medical reason why labour isn’t starting by itself (given my body has done it before with no help it must know what to do).

Yes I discussed due date with midwife and she agreed with me that he may not be late at all. She was a bit non commital but supported my feelings about induction and said she’s had lots of ladies refuse induction and all have delivered fine in the end.

How long have you got til you have to decide?

@RandomMess that is SO helpful, thank you for sharing your experiences. If the first part of induction got labour going and then it was all “normal” / all me from there I don’t think I’d mind! I suppose there may not be a way to know. It’s really great to hear your later inductions needed less intervention.

My scan was at what I thought was 12 weeks but they leapt it to 13 weeks and 4 days. Same happened with dd funnily enough but she came on “their” 40+8 so early enough to avoid induction.

I had a spontaneous labour with my first - was a 40 hour labour, ended with forceps and episiotomy. I had my second in February and I was induced as waters went early, to be honest I was terrified because I had read so many horror stories but actually it was fine... I had a pessary at 2:30pm and they wanted to put the drip in at 8pm because nothing was happening... I was determined not to have it so they agreed to leave it another few hours but unfortunately after walking up and down the hospital for hours they finally put me on the drip at about 2:30am... contractions became quite strong quite fast but my son was born at 5:15am so it was over very quickly and I only felt like I needed gas and air so actually, it was a better experience compared to my first.

Good luck with whatever you decide... it is a tough one but my experience definitely wouldn’t make me scared in future if I have any more children and an induction is recommended!

@Magpiefeather I’m only 26 weeks so loads of time. But I started reading as the consultant at 17 weeks just said ‘because of the risks of your age, we’ll induce early’ and moved the conversation on. I was just left thinking, but what does that mean? And do I not get a say?! I’m thinking the same as you, if there’s no progress before moving to the drip, might go straight to section. My two main disappointments of my first birth were being so exhausted after a four day labour, and missing the first 3 hours skin to skin/feeding etc because of surgery to repair the tear. So my choices will be based on minimising those I think. Next appointment in 3 weeks and I have lots of questions!!
I hope they listen to your concerns and you can come to a decision that’s good for you x

I would be utterly focusing on getting into optimal position that is more likely than anything to optimise a straightforward delivery.

I would be asking them to check very carefully on baby's position.

I went 17 days over with DC2 - super thick grade 3 meconium and she was very definitely fully cooked. At least it only took 1 pessary though.

Mine were like this:
41 weeks, 3 pessaries, ARM, 32 hours from 1st pessary
42+3, 1 pessary, 10 hours from 1st pessary
40 weeks, 3 pessaries, ARM, 32 hours from 1st pessary
42 weeks 2 pessaries, 11 hours from 1st pessary (official labour one minute - went 8cm, crowned, delivered in 3 quick contractions - midwives were a bit stunned)

Early dating scans are usually accurate to within 3-4 days because of what they measure/assess so you are probably between what you think and they measured.

I would be utterly focusing on getting into optimal position that is more likely than anything to optimise a straightforward delivery.

I would be asking them to check very carefully on baby's position.

I went 17 days over with DC2 - super thick grade 3 meconium and she was very definitely fully cooked. At least it only took 1 pessary though.

Mine were like this:
41 weeks, 3 pessaries, ARM, 32 hours from 1st pessary
42+3, 1 pessary, 10 hours from 1st pessary
40 weeks, 3 pessaries, ARM, 32 hours from 1st pessary
42 weeks 2 pessaries, 11 hours from 1st pessary (official labour one minute - went 8cm, crowned, delivered in 3 quick contractions - midwives were a bit stunned)

Early dating scans are usually accurate to within 3-4 days because of what they measure/assess so you are probably between what you think and they measured.

Thank you @RandomMess I will absolutely focus on getting baby in optimal position. My midwife wouldn’t quite commit to which way he was lying - I mean I know they can’t be sure 100% but she was quite vague - “I think he’s turned slightly posterior” . She did say she doesn’t think his back is fully against my spine so I don’t think he has the whole way round to turn.

Do they ever scan to find out position before induction? Or is it just by palpating?

Having given birth vaginally before, you have a high chance of your induction being straightforward. I had spontaneous labour at 40+1 with DC1 and was induced at 37 weeks with DC2 due to concerns about the cord - we had to go to the drip to get labour moving (not surprising given it was early) but then it was a straightforward birth. At 40+ weeks I'd say you'd have a good chance of the pessary or ARM getting you going, but as you know once they break the water, you have no real choice but to follow through with the drip if it doesn't take. It is your choice as PP said, but if you are "officially" over 42 weeks they will understandably want you to be monitored quite closely if you decline induction.

I was induced with my 3rd after 2 spontaneous vaginal deliveries. She was small compared to the boys and they were slightly worried so induced me at 38wks. It was very quick. I didn’t like being stuck on a bed but it was fine and she was fine, albeit small. The drugs worked very quickly.

Hi OP,

I could have written your exact post before the birth of my DC2.
I went in for induction at T+13, was already 2cm, had another sweep on arrival and walked around the hospital car park for a couple of hours with a few niggling contractions. When got back was 3-4cm so taken to labour ward where they broke my waters (a little uncomfortable but fine) and Dd arrived 22 minutes later and we were home 3hrs after that. No induction drugs required and despite me dreading it, a very positive experience.

Good luck!

Oh @crumbseverywhere that sounds wonderful! I can hold out hope that I’ll be the same. Thanks so much you’ve made me feel heaps better!!!

Thanks @SeagoingSexpot and @Neednewwellies, that definitely helps to keep me positive. Hopefully you’re right and as I’m further on I’ll respond well to the drugs. Just need to stay calm!!

With ARM do they use a speculum or just hold some kind of tool as they do a Vaginal examination?

@Magpiefeather good luck today, let us know how you get on x

Thanks @tmc14, I will do! Feeling quite positive about the whole thing this morning, focusing on the fact that we’ll have our baby soon and buoyed up by reading positive induction stories.

Taking dd out for a run around before someone else has to look after her for a bit! Also trying to enjoy this last bit of just her to worry about .

Hopefully before the day is through I’ll be holding a baby.

Hi @Magpiefeather how are you getting on?

Baby is here! I am feeding him as we speak and trying to jot down the full tale to tell you - it was not horrific at all and actually ended up being almost exactly the birth I originally wanted. Induction was definitely the right decision for us, I’m so glad I went for it

Ah amazing news!! So pleased you had a good birth experience & everything went well. Looking forward to hearing the full story when you’re ready to share. Enjoy the tiny baby cuddles xx

Congratulations, fantastic news!