Induction or planned c sec? Which is best?

[Makingnumber2]

I’m 41wks pregnant with dc2 and at my midwife appmt tomorrow they will want to ‘book me in’ for an induction which I think will be booked for 41+5. DC1 came at at 41+1 and weighed 7lb6. This child was estimated via growth scans and GAP chart projection to weigh 8lbs by 40wks.
I am very anxious about the prospect of not having a spontaneous vaginal birth like I did with DC1 and have been thinking about whether to ask for a planned c sec.
Has anyone had both an induction and a planned c sec and could share which they found better?
I’m trying to think of positives and
Negatives for each to stay rational but am struggling with positives for either tbh!
So far I have:
C sec- positive- know date in advance so can arrange childcare
Negative- major surgery comes with risk
Scarring
Recovery time after when I have a newborn and 3yo to deal with at home
Can’t drive for 6 weeks and very reliant on car where we live
Likely to need to stay at least overnight in hospital on PN ward which is my idea of a nightmare

Induction - positive: not major surgery
A low level induction like gel or pessary could work quickly but no guarantees

Negatives:
Likely to need a ward stay- again any ward stay is my nightmare
Can take a very long time- v unsettling for my DC1 for me
To be away for a number of days
Partner cant be with me until active labour due to covid- I would find it stressful to be alone whilst waiting for active labour to begin
Induction methods could need to be increased to drip- concerned then about pain and need for epidural and increased chances of assisted birth
Could result in an EMCS anyway

Thank you if you’ve read this far!

Are you being booked in for medical reasons or because you’re overdue? If it’s the latter, you will really have to plead for a c-section. They won’t just give them because you are overdue. I went in for induction when I was 12 days overdue and the whole process took 5 days overall. I begged and pleaded for a c-section on day 4 and the doctors would not agree it.

Yes it would be because I’m overdue. I am under the perinatal team for MH condition though so not sure if that means they would be more supportive of a planned CS or not. I am sorry you had to go through such long induction experience and were put in a position where you had to beg
For an alternative. I don’t find that women centred care at all and
It’s exactly the scenario I am so anxious about finding myself in.

Are you more scared of an epidural than of a spinal anesthetic for a C Section? Why? Is there a difference in risk or discomfort? I would have thought they were fairly similar in terms of patient experience.

A long induction doesn’t necessarily mean you’re in painful labour for days. My induction took 3?@ days, but for most of it I was having fairly mild contractions than tapered off as the pessary wore off. I did have to have the drip and I did find the contractions painful after a hour or two especially once my waters broke but they gave me an epidural and then my baby was born pretty soon after that. I was only on the drip for about 3 or 4 hours altogether.
Your risks of needing an instrumental birth are probably lower due to this being a 2nd baby with the first being a vaginal birth.

I'd choose induction if you're a multip, post dates and probably very ready to have a baby.

If you were

I was induced first time around and it was horrible. Really painful contractions for 48 hours which led to nothing and I had to have a c section anyway, by which time I was exhausted and recovery was slow.

I was offered induction when I went overdue with #2 and said no, I would rather have a section. A planned section was so much better - I wasn't exhausted and in pain for a couple of days for a start.

I have met so many women with the same experience. I would always recommend a section over induction.

@Diggersaursarethebest to be honest with you I am hugely needle phobic so both an epidural and a spinal block would be an issue for me.... I wondered if they could give a mild sedative to me to stop me panicking prior to a planned c sec spinal block though? I’m not sure if that’s something a pregnant woman could have as obviously it could cross placenta and impact baby.

@stmw123 thank you for your thoughts. I am holding on to hope that as a second timer with a vaginal birth experience previously my body could respond better to an induction than if I was first time mum.

Thinking aloud I wonder if I could ask for pessary/gel then to go home (we live 15 min drive to hospital) and come back if/when things start moving and if nothing starts to happen then have a planned c sec? I had a 12h active labour last time after 3 days latent labour so I feel confident that we would have time to get back to the hospital.
Anyone heard of that type of plan being agreed?

Like you’ve said @MyOtherProfile I don’t want to end up exhausted after 3 days of being on a ward with no sleep etc. Both the additional sleep deprivation and ward environment will hugely trigger my MH issue too and I am highly unlikely to relax enough for my body to feel safe enough to birth.

I had two failed sweeps then a 5 day induction (3 rounds) starting at 41+4 that ended up with epidural, ARM, forceps and episiotomy anyway and an infection which meant a Canula for 5 days after as well- 10 days in hospital overall. Also long term damage to bladder function. I’m choosing elective section this time.

I’m also pretty sure the sleep deprivation, exhaustion and general feeling like I’d given up after day 5 contributed to inability to have an unassisted birth.

I felt exactly the same as you in a similar situation quite recently and went for the induction as I was most worried about recovering from a section with a three year old at home. I was still really worried and was desperately hoping I would just go into labour before I went in for the induction! Induction went really smoothly - delivered within 18 hours of the pessary being inserted and went home the same day as baby arrived. Partner was allowed to be there 8-8 whilst on the induction ward. The fact this is your second baby and you had a spontaneous labour with your first, means the induction is much more likely to work than in a first pregnancy. Good luck with whichever you choose!

Thanks @HDready that is really heartening to hear- our situations are/were v similar! And having a 3yo at home is definitely a big consideration. Congratulations on your newest addition!

@Minorissue so sorry to hear you had such a rough time of it and I really hope you have a much more positive experience with your planned c sec this time round.

I tried for a sweep at my 40+2 appmt but she couldn’t even reach my cervix before I couldn’t take the pain anymore so that was deffo not a success and I’m not sure if I will ask for another one today.

Still holding out hope this baby might decide to arrive on their own and take the stress of making other plans away! 🤞🏻🤞🏻

@Makingnumber2

Yes it would be because I’m overdue. I am under the perinatal team for MH condition though so not sure if that means they would be more supportive of a planned CS or not. I am sorry you had to go through such long induction experience and were put in a position where you had to beg For an alternative. I don’t find that women centred care at all and It’s exactly the scenario I am so anxious about finding myself in.

Ah okay, I think being under the perinatal team will definitely put you in a better position. If you are given the choice, I’d recommend an ELCS. I haven’t personally had one and I’m just going off my personal experience and how horrible my induction was. My sister has had an EMCS and as a result an ELCS with her second and she couldn’t talk more positively about her experience. Good luck with whatever happens

Such a personal decision. A few other bits to add to your analysis/thoughts on it:

• you can drive as soon as you feel well enough after a section. Many women are back driving after a couple of weeks. You certainly don't need to wait 6 weeks unless you don't feel upto it.

• The average stay in hospital for c section is only about half a day longer than the average vaginal births. Most places will let you go home after 1 night. The likelihood is that you'll spend more time in hospital overall with an induction.

• Scarring/complications from vaginal birth. With a perfect vaginal birth, recovery will be quicker than for a section, but its not as clear cut where there are tears, birth injuries etc. Some women recover faster from an elective sectuon than their vaginal births. Some don't. Given you had a vaginal birth before, this is less of a risk for you (though second births arent always better, they often are).

• dont forget the other positives of sections

* pain free delivery!! * less exhaustion - I was full of energy after mine because I'd been able to sleep the night before, wasnt in pain, hadn't gone through labour and had lost virtually no blood * You can really concentrate on meeting your baby because of all the above things.

I loved my sections and wouldn't want to give birth any other way (I actively choose not to have vaginal births), but I appreciate that for some women, the opposite may be true.

For me, there was very little pain afterwards, and I was back to normal life within about a week. Others experience quite a bit of pain - it's the luck of the draw really.

Look at all the positives, all the negatives, all the risks, and decide what's right for you and your family. There are no rights or wrongs here.

Just wanted to add that you can choose neither option and just keep waiting for things to happen naturally, if you do wish. Legally speaking they can’t force you to do anything. Some women prefer to have more regular checks and as long as you and baby are happy, then you could just wait. A good thing to look at when making these decisions is to look at actual percentages, i.e. they might double, which sounds scary but that could be going from 5% to 10% or it might be going from 0.02% to 0.04%. You may be comfortable with one of those risks or you may not, either is totally fine but it’s good to know these things so you can make an informed decision

Thanks everyone for your thoughts and advice- made me feel calmer!
Good news is baby arrived of his own accord so I was giving birth when I should have been at the appointment discussing induction etc!

Brilliant news, congratulations!

Without doubt a planned section. With induction the chances of needing other interventions are much higher so you could end up with a section or instrumental interventions anyway.

Ahh just seen your update. Congratulations op

Lovely news, congrats!

That’s fab news, so pleased for you!

Perfect!