Induction questions - where do they put the pessary

[youknownuthinjonsnuh]

Hi! Induction booked for 28th Feb at 40 +11. Attempted sweep today and midwife said my cervix is very high and completely closed, and to be honest just her inserting a gloved finger hurt loads. Baby is measuring big at about 9.5lbs and isn’t fully engaged. When booking in the induction the midwife said they will put a pessary in, and I was shocked when she said they put it THROUGH the cervix. I was under the impression it would be put next to the cervix but in the vagina still, so when I asked how they would get it through if she couldn’t even perform a sweep, she said they force it through! I’m now even more terrified than I was before, is this true or was she (very unlikely) mistaken? 🤣 (wishful thinking I know) and also how long did it take for people with induced first births to get from pessary to 4cm?

Hmm, I swear I put it in myself? At least I did the second time after it fell out the first! I can’t imagine that it was put in through my cervix as when the pessary failed they had to break my waters with a hook because the midwife couldn’t fit a finger through my cervix.

I'm not sure exactly where they put mine but it wasn't too uncomfortable. My pessary was inserted around 10am on a Monday, my waters broke 3pm the following day and I had my DD 3am on the Wednesday. She really didn't want to leave!

I think they put it at the neck of the womb and it softens the cervix. I had one but it didn't work. 24 hours later I had another one and then 12 hours after that I had my waters broken...then 24 hours after that I had the baby.

A pessary goes behind your cervix, not inside it.

There is a new method called Dilapan which are Ross that go through your cervix and expand but not all trusts use it

I was extremely anxious about having the pessary inserted, especially as I had found having sweeps absolute agony! But it was actually very much ok. They were well lubed!! And went slowly. It looked like a shoe lace and they tucked it between two fingers and pushed it inside me and then pulled their fingers straight back out again. Easy!

I’m not sure either but it wasn’t that uncomfortable when they put it in.

I had pessary put it on a Thursday for 24 hours, didn’t do much, then I had 3 lots of gel 6 hours apart each, waters broke 5am Saturday, hormone drip put in at 11am, had baby at 5:32pm. I was 35+5 when it started though so my DD was no where near ready! You might be luckier than me

I was the same, OP, absolutely terrified and they couldn't do a sweep either. They said I could request gas and air on the ward if I was really really anxious for it to be inserted. I didn't need this in the end, it was actually ok. Good luck

I think it goes in the vagina usually the cervix is closed and it works to soften it? As to how long it takes, this varies. For me, it took approx 6.5 days and multiple attempts at induction including pessaries, gels, multiple sweeps. I wished I had opted for a c section. It does work though for some.

I’m sure they told me they put it behind the cervix. It was less uncomfortable than the attempted sweep.

I don’t know how long it took me to get to 4cm after the pessary was I started. I had the pessary inserted at 4pm. It had fallen out at 5am and I asked for it be reinserted. Nothing had happened by 10am, I went for a walk. Contractions started at 11am and were regular straight away. I asked for the pessary to be removed at 1pm (3hrs before it should be) and at that point she said my cervix was still facing back. 2pm my waters broke and they wanted to minimise my examinations at that time to limit infection. I got to delivery at 5pm and was 8cm. Baby arrived at 10.40pm so just under 31 hours in total. I had a failed sweep two days before, so a failed sweep isn’t a sign that induction won’t go well.

I think in your position I would probably ask for a scan before they start your induction. If the baby still isn’t engaged and their position, discuss how likely it is the baby will engage and discuss a c-section.

It gets put behind the cervix. Ask for gas and air if you're worried about the pain. I had it with both my inductions when they inserted it.

Inserting pessary much less uncomfortable than checking cervix. Definitely ask for gas and air and say if your anxious and they should go nice and slow. For me, don't know when I got to 4cm as I refused further VEs but baby born 10 hours after pessary inserted, labour started after 6 probably.

@2022IamHavingYa @InTheNightWeWillWish hi guys, you have both said behind the cervix and I may be being a little bit dim, but does this mean through the cervix and near the amniotic sac? Or something else?

After I had my pessary inserted at 5:30pm with my 1st (and only so far) I was told not to expect much, pains started pretty much straight away, 4cm by 11pm and baby in my arms by 1:30am so it’s not always slow, good luck and not long to go!!

Behind but not inside. Your cervix is like a tube. This link should help amara.org/en/videos/nlKzFSfy0IS9/en/1781740/4964131/

What happens if the pessaries and gels just aren’t working on your cervix at all? What do they then do and how long do they let this go on?

Iv had pessarys and they don’t go through your cervix because I was 1cm dilated no tablets would fit through there not to mention it fell out soon after lol. It didn’t work anyways well it did for a while but my cramps stopped. So I was moved from induction suite to delivery suite and thankfully I was now 3cm and they popped my waters. That didn’t go much either. Then the drip started. He arrived 4 hours later.
So don’t worry. It doesn’t hurt and even if it did your going into labour and giving birth the least of your worried is a tablet going in when you have a baby coming out lol. But there are plenty options if it fails don’t worry they are all prepared sometimes inductions take days Iv heard!

Pessary is on the outside of cervix. I had 1, nothing happened, 24h later had another. Went into labor within a few hours but they didn’t believe me, I was 6cm dilated before they figured it out and maybe 8-10 hours? DD born the following day at 4pm. So 52 hours from first pessary? I was 42+1 on first day of induction, 42+3 when she was born with an emergency instrumental delivery.

a couple of weeks ago I gave birth to my first baby by means of induction. The first thing they did was insert the pessary it was called cervidil. It is placed next to the cervix not inside. I think your midwife is mistaken. The cervidil is like a tampon with a string, it releases medicine to help the cervix thin out. It stays in there next to the cervix for 12 hours. After 12 hours they took it out and the cervix was mostly thinned out and 3 cm dilated. I had another one put in for 12 more hours. After they took out the second pessary I requested an epidural and then my doctor broke my water once the epidural kicked in, and she started me on the pitocin drip right away. 2 hours after the drip started I was dilated to 10 cm, and baby was born after two hours of active labor. I highly recommend the epidural.

@youknownuthinjonsnuh

What happens if the pessaries and gels just aren’t working on your cervix at all? What do they then do and how long do they let this go on?

They will repeat the pessary if the first one doesn’t work and then give you a break before the gels. If the pessary and gels aren’t getting things going, they’ll use them to open your cervix enough for your waters to be broken, so at this point they will use a small hook to break the waters. They will then give you some time to progress yourself and see if labour starts. If it doesn’t, they’ll want to put you on the hormone drop to start your labour. If you don’t progress as quick as they would like, you’ll be recommended a c-section. Have a look at your individual trust though, they should have a description of their process as it can vary from trust to trust.

Your story sounds similar to mine. After 4 very painful attempted sweeps starting at 39+4, I had the pessary inserted at 40+13 at 5pm. They put it next to the cervix (like where a tampon would be). It’s small and didn’t hurt. It was taken out at 5pm on 40+14 and I was examined where the midwife found I was 2cm dilated which was enough for them to break my waters. Waited until 8am on 40+15 where I was taken to labour ward and had my waters broken and put straight onto syntocin drip. Measured 4cm at 12pm, 6cm at 4pm and fully dilated at 7pm. DS was born by forceps at 10pm and a huge 9lb 12! Wishing you all the best!

Induction didn't work for me. Waters broke on Tuesday, went to hospital. Was examined and sent home. Slight pains but contractions didn't really kick in. Went back to hospital on Thursday for induction. Pessary inserted early morning. Nothing happened. 2nd pessary inserted in the afternoon. Still nothing. Onto drip at 11pm! Contractions all night. Friday 8am examination 1cm I was exhausted by this point I had an epidural so I could sleep and they could 'turn the drip up'. Had 4 hours sleep. Examined. No change. Consultant came in, was furious I'd been allowed to go so long without intervention. Had an emergency c-section at 12.40pm on Friday. From consultant shouting at midwife to delivery was 12 minutes! Wish I'd just had a c-section 2 days before I did! Would have saved a lot of bother (and the hideous infection I had for weeks after).

I’d really discuss a CS at this point. I was in the same position as you and the pessary / sweeps were really uncomfortable. Didn’t progress at all, laboured for 2 days, ended up with EMCS anyway.

Best of luck!

There are different methods of induction, think it depends on your hospital.
I was offered the rods which stretch your cervix ipen which sounded barbaric so i opted for the pessary.
Its like a tampon and is inserted so it sits basically against your cervix.
It releases hormones to encourage your cervix to open.

In my case the pessary was in for 5hours befoee i started getting back to back contractions and my waters broke spontaneously.
I was 5cms dilated at this point and rushed to delivery. Baby was born less than an hour and a half later.
My circumstance was different as I had pre-eclampsia so labour is quicker but i was advised induction can take up to 3 days.