Second birth - scared of induction after home birth

[User65412]

Hi, looking for any advice or anyone with similar experience.
I'm 38 weeks pregnant with my second child. I felt very in control with my first pregnancy. I had a straightforward pregnancy and denied all offers of sweeps or inductions until she came naturally at 41+4. I had planned a homebirth with an open mind to going in, but managed fine at home. Waters went at 9pm, 3 in 10 contractions started straight away and she was here by 6am. Obviously painful and challenging but very positive.
This time, I've had a very different pregnancy. Low iron, severe pgp, low papp - a and gestational diabetes diagnosed last week (a complete shock as I have no risk factors).
So I've been having growth scans throughout because of low papp-a and growth has been steadily dropping. Yesterday baby dropped below 10th centile and they have said they suspect IUGR (although they can't be sure and could just be a small baby). Fluid, blood flow and movements absolutely fine. With this and the added complication of diabetes, consultant was very keen for me to be induced today but I insisted I wanted to wait. I've agreed to induction next week with daily monitoring until then.
I feel so lost and confused this time. I'm now worried that my baby is at risk and I should be induced sooner rather than later. Or I'm concerned that they've scared me into an induction when I should wait for my baby to be ready. I feel like I can't make an informed decision. I'm very data orientated and stastsics-led (love maths!) and assess risk in a black and white way, but I can't find enough evidence or studies to make the risks clear. I had planned a homebirth this time but kept being told it depends on the next scan. 2 weeks ago baby was on the 10th (before the gd diagnosis) so consultant and midwife were happy with homebirth. Since the drop in growth and the gd diagnosis, neither consultant nor midwife will support a homebirth. I am fine with this and not hugely opposed to going to hospital (especially if I can go into labour naturally), but the EMCS and instrumental delivery rate at my local hospital terrify me. (45% section, 15% instrumental).
Out of all of my friends who have had babies there, they've all had traumatising experiences usually ending in forceps or section (and many of them induced). Of course I know that sometimes these interventions are necessary, but when I had my homebirth my midwives said that if I'd been in hospital, they'd have used forceps by now due to' failure to progress' because of the 2 hour rule and need for beds. So I have concerns around the motivation for intervention at my trust.
On top of all this, I'm absolutely terrified of being induced with the hormone drip as everything I've heard and read says it's absolute hell. So if that happens, should I have an epidural first? After a natural labour last time, I feel like I should at least try again but I've read loads of threads on here now advising epidural before drip.
Sorry for the ramble. I feel so disappointed in my body this time and so out of control. People keep saying to me 'as long as baby gets here safe it doesn't matter' and I totally get that, but I also think my feelings deserve some validation and I can't help how I feel.
I'd love to hear from anyone who had a hospital birth after a homebirth, or if anyone has any more info on the risks of small babies combined with gd!

No homebirth here, but induction bc of IUGR and then static (no) growth.

for you it’s not just the one scan that showed the baby at 10th percentile. the baby has been steadily growing at a worse rate for a while now.

same happened to mine, all good until 28 weeks, then fell off her average growth rate. Born at the 2nd percentile. Btw I had scans every two weeks, the placental flow was checked every time, and it all looked good. No obstruction. Placenta also looked good when birthed. So it’s probably the low Papp-a I had (0.45) and that is not massively low (it’s considered ok if bigger than 0.5). I also took aspirin to help with it.

you have GD on top of that, so more risks.

so your placenta is steadily functioning worse and the GD is adding possible complications.

no one can quantify the exact risks for you or give you any certainty.

I had a horrible induction. Could have been partially bc I was stuborn and tried to do it without an epidural, when I got the epidural it was like 24h later, dilated very quick after it, but was too exhausted to push so had forceps.

but it had to be done, I wouldn’t have take the risks. I know 2 mums with still birth, no signs, and classed as low risk. We are high risk, so at least we know intervention is needed.

id like a better birth this time, maybe I’ll have a CS, maybe I’ll go for another induction. There is pro and cons for each. Second time my body might respond better and I’ll get the epidural asap.

I don’t know why you have concern about intervention. While the exact risks are u known, you have clear unquestionable risks, more than 1.

good you know the 2h risk so you can push against it, if it comes to that. You’ll be monitored throughout and you can tell them as long as the heart rate is fine, you want to wait. (get a bouncing ball, if they don’t have one there, for me they did, to help with the pain, as your movements will be restricted, being attached to the monitor)

they didn’t put the drip for me until 20-24h in, but it was still very painful from start, I have very low tolerance with pain anyway. You can be in control of this, you can ask why is it needed, can you have some more time, etc. again if your heart rates are fine, you can take it slow. Just be firm and stay calm.

your body is not at fault, these things happen, don’t be too harsh on yourself.

good luck with your labour x

You have other options.

You could go straight to section. Not what you want but no risk of other interventions.

You could get induced at another hospital where you feel safer. If they want to induce they'll make the paperwork happen.

You could push for a sweep now to try for a more natural labour with full induction next week as back up.

If it's not contraindicated with your risks, and I suspect it might, you can sometimes ask to be sent home with the pressary.

No advice but I totally get how you are feeling. Had a spontaneous labour last time, had planned a home birth this time.

Sent for growth scans twice for reduced fundal height, last scan showed growth now below 10th centile. I have another scan booked but if baby is still below the 10th then I know they'll be advising induction.

I don't want to be prodded and poked and have a hundred fingers inside me. I don't want to feel out of control. I Def don't want a horrendous forceps birth. DH keeps spouting "a healthy baby is what matters" line... Yes but I also don't want to come away feeling violated and broken.

Hope it all works out for you OP

Thanks all.
@CristinaNov182 thanks for sharing your experience. It's really helpful - the consultant didn't explain anything about the induction process to me when I was there this week. I have discussed with the midwife the possibility of having the pessary and seeing how I go, but having an epidural before the drip for certain.
@GingerbreadPanda thank you. I have considered the idea of another hospital. This hospital is already 40 mins away and after that it's about 1hr and 15. The extra distance puts me off if I were to need to stay in but it's definitely something I'll look in to. I actually went for monitoring yesterday and had a sweep while I was there. The midwife advised another one on Tuesday and thinks that might be enough to get things going or at least mean that pessary should be enough!
@BigSidLittleSid I totally understand. I find it difficult to articulate how I'm feeling and friends and family don't really understand. I'm actually made to feel quite uncomfortable when asked about my previous birth. Most of my friends have had quite traumatic experiences which is awful for them and I can't imagine what it must be like. If ever my birth experience comes up, I can sense something that's hard to explain. Maybe it's all in my head but I feel like it annoys them (not that I ever bring it up or mention it unless asked), and that they think that a traumatic horrible experience is a kind of 'right of passage' that I have avoided unfairly. I do feel extremely grateful for my previous experience which is perhaps why I'm so apprehensive this time.
I am booked in for an induction on Thursday and monitoring movements very carefully in the meantime. I had a panic yesterday about SGA/IUGR babies and still birth, so asked if I could have the induction brought forward. I'm not normally indecisive at all but I'm swaying from one extreme to the other! They can't fit me in before then anyway, and the midwife reassured me that if the consultant was that concerned then they'd definitely make room earlier.
Here's hoping it happens naturally before then!

@User65412 hope you go into labour naturally until then. Hope the sweeps help too.

i was told by sil and sister that long walks help too. This is what I plan to try this time. Sil did smtg like 20,000 but she’s used to long walks. I don’t know how much my sis did, definitely nothing as much, but the idea is to push yourself a bit more, with breaks and see how long you can go. My sil went into labour same or next day, can’t remember, my sister did these walks on and off for the last few months, and every day for the last week, smtg like that.
I plan to go walking for the whole day lol, with breaks for lunch, etc. and ramp up the walks in advance too.
I’d do anything not to have another painful labour
I’ll probably try everything I can hear about :))

I had an induction at 37 weeks with DD2 after a home birth with DD1. My waters leaked a little at 35 weeks which is why they induced.

Obviously every induction is different but mine was fine. I was 0cm at the start but just needed the gel (couldn't have the pessary due to waters having broken), contractions started right away. They broke my waters, which were in front of DD, about 9 hours after the gel and she was born 2 hours after that. No drip, no epidural - like you I was terrified of the drip and after they gave me the gel I bounced on the birthing ball and paced round the hospital like a mad woman desperate to do anything that might help me not need it! I'd have requested an epidural if I'd needed the drip.

Overall it was a much better birth than DD1's really. I had a PPH with DD1 and didn't have any abnormal bleeding with DD2, plus it was about half the time from start to finish and wasn't really that painful until they broke my waters and it all ramped up.

I just wanted to give a positive induction experience as I read a lot of negative ones before mine, and really scared myself!

I can understand it’s disappointing but it’s just luck of the draw unfortunately having had a straightforward birth I wouldn’t personally go straight to section. It depends when you would be induced, if it’s 38 weeks onwards you have a pretty good shot at just having the pessary and avoiding the drip. If you need the drip I would recommend an epidural, not just for pain but to conserve energy for pushing - inductions are more painful than normal labour and you can get tired very quickly. I would follow the doctors’ advice though, with just one risk factor then it might be worth exploring others options, but you now have a few which means you’ll be safer in hospital. Good luck! I’m being induced for the second time at 37 weeks with DD2 in March, it isn’t my dream birth but needs must.

If baby was at really high risk of issues they would have suggested a section over induction as induction can stress the baby so while you think about your choices at least that may relax you a little. As long as you're monitoring movements etc then you'll be fine until your induction date. Just have a lower tolerance than normal for being seen.

I had a drip induction with DS3 with no epidural and though the final hour was very intense it was ok, I knew I was near the end. Once it got going the labour was much like DS2 only a bit faster again, and the pushing stage was only really one giant push. (Midwife nearly didn't catch him!) I was 39 weeks but my waters had started to go and I'm in France where they're v strict about inducing very quickly in this situation (within 12 hours). I was having barely noticeable contractions so I suppose would have gone into labour within a day or so anyway. It is very unusual not to have an epidural here so they were constantly offering it but it was honestly ok.

@CristinaNov182 yes I've heard that walking helps but unfortunately my pgp means I can't manage much. I used to walk loads, at least 10k a day but this pgp is awful! I've done a brisk dog walk this morning so hopefully that will help.
@BonesOfWhatYouBelieve that's a fantastic experience to read! So glad you found it to be a postive experience overall. They do say your body is more ready second time so hopefully my experience will be similar to yours!
@consideringachange wow well done you! I think you're the only person I've heard of/read about that has managed on the drip without an epidural (and not said it was absolutely horrendous!) - very reassuring to read.
I'm feeling much better about it all now I've had time to adjust my mindset a bit. I like to think I'm a 'go with the flow' type person but it's amazing how focused you can be on something you've imaged in your head a million times.

I had both children after my waters were broken for induction, at 38 and 37 weeks. Needed the drip for the second baby, had epidurals for both, episiotomy for one and small tear for 2 who was back to back.

They were both positive experiences. Once you’ve had a vaginal birth your chance of caesarean or instrumental drops substantially with subsequent births. (www.bmj.com/content/371/bmj.m3377)

@CaramelWaferAndTea thank you - so helpful to read of your positive experiences, especially regarding the drip.
I'm being induced tomorrow and now I'm just really looking forward to meeting my baby.
I really appreciate everyone's input. I hardly recognise myself - I wasn't scared at all first time round and had so much faith and confidence in my body. I don't know why I'm struggling with it so much this time - perhaps feeling a loss of control.
I've had loads of hospital appointments and I've always found the midwives and consultants so helpful and kind, so I'm focusing on that as well.

Good luck tomorrow, hope you have an easy and quick labour x

Best of luck for tomorrow OP! I think mindset is key, so hopefully now you are in more positive mindframe this helps. As others said hopefully you can get there without the drip, but no shame in an epidural to conserve energy and help with the pain.

I planned a home birth with DD and ended up transfering to hospital after 3 days of labour. I had the drip and an epidural, I was exhausted. She came a few hours later. It did need to be forceps in the end but only small ones as she was low (I'd insisted on pushing on all fours for a while which helped k think, which you can do if the epidural is a lower dose!). I did tear badly but I've healed well with no lasting issues. And as this is your second birth, you are much more likely to avoid instruments as PP said!

I'm pregnant again and hoping for a home birth again but having been through loads of interventions last time, I'm not so scared of it now if they are needed... We can handle it. 💪

Let us know how it goes xxx

I would honestly look for threads about inductions specifically with second babies.
I was induced with both of mine and they were night and day. With my second I had one pessary and had hyperstimulation, to the extent they gave me the 'antidote' but she was on her way by then, they didn't believe me so I had her on two lots of two paracetamol and a bit of gas and air towards the end. No chance for a drip or any of all that! You can have gas and air for the pessary if you like but they won't offer it.

My first induction took four days to even get going, I had the drip so I had an epidural sited before they broke my waters, at my request. Wasn't pleasant so was dreading having it again but I wasn't even in the hospital for 24 hours this time, had baby at breakfast time and was at home for my lunch! I'm sure it was a second baby thing and I'd be much less worried about another induction if we were to have a third. I think a lot of the induction horror stories (like my first one) are first babies?

Good luck for tomorrow. I had an induction for my second child today and it was a quick, straightforward process. I had a balloon catheter fitted last night when I was 1cm dilated, bit uncomfortable but it fell out about 4 hours later when I was about 3cm dilated, midwife broke my waters but after an hour contractions were still very weak so started on drip, doubling dose every 30-60 mins, DD2 was born 4 hours later. Managed with gas and air, but only because I waited too long to request morphine and declined epidural because I didn't think I'd be able to feel when to push. It was intense but no complications or interventions required.

@TwistofFate congratulations on your new baby! And thank you so much for sharing.
I think you're all right regarding many negative induction stories being first babies. I'm definitely going to have a little browse of second induction stories tonight.
I'm feeling very antsy and just keen to get there. My midwife just told me that some women are having to wait days from their planned induction to actually go in because the wards are so busy and staffing is so stretched. I'm really hoping I can go in tomorrow now I'm all psyched for it! I have to call at 9am to see if there's room so fingers crossed.
I had another sweep yesterday and had a bishops score of 4 and was 2cm dilated. The midwife seemed to think that by tomorrow this might have improved, meaning a better success rate on the pessary. She also said second labours have much lower intervention rates which was reassuring!

Good luck tomorrow. I was induced with my second after spontaneous birth with first. I only had the pessary and my waters broke. Then she was out in about four hours- it was great!
Good luck and enjoy your baby!

I was induced at 37+5 due to my daughter stopping growing. She was down to 7th percentile by the day of my induction. I had heard so many horror stories about induction so was prepared for the absolute worst. It wasn't that bad at all. I was offered an epidural but refused. My midwives made it clear that I could change my mind and ask at any point but I honestly didn't feel the need. The only sticky moment was when the surgeon came in and told me she was going to use forceps because I had been pushing for too long. My daughter wasn't in any distress they just wanted to speed things up and free up the delivery room. I may have made a suggestion about where she could stick her forceps.
Make sure they answer your questions. I had the overnight surgeon off finding out everything I wanted to know about risk percentages while I was waiting for the pessary to work because I need data and facts/statistics to make a decision. I won't just take someone's word for it. I need to see for myself.

With your GD, has anyone talked to you about colostrum harvesting? Crack on tonight and / or nipple stimulation and it might just get things moving before your induction.

I had a suspected IUGR baby (5lbs 12oz at 38w) and had induction booked for 39w. Tried some colostrum harvesting at 37.5w and i went into labour the next day.

@milawops that's exactly what I'm like - I need the statistics! I'll make sure I ask. Did you have continuous monitoring? I'm keen to avoid it as I know there's more chance of a 'baby in distress' decision being made eventhough evidence shows that it's likely just picking up minor fluctuations in heart rate that happen in all labours.
@YorkshireTeaCup yes I've been harvesting since 37 weeks! Hasn't seem to have started anything but I have plenty of colostrum which is great. Again, evidence shows that if a baby is born with unstable blood sugars, the best thing to stabilise them is colostrum above all else. Hopefully baby's sugars will be fine and we can come straight home!

Hello - just wanted to briefly say that I had an induction back in March with my first. Ended up trying all the induction methods (sweep, pessary, breaking water, drip) before things eventually got going, and the ultimately having a c section when my little ones heart rate became concerning when I was in active labour. Even with all of that, it was honestly a really positive experience - I felt well informed and in charge, pain control was good, and I look back on the couple of days that I spent trying to get things going really fondly - as well as all the medical induction methods I did all the bouncing on a ball, watched lots of comedy (laughter must be helpful?!) and a lovely body lotion meant that my room smelled gorgeous! I really hope you have a good experience, and enjoy meeting your little one very soon!

@Sleepsleeprepeat thank you so much! It's so helpful to hear your experience even with a more complicated birth.
The hospital have said they are very busy (as always) and to call back this afternoon. I hope this doesn't go on for days 😭

Just wanted to send you my support. I haven't had your experience but I'd like to think that given your homebirth experience before, you'll do brilliantly because you know what to expect and maybe hypnobirthing techniques etc.
My friend had an epidural that you could still stay mobile with? Worth asking? I think being able to change your position will make a big difference to your comfort.
I hope they get you in soon and don't keep you hanging.

@User65412 yes as soon as the drip started they had me on a monitor. Total pain when you need a wee by the way 😂
She was having little dips every now and then but nothing of concern. The surgeon was open about wanting to use forceps purely because they were busy and needed the delivery suites.