induction vs c section with a high risk pregnancy

[Amyjay19]

Apologies in advance for the long post!!
I'm currently 37+2 with my first baby, I've not had the easiest pregnancy with lots of complications along the way!
At 20 weeks baby was diagnosed with multi-cystic kidney so we've been monitored by the fetal medicine unit, at the same scan they told me I had a low lying placenta. I was then diagnosed with gestational diabetes afew weeks later. Then around 28 weeks I had severe itching that wouldn't go away I ended up being tested for cholestasis and was diagnosed immediately as my liver function test was very abnormal and my bile acids came back at 79 I've been on medication and monitored closely with twice weekly blood tests and ctgs.
Throughout all this I've not been happy with the way I've been treated by hospital staff and my consultant. I've been told it's not safe to go over 37 weeks due to increased risks of stillborn I was then told I'd have to have him by 38 weeks I saw a new consultant today who was very rude about the fact that I was scared to wait too long incase something goes wrong but she wants me to have him at 39 weeks, I've expressed my concerns about induction and not wanted to end up being rushed into and emergency c section and she's made me feel very bad about the choice I've made when all I want is my baby to be delivered in the SAFEST way possible I don't want to put him at any risk of stress or harm and I've heard some bad things about induction.. with having so many complications what is the best and safest option for me? I'd love to just wait it out and go naturally but that's not an option in my case. Please help a stressed first time mum ☹️

I was induced for reduced movements at 39+5 after an uncomplicated pregnancy. My body wasn't ready to go into labour and it ended in an emergency C-section. I'm now coming up to 32 weeks and hoping for a VBAC but I would not go for an induction if my body wasn't showing signs of being close to labour. If we need to get the baby out and my body isn't looking ready, we will just go straight for a C-section.

In your situation I would insist on a C-section because it sounds like that is what you want and what will be the least stressful for you. Your pregnancy has been complicated enough, you don't need the extra stress of trying to give birth vaginally when you could have a nice calm C-section and you're happy with that option.

@babyjellyfish It's really not about me and what I want that went out the window when I realised I couldn't have a natural birth.. now I'm just trying to make the best informed decision about what is the safest thing for my baby I wouldn't forgive myself if something went wrong after trying to protect and keep him healthy for the last 9 months!
I feel like such a bad mum already I'm worrying and crying everyday about it☹️

You're not a bad mum.

You need to look after your baby and so to a certain extent what is best for you is also what will be best for your baby.

Go back and talk to the doctor about the risks and benefits of waiting longer to give birth. But certainly even in an uncomplicated pregnancy there would be no more advantage to the baby in staying inside past 39 weeks, and in your case if there are additional risks to waiting that long, it may be least risky on balance to have your baby sooner.

There is no particular benefit to your baby in being born vaginally rather than being born by C-section, and if you have a difficult labour there may be additional risks which could be eliminated by having a planned C-section. At worst, C-section babies are a bit more mucousy for the first few days and your milk might take slightly longer to come in. These things had no impact on my son beyond the first week.

Thankyou that makes me feel a lot more at ease! ive been collecting my colostrum to make sure he has that to help his immune system once he's born and also while waiting for my milk to come in properly! I'm sure everything will be fine once he's here

So your bile results are not that bad now (actually quite good, considering the issue can’t go away completely) and your GD is under control.

So it looks like 39 weeks delivery is an option, maybe you don’t have to rush for 38 weeks. Just keep counting those kicks (can get apps for that as well to make it easier)

You also have low lying placenta, so, yes, definitely a CS is the best.

I don’t know why you think you’re a bad mum, you’re great, you’ve been dealt some though health issues, no fault of your own, these things happen, and you’re doing your best to make the right choices, you’ve got your health issues to the best state they can be.

try to get some rest before the baby comes, and plenty of sleep, you’ll need it x

@CristinaNov182 Thankyou for that❤️ I'm just stressing myself out as you never expect for this many things to go wrong especially with your first☹️ I'm going to try and keep calm now I feel a lot more at ease after talking to you than I did after the consultant I will update the post once I know more Thankyou again for making me feel a lot better!!

Urgh, I had a similar experience with a consultant when I had DS2.

With DS1, everything was fine until I needed to be induced because I was a week overdue and had pre eclampsia. My induction was awful and I won't scare you with exactly what happened other than I had an emergency csection and DS1 and I are both still alive (there was a point when that wasn't guaranteed TBH).

With DS2, I had an awful pregnancy. I was offered the option of an elective csection or to have him naturally. The consultant I saw at 20 weeks told me under no circumstances should I consider an induction because of what happened last time and the risks of rupturing my existing scar (2 years between babies, this risk reduces if you're sensible and wait longer). I was also told that I was likely to get pre eclampsia again due to it being second pregnancy and me being older. So there was a high chance I'd need to have him early.

Then the consultant I saw at 32 weeks was absolutely useless. Tried to talk me out another csection. Told me it was basically the worst thing ever (even though my first child almost died during attempted vaginally delivery!). So yes, that went down like a lead balloon. I always remember her saying to me that I'd need to have any other babies by csection if I had DS2 by section. When told I wasn't having anymore (still haven't!), she snapped back at me 'They all say that!'.

I booked in for a csection with the midwife at 39 weeks. She didn't bat an eye at asking for a section.

When I was 37 weeks, I got pre eclampsia and was hospitalised after having Bells Palsy. I had DS2 at 38 weeks by csection. I had to have steroid injections (for baby and for me!). He was a good weight (8lbs) and has had no health conditions. He is a healthier child in general than DS1 who was born at 41 weeks, had CMPA, and now has asthma.

39 weeks is the optimum. But obviously other risks and health concerns can mean baby needs to come earlier. My friend had all her babies by csection at 37 weeks after her first child was still born. Again, all are generally healthy kids.

It really does depend on the individual- there's no right or wrong way.

I've had an emergency section and I have an elective scheduled for next month. I'd choose a section over induction 10 times over.

Oh OP that sounds so rough. As others have said, and as you seem to have decided, I’d say go for an ELCS. I’m so sorry you’re having such a hard time getting a consultant who will listen to you. I know you’ve already changed hospital but any chance of chasing consultant? I’d also really recommend taking someone with you to your appointments who is happy to be the “bad cop” and really advocate for what you want and your concerns. I felt very vulnerable when I was pregnant and at times felt talked down to by doctors. I always made sure I either had DH or a family member with me who knew my wants and would be happy to speak for me or at least back me up.

To add my second DC was an ELCS and I’m petrified of surgery. My section was my first every surgery and had there not been a few issues leading up to the birth I would have definitely gone for a natural birth. However, please believe me when I say it was absolutely fine. I was very scared but I can’t tell you just how nice everyone was, I was made to feel totally comfortable and it felt like there was a big effort to make the experience pleasant and not stressful.

You are not a bad mum, your thoughts are for your child. I had no choices at all in my first pregnancy, as it was very complex and I had a specific team ready to deal with my son's medical issues. The theatre was full of people. I wasn't allowed to touch him and he was rushed straight to the NICU. I had no idea how he was and had no reception to keep in contact with his dad (he also went to NICU, as I was terrified our son would die surrounded by strangers). It was horrible really, but everything was about keeping him alive, so obviously I was very keen to just do whatever was necessary. Everyone was. We got super lucky and my son is healthy.

So this time, I really wanted the opposite, not medicalised, a water birth etc. Actually I really wanted a home birth but I am older now, have a previous section scar, am having a big baby, it is an IVF pregnancy, so there are too many risk factors for me to stay at home. Like you, I just want my baby here safely, even if that means I just am not destined to have the intervention free water birth I envision. Your wants go out the window when it comes to needs to keep everyone safe.

Thinking about what is best for your baby certainly means you are already a good mum. You can have a low risk elcs, there is no need for an induction if you don't want one, have you looked at gentle c sections? There is zero chance of me choosing an induction over that.

I have experienced being treated as a vessel for the baby and not as a person with my own needs, and I am not having it this time. This needs to work for you and your baby and you know better than anyone how to make this work for you both. You are far too invested to make risky choices for your baby, so that is not a worry. Trust yourself.

@Amyjay19 glad it helped! They have treated you appalling, especially with trying to shame you for asking questions and not just going along.
but you’re almost there x