Induction vs. C-Section - 1st Baby. Pros and Cons?

[TiffanyJB]

HI all

Make a cuppa- this is a long one. I’ll give you the context first but essentially the question is simple, what are your thoughts on Inductions vs Planned C Sections,

…. Any comments welcome!

THE CONTEXT:
I’m 27 years old and the proud owner of a 39+6 babe!
Baby’s estimated weight is 7lb 4 and I’m a low risk pregnancy- I’ve had no issues at all my whole pregnancy and have been very lucky.

Two days ago however, I had to pop up the MAU for reduced movements. Bub was moving but just not his normal active self so took the better safe than sorry approach.
The team were happy baby was fine after monitoring (even though I only clicked the button twice?!) but I was offered a sweep and/or an induction anyway, to which I declined. I felt like the doctor was not in any way pushing this on me, and was trying to be informative by telling me babies with reduced movement after 39 weeks have more chance of stillbirth, and that the placenta could be dying, but I must admit, it also felt a bit scare tactic considering they had just told me baby was absolutely fine…. The midwife even said they could see me having contractions on the monitor, so I’m not sure why if everything is ok, the signs of my body building up to spontaneous labour is good and I’m not even at due date with first ever low risk baby they would even offer induction.
None the less, I was offered to come back in the day after for more monitoring and a scan, which I figured wouldn’t hurt and would only further reassure me that baby is fine.

To add as a side note; The MAU was absolutely manic, and I mean chaos, people had been waiting in excess of 6 hours to be seen when I went in, and after I had been in from 4pm-9pm the same people who were there hours before me were still waiting…

When I got home I was questioning if I had made the right choice for baby, as feeling movement twice in 30 mins isn’t normal for him, but all through that night and into the morning baby was moving much much more normally which really settled me.

The next morning I popped back and had the scan, everything went ok. Weight great, measurements great and baby’s growth hadn’t dropped off. Furthermore, blood flow from the placenta to baby was all fine too.
I went up to the MAU to be monitored as planned and everyone up there was a bit annoyed as to why I was there. I couldn’t tell them why I was there (I just said was asked to come back to check all ok so here I am, which they didn’t like!) but it was much quieter, and so I was hooked up to monitoring and ended up pressing the movement button a multitude of times which really made me feel much happier and again, reassured.
Midwife confirmed after monitoring that again, baby is happy and healthy, but midwife said that a doctor would be in to talk to me all the same.
I had felt some discomfort whilst on the machine, some cramping I had to breathe through that I definitely hadn’t experienced as intensely the day before, or indeed through my whole pregnancy, and so before she left I asked the midwife who assessed my printout if she could see any contractions on the paper and explained what the other midwife yesterday evening said about seeing some on there, she point blank just laughed at me as if I was silly, and despite her colleagues coming out with it unprompted only the day prior, that I categorically and absolutely wouldn’t have been having any contractions at all… and to be honest, she made me feel a bit daft actually as I really thought that was a positive sign of my body gearing up to do the right thing and it was definitely taken into consideration when I made the decision to decline the initial offer of an induction.

Doctors came in to me then, and yet again despite everything being ok, I was offered an induction, with stillbirth being sighted. I did reiterate that I was up there because I was asked to come back and not because I had reduced movements again and if anything, I was more than happy with the movements pre, during and post monitoring, but that didn’t make a difference.
I was also offered a sweep to which I declined (I know it’s great for lots of women, but my own view is that the science just isn’t there to justify it as an option for me personally) and the doctor basically scoffed and said ‘because it’s painful?’ (I simply bit my tongue and gave him a ‘no’ rather than a piece of my mind)
Doc then asked if I was completely adverse to an induction, but more in a line of questioning than genuinely wanting to explore my options, and I said I wasn’t completely adverse, and that if I was overdue I would obviously give it some serious consideration and if I was strongly advised to have one by doctors for any legitimate reason I again would obviously listen to and seriously assess that advice, but currently, I’m not even at my due date, I’ve been told everything is fine twice by monitor and once by scan in the past 24 hours and have had improved movements to a point I feel much more contented, so I don’t see a need to induce unless they do and they left me be after that and said that seemed ‘reasonable’ and I could go home.

THE QUESTION:
Naturally I’ve come away from this and have started to think about my ideal and my backups.
My ideal is a natural, spontaneous labour in the water. Being as upright and mobile as possible. I do not want to be hooked to a drip or tied to a bed for monitoring, I do not want to push on my back.

However, if I end up going back for reduced movements, I feel like I would be frightened having had the exchanges with doctors I have had to decline intervention again, so have started to look at the possibility of what I would want to do, should he need to come out, or should I go over my due date.

With the induction process, I didn’t know how it worked before, just that it forces the process along which I wasn’t particularly keen on. However, after some research, i now really dislike the thought of induction due to the 'cascade of interventions' which according to one consultant leads to a 1 in 2 chance of a c-section anyway.
I have read lots of positive birth stories for induction but I really don’t think it’s for me.

I previously had a twisted pelvis, it’s since been untwisted by a chiropractor during pregnancy to allow me a vaginal delivery, but because of this, I had already researched the pros and cons of Caesarian sections and had planned on having a planned C due to the chances of interventions with twisted pelvis being extremely high and me not really wanting to experience this if I could try and avoid it.
The idea of a C Section now is now something that is even more appealing to me when compared with an Induction. I'd personally much rather skip the potential for trauma and possibly needing an emergency C anyway, and go for something planned and manageable (but with it's own risks) instead.

I would be really really interested to hear your advice and opinions from you all on Induction vs planned C-Section in this scenario.

Thanks so much x

Doctor sounds like a nob, you are obviously well informed and know that induction can be stressful for you and babe and also end up in emc regardless.

My thoughts are this - if they are offering induction over csection then your baby is in no immediate danger else they would be wheeling you straight to theatres.

I declined induction in both my pregnancies and if they had concerns I asked for additional monitoring and a out of guidelines care plan for my birth but I ended up with a 41+6 MLU birth (suspected big baby) and a 41+3 home birth (suspected small baby)

If they are willing to wait upto 5 days for an induction to work then I was comfortable waiting too.

Hi @HairsprayBabe.

Thank you so much for taking the time to read and reply with your thoughts and experiences,

What you have said is exactly what I was thinking.
Surely if there was enough of a worry to recommend/push for induction in a low risk pregnancy, that is pre due date, then they would want him out ASAP in the most controlled setting.

Agree totally on if they’re willing to wait then so am I mentality. Great way to look at it.

Thank you so much again - you’ve made me feel loads better😌x

“Because it hurts?” 😂 my midwife actually said “thank goodness” when I refused a sweep because she had written a paper on how a sweep makes zero difference unless you’re on the cusp anyway.
Midwives (and I suppose all medical professionals) all have different options, and there seems to be zero continuity of advice and guidance.
You know your baby and body better than anyone and if you’re happy with movements and you want a spontaneous labour then try for that. If you like the idea of a planned section then that’s a valid decision too.
If I were you I’d wait. But it’s totally your choice. I did end up on a drip with DC1 but only because my labour had stalled (waters were first to go and labour lasted 39 hours), I had planned to decline it otherwise but circumstances change.

Hi OP,
Im glad to hear all is ok with baby and movements are normal now!
I have had two babies. First baby, went into spontaneous labour, but still ended up hooked up to machines and had an assisted delivery in theatre with forceps due to her unusual position.
Second baby, I was determined for a more “natural” birth. Did hypnobirthing, and planned for a water birth. To cut a long story short, birth went pretty much exactly as second. And I tried my best to avoid it, but again, baby was in unusual position.
Looking TTC a third baby this and this time, I am going for a maternal request c section- 100%, I have looked into the pros and cons and it is the best option compared to what I have been through.
Just my own experience of course, but I vote for the section!
Good luck whichever you choose, and how exciting you will soon have your bubs in your arms! X

Sorry, meant second birth went pretty much exactly as first x

It’s up to you. I would take the induction personally. Baby is completely term, you’ve had a couple of episodes of reduced movement and there’s evidence that inducing at 39w decreases the likelihood of a c-section. I always go with medical advice because god forbid if something went wrong, I wouldn’t want to blame myself. Good luck whatever you decide.

Recovery from an induction is far more preferable to recovering from major surgery, not able to drive for 6 weeks, painful to even lift your own baby, potential complications with the scar.

My first was induced due to pre-eclampsia, the process was LONG almost 60 hours of active labour but I went home 8 hours after birth.

If you're unlucky, recovery from induction might mean dealing with 3rd or 4th degree tears, urinary or fecal incontinence, prolapse, painful sex and a dozen other perks of avvaginal birth.

It's not all black or white.

And not to mention you have a pretty decent chance to end up with an EMCS anyways, having endured the whole induction horror.

Granted, but that's a possible outcome, if you have a section its guaranteed you have to recover from major surgery and everything that goes with it.

All births have a risk associated to them. I've had 3, one induction, zero pain relief on them all, no tears, grazes or anything. My issue was the pressure of pushing damaged my cocxyc bone which was painful.

My sister had an induction followed by an emergency csection and that child is now disabled.

Another friend refused all intervention, gave birth naturally at just over 42 weeks and her baby has cerebral palsy.

SIL had a pre-planned csection and ended up with an infected scar and necrosis.

Birth is always a gamble. I'm just saying a csection is a promise that you need to recover from major surgery, the other outcomes are, as you say, based off luck (or lack of)

I had planned a water birth with Hypnobirthing to get me through but unfortunately I was induced due to low waters and ended up having a category one c section as forceps failed. In theatre the surgeon also said I have CPD, wonky pelvis, so baby would never have come out vaginally and that next pregnancy I should go straight for a c section. I do feel gutted that the option is taken out of my hands but at least I know next time will be far more relaxed than an emergency!

I also didn't want to be induced but looking back I'm glad I was and that I didn't wait for my baby to come in his own time because when he came out he had a rash all over his body due to an infection and subsequently spent 5 days in special care on antibiotics and I dread to think how poorly he may have become had I declined the induction and his infection could have taken hold.

The doctor sounds like an idiot. Whatever you decide you need to be happy with your choice. Don't feel pressured by other people

I was given a sweep that I hadn’t agreed to, and would not have agreed to as I completely agree with the above. Sweeps only “work” when you are at the point of going into labour anyway. They are utterly pointless, imo and can be really painful.
Induction has a high incidence of going on to be a c-section, I don’t think it is unreasonable to ask for a c section instead at that stage if you feel that your body isn’t actually ready for labour. Hopefully it won’t come to that, and you will go into labour naturally.
I agree with pp that the doctor sounds like a knob, and a bit of an arrogant bully. You are clearly well informed, sensible, and listening to your own body, don’t be swayed from that.
I asked for a c-section after an initial attempt at induction failed, I had been given the sweep and a pessary. Nothing at all was happening, and the next step would have been an epidural etc. I had a very strong gut feeling that I would end up with a c section eight hours later, after loads of intervention and with a baby getting distressed. It was days before my due date, I wasn’t close to natural labour. Cervix tightly closed.

Sounds like your doctor could use a revisit to bedside manner training. Or a new job where they never need to interact with actual humans.

I've had two 37 week induced births with the drip. First was a vaginal birth with gas+air and diamorphine, where early on in labour I decided to lie on my side and not move. Second was an emergency C-section where I was upright and mobile for much of labour. Has a late epidural as progress was slow, then stalled, and the pain got too much. Baby managed to get himself into an undeliverable position.

It tickles me now that I beat the odds with both births. First birth was far more likely to be assisted than not, while the second should've been "faster and easier". Just goes to show it's all a crap shoot in the end.

Recovery from both was fine. Comparatively though, the vaginal was far less painful to recover from. Also the C-section wound got infected, and has, seemingly perpetual, thrush around it. Postpartum bleeding was heavier with the vaginal birth.

All you can do in the end is what feels right for you. For me, that will always be the induction route. But it is your absolute right to choose. You're the one that rolls the dice. You're the one who has to go through it. You're the one whose body will be affected. You're the one who has to recover from it all.

Best of luck with whatever you choose.

I was offered an induction when I went in with some concerns over reduced movements for DC2. They also crushed any plans of a water birth as apparently if you go to the MAU with reduced movements past 38 weeks they won’t let you use the birth centre (but I imagine this is different for each trust). I won’t give you the long backstory but I was very averse to induction and I didn’t like the risk factors associated with it. DC2 was measuring big and there were serious concerns over shoulder dystocia. They then offered me a c-section which I accepted. I know if I’d been a first time mum with no experience of birth I would have blindly accepted the induction without giving it the serious consideration that I did so I really commend you for standing your ground!

To be honest my worst case scenario was having a long and painful induction only to end up with a c-section. I’d had one too many friends experience this and I wanted to feel more in control and not put myself through any unnecessary trauma. I also instinctively didn’t feel baby was ready to come at 39 weeks. My personal opinion (and it’s only my opinion) is that if baby isn’t ready to come “naturally” or is on the cusp of arriving naturally then inducing and forcing them out is traumatic for both mother and baby. As it was my DC2 arrived via elective c-section at 39+5 and it very much felt like the right decision.