ELCS instead of induction

[fr4zzledmum]

I'm currently 28+1 with second baby. First delivery was 5 years ago and I had a perfectly fine vaginal birth, only a slight graze that required no stitches and a 7lb 10oz baby.

During first pregnancy, went through the rigmarole of bump and growth scans which had estimated baby's weight as 10lb+ and so was told I'd be induced no later than 40+5. I went into labour at 40+1 and gave birth 40+3.

This time round I'm consultant led care, owing to a BMI higher than 40 and so will be having growth scans - bump measurements already predicted baby is 4lb already (taking this with a fist of salt). But I can't help but feel like I'll be pushed to go for an induction.

I'm pretty sure I don't want this, after hearing so many horrible stories and also reading that inductions can increase the risk of intervention and also end up with EMCS anyway. I'm pretty easy going birth wise, but a big no no for me is forceps.

If I go into labour naturally then I'm going down the epidural route (terrified that I'd get the big baby and I'm terrified of birth injuries and teara).

But would it be unreasonable to just ask for an ELCS? I have my first consultant and growth scan appt on Thursday, so will get a flavour of how they're likely to proceed then

Also, can I request a tubal ligation if I go down the CS route, at the same time?

Since you've had a previous vaginal birth, my understanding is that you have 90% odds the induction will be successful - you have a substantially higher change of an induction being uncomplicated than a FTM.

how overweight?
much more overweight than first time around?

Unsure of exact difference, but I'm at least 4 stone heavier at booking with this pregnancy.

in that case please just follow whatever your consultant advises

I don't understand why I should follow blindly just because I am fat.

Just trying to get some info for an informed decision. Nothing is definite yet.

but a big no no for me is forceps.

and it was for me (although no way did it verbalise this because who would want forceps?? but i accepted may be medically necessary)

but then my baby was is distress and needed to come out quickly
and then i was incredibly happy and relieved

Op even if you were ideal weight for first pregnancy, you are now very overweight and 5 years older

im not saying blindly follow
but i am saying don’t blindly refuse or request based on your own research and mumsnet

It's never unreasonable to ask for an elective if that's what you want. It's your birth, it's up to you.

Maybe ask your consultant for more detailed information on the likelihood of an induction resulting in for example operative delivery, emcs and so on with data from people of a similar risk profile (so similar BMI and age and so on). That will enable you to make a more informed choice than more generic stats.

As you've had a previous 'successful' spontaneous vaginal birth without any intervention though I'd imagine you have a high likelihood of the same again, and also a good likelihood of an intervention-free vaginal birth even if you are induced.

I agree with this 100%

it is not as simple as that

When the OP last birthed, she was:
5 years younger
4 stone lighter

So the 90% would be heavily adjusted to reflect the increased risk by virtue of weight and 5 years later

my choice would be ELCS.

This is based on what I have heard from women who have had multiple pregnancies (both inducted and natural pregnancies) and my own experience of 2 x ELCS.

none of my friends have anything good to say about their inductions…actually one does.
it was her only birth and she was induced and she thinks it was great. She ended up with a 4th degree tear which reopened…twice 😵‍💫🫣 and still has medical issues 3 years post birth.

My first was an EMCS; i was offered induction for my 2nd due to gestational diabetes, but after reading into success rates for induction TAKING ACCOUNT OF my age, bmi, and previous EMCS, the likelihood of success was around something like 20% so i went for ELCS which was accepted without question by my consultant.

I appreciate that you have had a successful vaginal birth which would give you a higher chance of success than he, but i doubt very much its at the 90% PP suggested.

If you are nervous of induction for whatever reason i dont think youre unreasonable to request ELCS.

I 100% agreed with that poster that she’s likely to have a successful birth with an induction following a vaginal birth

ah apologies

Giving you had a straight forward vaginal birth first time I'd 100% option one wait it out for spontaneous labour or option 2 induction perhaps none hormone based like the balloon

I've just had such a positive consultant experience.

Baby measuring on the 90th centile at 28+3 (taking with a big pinch of salt anyway after previous experience!), and consultant happy with all my other assessments. Asked how I was feeling about birth, mentioned possible induction but then when I mentioned I'm leaning more towards ELCS if its a choice between that and induction, was really fantastic - I expected a fight. Basically said we'll do whatever you want.

Not much point to this post, but just wanted to share a positive experience, as I seem to find myself bogged down with negative ones and this appointment has been stressing me out.