To induce or not to induce

[Shazzyd]

Hi, am really desperate for advice!
I was due on the 27th feb, had an emergency c-secton two years ago. Basically the consutant and the midwives are pushing me to be induced on 14th March.
They tried to push me into a cesarian today, which I refused. Now they think I am a trouble maker and I have no support from them at all.
When I refused the c-s, at my appointment, the doctor and midwife discussed the induction directly with eachother, as if I wasn't even in the room! They then proceeded to book the induction, and any concerns I voiced about it were ignored!
Now, I don't know what to do.
I know I don't want to be induced, I have it in my birth plan, but they are acting as though I have no choice, I feel rather like a silly child who isn't fit to make decisions at all. Yet I have thought long and hard throughout this pregnancy, about what I want to do, and what I want to avoid.
At the same time I don't want to jeopardise the health of my baby.
I now don't trust the hospital; where I am about to have the baby, I don't trust the doctors and the midwives, I feel totally alone, and bewildered.
I am so stressed about it, and can't sleep at night, keep bursting into tears for no reason, and am absolutely frightened about having the baby.
Please help me, how can I handle this?
Shazzy

My midwife was very anti-induction, she felt it didn't help matters. But even she didn't like me going much over dates with DS2 after an elective section the first time around.

Why did you have a section, the first time?

And have you looked into non-medical inductions? (Sweep? Reflexology?)

I don't want to alarm you but I have been told that you should NEVER be induced after a previous section and I can't believe your M/W is considering it.

FWIW I actively chose to have a second section after my first emergency one - I did my own birth plan which was stuck to and it was a very positive experience. Butif you want a VBAC you should be supported in that without being induced.

My m/w who is very against c-sections advised that I could go to a week past my due date and then have a c-section. I was told that my hospital (Addenbrookes - one of the best NHS in the country) refuse to induce women who have had a previous section.

My friend swears by acupuncture to bring on labour on time.

Hi Shazzyd, first of all remember that this is your birth and you should try to remain in control. Try and work with the "professionals" if you can and get them on side . Find out why they are so keen for you to have a Section, are they worried about your helath or the babies ? if so what are they particualry concerned about. You are right to say that the priority must be yours and the babies health but you should be reassured in knowing that different health authorities have different policies relating to induction due to dates. Some induce or section at date + 7 days, some date+ 10 and other dates+14. the vast majority of women do start labour within 14 days of their due date. If they are concerned about yours and your babies health offer to go to the day assessment unit where you can be monitored, that'll show them that you too are concerned about yours and baby health and providing that yours and baby's health is fine and that their are no contrainidcations stick with it. Hope this helps and Good Luck !!!!

I was also under the impression that you shouldn't be induced after having a previous c section.

You need the advice from someone like Mears...

Is there anyone somewhat medical, local to you, who you can go to for support? A local home birth group? A doula?

A lot of independent midwives will talk to you on the phone about your situation even if you're not a potential client.

As ionesmum says, induction after a section is generally not a popular option, although some people go for it. Ideally, for a VBAC, you want as little intervention as possible.

I had an elective section for breech, followed by an "emergency" section, as my waters broke and DS2 wouldn't engage. My midwife felt I was unlikely to get anywhere, and I trust her, so we went for a section early, rather than after hours of trying and risking a cord prolapse. I really really wanted a VBAC, but it didn't happen. And in the end, everyone is well, so that's fine.

I had the c-section previously because of fetal distress, but looking back at what happened, I think it could have been avoided.
I have been trying all the natural methods of induction, and well, obviously they are not working! I haven't tried reflexology, but am now out of time I fear.
It isnormal for women in my family to be overdue, we have long cycles.
The baby is moving regularly and has a strong heartbeat, but still they seem to be pushing me into an induction, I don't know what to do for the best.
I want to know what to say to them, and how to get what I want, and to balance this with the best care for this baby
Shazzy

...they won't induce, ie syntocin drip etc after a previous C-Section. so it's down to playing a waiting game for labour to start

when they say they're going to induce, what are they saying they're going to do ?

Shazzy - you can request a scan every other day to check placenta and fluid... that is a very good indicator.
Don't be bullied and you have the right to decline an induction.

For VBAC the induction is different - you would not get the gel but probably an ARM (breaking waters) and possibly syntocynon.

Where in the country are you ? Do you mind saying wich hospital you are meant to go to?

A section because of fetal distress I think means you have a good chance of a VBAC, all things considered.

Given what you know about your dates, maybe your due date is wrong? Or could you argue this?

Have you had an internal? Any chance of a sweep?

You're doing your best to hold on, they really don't like women going much over dates after a section - I had to push to get my section booked for 40+10. Then again, DS1 was big, so they expected DS2 to be bigger, despite my insistence he would be smaller. (Waters broke at 40+5, so booked section was irrelevant.)

I think going much over dates increases your chance of a uterine rupture. That being said, apparently the signs of a rupture are fairly obvious and early, and you can just go for a section then.

It's worrisome that you don't have any medical people you trust, this is a hard time, which is made much easier by good support. Are there any good local community midwives?

i think perhaps it differs from hospital to hospital. i had a cs with my son (nearly 8 now) and i wanted to try for a vb with dd. i didnt research it at all, i assumed i would go into labour and that would be it. but my waters broke at around 6pm on a friday night and although i was having regular contractions (had been for three nights before too), i was told i wasnt in labour. i was in a lot of pain and no-one had examined me. by midday on saturday baby's heartrate was going up and down and i was told i would be induced as my 18 hours were up. this frightened me, i was tired after no sleep for 3 days, in pain, scared of what would happen to my scar if induced and so i asked for another cs. i hated it...it wasnt at all what i wanted. since then (yesterday in fact) ive seen on another thread that its possible to go a lot longer than that after waters breaking and ive thought a lot today, if only i had known that then, maybe i could have had the birth i truly wanted. i still wont ever know if what i did was the best thing for baby and me and the only thing i can say is research, research and research again. like you, i never trusted my hospital, id had past experiences with them which werent great.

Steppy yes they can put up a drip - its a decision made on a case by case basis and there are reasons why they do it for some and not others.

I think induction post-section rules vary from hospital to hospital - I was told I would have the gel. My midwife was strongly opposed, so we didn't consider it.

I heard that the reason they do not like women to go too far past their due dates is because the placenta is no longer as effective. Is it possible that they would consider another scan to see how the placenta is working? If it is still doing its job as well as it should perhaps they would be a little more reassured and give you some more time for labour to start naturally.

Hi nightowl, you're right on the research but additionally need to then find out what the policy is in your local hospital as it does vary between health authorities, which is ridiculous but a fact

hi steppy, im one of those people who wants to get hold of my records. im not (definatly not!) planning another baby right now but i havent dismissed it totally, maybe in the future. if i do this again im going in prepared! i would also like to try for a vb but was told by dr its not possible after 2 cs. since then ive heard it is possible. conflicting information everywhere you look really. sorry, didnt mean to hyjack thread.

I was induced with dd1 and it was the cause of me needing a section as dd's oxygen levels went too low. I've since read evidence that the drug used can cause this to happen. I wish now I'd had a section straight away without being induced at all.

Agree - do lots of research - the radical midwives' site is good - can't think of the address but a Google will bring it up.

Also try the NCT site - they have a help pag eI think.

Hi Nightowl, it's unusual but not impossible after 2 sections though depends on the type of section (very prem. secs can be different to term sections I believe) Like anything it's considering the risks involved when making your choice, but as I mentioned earlier you will need to check what you rlocal hospital policy is

hi again steppy. i dont think to be honest my local hospital would be very supportive..(well its closed now but moved to another an equal distance so im assuming its going to be the same). my ds was born at 33 weeks as the local hosp said he was in distress and not growing properly. they wanted me to have a cs there and then but had no special care cots. they then sent me to stoke where they said they had more advanced scanners, and at that hosp the consultant said hed never seen a better scan but would go with my local hosp's wishes. ds was born weighing 3lb 10. when i had dd she was 3 days overdue and she was only 5lb 5..dont know if any of this is relevant!!? (hope you dont mind me chatting on your thread shazzyd)

Ok, here are the stats - the National Institute for Clinical Excellence?s guidelines for induction are based on randomised controlled trials which found the stillbirth rate increased from 3 per 3000 ongoing pregnancies at 42 weeks to 6 per 3000 ongoing pregnancies at 43 weeks. However, hospitals like St Georges in London now will not induce before the end of the 42nd week as they have found that, by doing so, they can drastically reduce the number of inductions and subsequent c-section. They will allow mums to go on longer as long as mum and baby are ok. This involves regular scans and heart monitoring of the baby - but, as yet, there have been no stillbirths attributable to late delivery.

I don't mind anyone hijacking this thread
Pupuce, I am in Essex, and the name of the hospital is King George Hospital in Goodmayes.
They say they are going to try ARM, and then the prostin pressary, and then syntocinin drip.
I am not keen even on the ARM, as I am convinced that this was a factor in my previous c-section,
I definately don't want a pressary, followed by the drip.
I haven't had a sweep, I had a sweep previously, and began having very strong and erratic
contractions, which I believe now, lead to the whole gamut of interventions that resulted in my c-s.
I have asked for monitoring, but this was just ignored.
Maybe I could just have the baby accidently at home, I have given this serious consideration, I kid you not!
Thanks for the support everyone,
Shazzy

Shazzy -the pessary is a no-no for VBAC induction as there is a significant higher incidence of uterine rupture.

I really can't see tjem ARM first to be honest.

You should only induce a woman who has a bishop score of 6 or 7 (or higher)... anything lower and the chances of failing are high anyway.

If you ever read my posts you will know I am quite anti induction and I think you are right to stick to your guns. but one induction is not the next so I would not panic that the induction would fail (if you BS is high enough). There are women who go very healthilty to 44 weeks.... these are women who don't agree to induction... they KNOW they have longer gestational ages ! Try doing a search on mumsnet as I have posted about this (search with my nickname and 44 weeks pregnancy).

If they did an ARM they should feel your cervix is quite soft, low and open.... now a 2nd time mum would have an open (slightly) cervuix anyway.

Now off for the day - I'll log on tonight again

If you CAT me I'll give you some info on Essex tonight.

sorry I meant to say I can't see them ARM first THEN prostin gel..... sounds weird and dodgy.... maybe Mears has an explanation.

Well, am up early again, having another morning of contractions,coming every 6 to 7 minutes, lasting 60 seconds each. Had booked another morning of natural induction with hubby this morning before twwo yearold wakes, now will have to wait and see. Hubby gone to bed, with "let me know".
This has been happening for two or three weeks now, get contractions for around three to four hours, and wonder if thisis it, only for them to stop again!(angry)
Keep trying not to get excited, but at two weeks overdue, is hard not to! Oh weell, if I can sit here typing, then it can't be the real thing, I suppose!
I think the hospital can not be bothered to monitor me, it is far easier for them to fit me into their schedule this way! I think they have a staffing problem, and seee me as a nuisance.
There are no problems with this baby, it is not too large, I am not diabetic or anything, it makes no sense to me.
My hubby's friend, a gp, was livid when he told him last night, and said they are not leaving me with an option, and that I should be stuborn, that it won't be much longer. I am thinking of asking him to refer me for monitoring directly, they might listen that way.
Aha! the contractions seem to have stopped.(sad)
Going to wake up hubby,(grin)
Shazzy