Induction concerns...

[NoisyBrain]

I'm a bit fed up today having been told yesterday at my 36-week consultant's appointment that I will be induced at 39 weeks.

Bit of background - I'm 39 years old, and have basically felt pretty good during my pregnancy for and old(er) girl lol. However, I've been on Labetolol (sp?) and soluble aspirin daily since 20-something weeks as my BP was high-ish, which is an issue I've had pre-pg. My consultant had already told me she would insist I have an epidural during labour, as it keeps BP down. I was OK with this.

Then I was diagnosed with borderline GD at around 33 weeks. I've been trying to diet-control it, but because 11 of the 45 readings I'd taken since my previous appointment were 7.9 or over, I'm now on Metaformin and the decision has been made to induce me early.

I know these things are all for the good of mine and my baby's health and I certainly don't have a problem with him coming a little earlier for safety's sake.

However, I've now read up in more detail about the induction process and am feeling more stressed than I ever was about the idea of natural childbirth! It just sounds really unpleasant, with a reasonable likelihood of CS at the end. One of my friends went in for an induction on Wednesday morning and as of last night there was still no baby. The thought of spending 3 days in hospital just waiting brings me out in a cold sweat.

I'm not due to see my consultant again before D-day, so who should I talk to about this? Can I just call her? Or my community midwife? I feel like I want to at least discuss whether I can have a planned CS instead. I don't see CS as an 'easy' option btw, just one I'd like to explore seeing as all control of the birth process is being taken out of my hands anyway

I was induced at week 39 for medical reasons. I went in on the Wednesday night and DD arrived on Sunday evening. My waters went when I got up on the Friday morning and by Sunday morning I was 3cm dilated. I was put on a syntocin drip at noon and DD arrived at 8pm (glad I had an epidural though). So the only pain I was in was duing those 8 hours of active labour - which wasn't too bad.

TBH I rather enjoyed those few days in hospital, I walked a lot (anything to get things moving) and talked to lots of interesting women who were also stuck on the antenatal ward - some for weeks. I felt very calm and serene. I think I knew that I wouldn't be going home until I'd had the baby, that I had only one job to do and nobody was expecting me to do anything else. With hindsight it was a rather lovely time, like being cocooned from the real world, and I even made one long term friend.

I know how worried and frightened I was when the consultant first raised the prospect of induction, so I agree it would be useful if you could talk things through, maybe start with the MW as she may have more time to listen to your concerns.

I hope you are able to make a choice that suits you.

Def talk to your community midwife about it. I had to have an induction with my first (and prob will with my second!) because of going so post-term. I cried on my midwife because i was so stressed, and reading about the horror stories didn't help!

It is totally natural to have concerns about it and they will be very used to it.

On the plus side, with induction you know the date you will go in so are prepared, and it is quite nice turning up at the hospital knowing you will be having your baby and not having that stress of wondering when it is going to happen! Plus I got excellent and pretty constant care when I was induced. You will be well looked after.

And they don't by any means all end up in c-sections (22% according to this www.nhs.uk/conditions/pregnancy-and-baby/pages/induction-labour.aspx#close ). Mine was pretty straightforward, she arrived after 8 hours of being on a drip, with an epidural.

HTHxx

Thanks ladies

Think I'll give the midwife a call on Monday.

piprabbit can I ask, apart from walking and chatting to people, HOW did you keep yourself occupied in the days til labour kicked in? Did you manage to sleep OK? I'm a bad sleeper at the best of times so the thought of trying to do so on a noisy ward, even with earplugs, is also making me

I tried to have a routine, breakfast, get up, get washed (nab a shower if there was one free), get dressed in proper clothes etc.
I had books and crosswords, plus there was a TV by my bed. My DH and/or parents visited everyday. I was in a 4 bed bay and there were generally a couple of people wanting a natter. I tried to walk for at least 15mins every hour - but would always bump into someone and have a natter with them too. The time went quite fast - but as I said I was in a very relaxed serene mood.

The sleeping wasn't good - partly because that's when my minor contractions would kick in and partly because I hate hospital beds. I would listen to the radio on my headphones for a bit until I dropped off again.

TBH I'm normally a bit of an anti-social, control freak - I blame the hormones for turning me into a chilled-out sociable person.

Oh - and as you aren't actually ill, there's no reason why you can't leave the ward (so long as there are no rounds etc.) so I'd take a walk to the hospital shop, or take my visitors for a cup of tea in the cafe for a change of scene.

I've had inductions with both of mine.

The first one was because I was 2 weeks overdue and involved 3 pessaries and then being left to get on with it - it took from Sunday night (first pessary) until Ds1 was born at 2am on the Tuesday morning, so around 30 hours all in. I started off being able to walk around, and was encouraged to do so, but as labour progressed I couldn't stay on my feet, had to lie down and be wheelchaired around to the loo etc. The stage 2 labour was around half an hour and I nearly gave birth to DS1 without any MW there, as they were dealing with emergencies and when they'd checked me at 11:30pm, I was only 1cm dilated still. They were going to give me another 4h to see if I progressed (DS1 was all fine) but he beat their time limit and so I avoided the syntocin drip. The MW who cleaned me up said that inductions can go like that - instead of the suggested 1cm dilation/hr, it can go from 1 --> 10 very quickly.

The 2nd one was VERY different. I had to be induced at 39w because I was a) older (45)
b) had unstable lie and therefore had an ECV (manual turning of the baby to get him head down)
c) had polyhydramnios which was contributing to unstable lie
d) they were worried about placental disintegration if it was left any longer.
A much different situation - 2 days before the ECV, I was given something called Cervidil, to ripen my cervix as it was in no way ready - it did work, gave me lots of period type contraction pains but as soon as it was removed, they stopped. However, it was all good enough that I avoided the next thing, which was a balloon expander!
So - first thing Weds morning, they did the turn. Ouch! Then held him in place with rolled towels and tried to manually break my waters (ARM) - didn't work. So they put me on the syntocin drip (I'd like to say at this point that I hadn't wanted any of this prior to delivery, but it was either try this or go straight for CS, so I agreed to it all) to get the contractions going and get DS2 to try and connect with the cervix so they could do the ARM, which, 2h later, they managed. THEN the contractions really kicked in - prior to that it had been manageable and a bit "what's the fuss all about?" - I needed gas and air and the biggest difference was that, with the syntocin drip, there is no real respite between contractions. But it all worked and DS2 was born after about 2.5 hours of stage 2 labour (he got a bit stuck, was presenting with the back of his head instead of the top, but when they turned me onto my back, something else I didn't want! he changed position and shot out!)

Different experiences but not bad ones. HTH. :)

These sound like just the reasons I was induced with ds. I had him last week after they couldn't control my blood pressure (had gd as well but that wasn't the main reason for induction).

I had the pessary at 9am and got pretty regular contractions until about 9pm. All manageable with no pain relief but annoyed to see I hadn't increased at the next examination.

They gave me something to help me sleep but it didn't work as kept having contractions (again manageable) so I got up and wandered around. At half four my waters went and then it was pretty hectic after that, two and a half hours later with gas and air ds came along.

Totally different experience to dd who was 32 hour natural (not induced) labour with every drug available, I feel the recovery this time round has been a great deal easier.

Agree to make the most you can of being in hospital, I wished I'd got up and walked more, although my inducing ward only had two beds and we got a flat screen tv!

So all in all from start to finish was 22 hours but manageable for about 19 of it and easy to be kept busy!

Induced with dc2, was 16 days over. No medical reasons. had the gel put up at 1pmish, pootled about for the next couple of hours, was a bit bored, ran a bath about 4pm, got in, waters went so had to get out and contractions straight away - baby was born by 7.30pm that night.

Not all inductions are horrendous, not all end in interventions, you just don't tend to hear much about the straight forward ones, as with anything people are all too ready to talk about the horror stories.

Good luck!!

Hi - I'm in a similar position, will be induced probably at 38 weeks because of T1 diabetes, and was for a while much more keen on the idea of going straight to ELCS. When I spoke to the obstetrician about this he implied that even if I ended up with an EMCS, as there is a high proportion of induced labours ending that way, the hormonal process of going into labour (induced or otherwise) was better for getting the baby ready to be born at that earlier stage of gestation - promoting lung maturity etc. i dont know much more than this but it did reassure me that it was a preferable way for things to get started.

A thought - when I was having DS1, I was moaning and wailing about the pains I was having (I was also sick with the contractions) and they brought the anaesthetist to see me (I can't remember whether or not I actually ASKED for him). He told me that, because I was induced, if they DID give me an epidural then it was far more likely to lead to further intervention (forceps, ventouse, CS) so I just had a shot of pethidine and got on with it. I still don't really know if I asked about epidurals, because it was one of the things I REALLY wanted to avoid (and did, both times), I just wanted something to take the pain away.

I don't know about the stats for induction --> CS without epidurals, but it seems that having an epidural will increase the chances of needing a CS quite a lot.

annamelissa that's interesting, I guess it makes sense when you think about it.

thumbwitch - I've already been told I WILL be having an epidural, to keep my BP down (although the Labetelol seems to be doing a grand job of that so far so I'm not sure what my consultant thinks is going to change during labour but hey, she's the expert).

I shall try and be encouraged by posy's story. PMA and all that!

I was induced at 38 weeks because of gd and was a positive experience.

I had a slow start as the delivery suite was busy so was stuck in induction ward for 2 nights but I wasn't in labour at this point so it was just boring.

Once they took me down to delivery suite it all happened in 8hrs. I had an epidural but baby came out in one contraction - no ventouse/forceps.

I'm now pregnant with gd again and will be induced at 38 weeks. This time it doesn't worry me at all because I never had any expectation of a "natural" birth to be disappointed about.

Thanks for another positive reply Tarka.

I had a good long chat with my best friend yesterday. She was induced for one of her DCs and she made me feel a lot better. I decided the only thing I was going to ask about today was possibly waiting a few days, to be induced on Monday instead of the Friday.

I'm confused about whose care I'm actually supposed to be under now, as I have an orange notebook (with all the diabetes peoples' contact details) as well as my green one. The sticker on the front of my green folder has the name of both my consultant and the diabetologist on it.

To start with I tried to call the diabetes midwife I saw a few weeks ago first. She's on holiday til the end of the week. So I tried the other diabetes midwife, who I've never met. Her voicemail message said she's away til the 7th (last Wednesday!) so assuming she just hadn't updated it, I left a message at around midday. No call back yet.

I also tried to call my community midwife. She's away til the 20th. My consultant is also away now til I'm not sure when (gotta love August!).

The induction question is one thing, but also the Metformin is now making me feel really rough and I want to ask someone what to do. I started it on Friday evening and was advised to increase the dose from one to two tablets twice a day when I got 'used to it'. I don't feel happy doing so as I'm still getting stomach pains, plus headaches and wheeziness. I Googled a bit (I know, I know) and apparently there are possible interactions between Metformin and Labetalol and I should report it straight away if I experience amongst other things headaches and shortness of breath.

So, who the fuck am I supposed to tell if I can't reach anyone on the fucking phone?! Excuse the potty mouth, but I'm feeling pretty frustrated, helpless and stabby right now. If you were me would you just call the CLU?

Noisy - I would call your GP, to be honest. And if you can't get anything useful from them, then perhaps take yourself into the maternity unit. You could also try asking your pharmacist about the interactions (they'll know, or be able to look up, if your symptoms are classic reactions to the combination)
If your wheeziness gets any worse (even slightly) then just go to hospital immediately.

Bloody unhelpful of everyone to be away at the same time, isn't it!

I agree, speak to your gp about your medication concerns. That's an urgent medical situation and neither drug is particularly obscure so gp should be able to cope.

There is a more expensive version of metformin (modified release) you might be able to have which is a coated pill so fewer gastro side effects but don't know about interactions with other medication.

It's really frustrating that everyone has buggered off on holiday! I'd like to hope that there must be a diabetic midwife on cover to pick up your message. Leave lots of messages on all the numbers you have until someone calls you back!

Actually the CLU might be the place to call to discuss the induction anyway.

Sorry to hear you can't get any support. My midwife is also away and I'm seeing a different midwife in the same unit in her absence. Is there not a general number you can call and talk to someone else? They don't usually work on their own, they is usually a big team of them even if they are based at different surgeries.

Thanks ladies, feeling a little less murderous today Although, after more stomach pains in the early hours I've decided to phone the CLU today. Hopefully they'll at least tell me who I should speak to about the meds.

If I feel I'm getting nowhere, as a last resort I'll just turn up at the Maternity Unit and refuse to leave til someone sees me!

Please make sure you see/speak to someone today though - I don't like the potential implications of SOB/wheezing while you're pregnant, there is a minor possibility that you could have developed a blood clot and if so, you need to be treated ASAP. Honestly. Look up Linerunner's thread...

I was induced because waters broke on a Saturday morning at 40+5 but no contractions. Admitted Sunday and given the pessary, then several more on Monday and nothing happened. It was quite boring but I just did a lot of MN'ing and stuff on my phone and rested a lot.

The Tuesday, they took me down to delivery suite at 1pm and stuck me on the synto drip, and I was contracting by 5pm, had epidural at 7pm and had DD at 3am. Most of the time in delivery suite went pretty fast. I was 10cm by about 1am and then they got concerned about DD's heart rate and whipped her out with a ventouse in the end.

Mostly I would say my experience was positive. DD had passed meconium and had to go to SCBU for 24 hours but she was fine. I was unlucky enough to get a post-epidural headache but that's very rare. I also did a lot of puking after the birth but not sure why, possibly a reaction to the copious amounts of gas and air I'd inhaled.

Friend had GD and was induced early as a result, we thought she'd be a while as her body presumably not geared up for labour, but she had the pessary late morning, was in pain at 2pm, in agony by 10pm, discovered to be 9cm dilated already! Unfortunately she didn't dilate any further and ended up with a section the next morning, but still, she was holding her DS within 24 hours of first pessary which is more than I managed. Her GD disappeared as soon as she gave birth too (she had been on insulin). She had been adamant she didn't want an epidural but was very pleased to have it, and had no after effects.

Good luck, I am sure it will turn out just fine whatever ends up happening. I think it helps if you can just go with the flow as events can seem to takeover and dictate what happens, it seems.

Noisy are you ok? Did you see someone? Please let us know you're all right now.

Hello, sorry yes I'm fine. I ended up going to bed for quite a while yesterday afternoon and then didn't get round to phoning the CLU

However, the other diabetes midwife called me back first thing this morning and we had a very helpful conversation. Thankfully the Metformin side effects seem to be easing, but she said I don't need to increase the dose as my blood sugar readings have come down nicely on the lower dose. I have an appointment with her on the 23rd, and she said we can discuss the induction dates etc when I see her.

Feeling much better about it all now, thanks

OK but please do be very aware of any breathlessness increase and do go straight to see someone if it happens. Pulmonary embolism is not uncommon in pregnancy and just post-partum and can be extremely dangerous if not caught. Sorry to seem like a scaremongerer but I'm not, really - it's a very real problem for many women.

If you can bear it, have a read through this thread www.mumsnet.com/Talk/_chat/1823863-Good-vibes-over-here-for-our-LineRunner-please - there are a couple of people on there who had PEs in/after pregnancy.