Please Help with Birth Plan

[HappyFeet76]

Hello everyone,

I'm a first timer is every way - First baby (at >40yrs), first time on Mumsnet, first post here. Advance apologies for any gaffs.

I'm going to have my baby abroad, in Nigeria, as I just cant afford private maternity & delivery in the UK (about 20,000 pounds!). FYI, I currently don't reside in the UK so I am not entitled to NHS.

There are unacceptable levels of medical misconduct in Nigeria but I have sourced a good hospital and a very competent Obstetrician, whom I really trust.

I'm 33 weeks and have had a peachy pregnancy so far. I am terrified of trying VBAC as I don't want to risk going into labour while my Dr is not around (he is in very high demand), or unavailability of critical equipment and/or medical staff - which happens. Hence I feel an elective delivery is the best way to go - with everything planned and on standby.

Now I can't decide between elective Induction or C-Section at 39 weeks confused. I know this topic has been discussed several times but my circumstances are peculiar

If it's your first baby then surely you won't be having a VBAC?

Lj8893, Thanks for spotting! I meant to type VB. Not VBAC. This is my first baby, yes.

Ah that makes more sense

I don't know how it works where you are but generally in the UK an elective induction/section are rarely offered, only if there are medical or social reasons (husband in army, fear of childbirth etc).

If you are able to have this though where you are, it's worth looking at the risks for both in detail. Generally risks are low for elective sections, although obviously the risks are still higher than VB. however with induction, there is an increased risk of ending up with an emergency section which carries much higher risks than an elective.

Induction may or may not work.

That's why it's not really offered as an 'elective' option in UK

Yes, having relayed my concerns to the Dr I've been offered the option of elective CS or Induction. I have researched both a fair bit.... they both have pluses and minuses and it's really tough to choose.

Induction can be a really slow, drawn out process. For a 1st baby at 39 weeks it could take days (and still not work first time), so would it still be guaranteed your doctor would be avaliable?

arbrighton and Lj8893, many thanks for your input. So yes, induction may not work. That's the big minus. Would my Dr still be available? Well I certainly hope so!

What I meant by your doctor not being available is that with an induction there still isn't really any guarantee of when you will deliver?

Yes, somehow doubt an indemand obstetrician is going to hang around while waiting to see if you start contracting and progress having done induction

I can't see an in demand obstetrician spending the entire process with you waiting for you to deliver. Induction can take anywhere from a few hours (unlikely 1st time labour at 39 weeks) to a week (if needed to have a rest and begin process again if 1st round fails).

My induction took three and ended up with foreceps in theatre. This isn't atypical if my friends experiences are anything to go by, though obviously this is anecdotal evidence! I'd go for CS over another induction, so in your shoes, CS. Congrats and good luck!

three days!

I have agree with previous posters that you have to consider will you very busy obstetrician be constantly on hand for the few days that it can take for induction? As he presumably has other patients and needs to sleep etc.
My induction lasted two full days and ended in an emergency c section. As far as I am aware you are at increased likelihood of needing an intervention such as forceps when induced.
I think your only way of knowing exactly when baby will be born and ensuring the Dr is there (providing there are no emergency cases that take priority over you) is to go for an elective c section. There are still too many variables with induction in terms of length of time, how your body will cope, how favourable your cervix is, interventions you may need etc that will give you a guarantee that you will have the staff and equipment you feel is appropriate. It's could be short and over on 6 hours or could be two days ending in emcs anyway, and no way to tell beforehand.

Ladies, bless you all! You're gems. Thank you for your useful feedback. I hadn't taken the lengthy duration of induction into account. I actually hadn't realised it could take that long! It will be almost impossible for the obstretician to be attendant the entire duration of its over 6 hours. The neatest option is elective CS then

Thanks again

I first induction at 39 weeks may well not work and you'd have to accept the risk of needing an emergency CS if labour does not progress.

I have no idea what obstetric care is available in Nigeria so this suggesting may be entirely irrelevant but could you access good midwifery care? Pay a private midwife to be available to you @ the expected time of delivery of your baby?

Also, consider whether you'd wish to try for a further pregnancy in the future as an operative delivery this time round may increase your risk of a further CS - not that that should discount a CS, it's just another thing to consider.

A first induction... sorry.

Good luck what ever you decide

PacificDogWod,

Thanks for chipping in.

Sadly, midwifery is poorly developed and regulated as a vocation over here. And if anything went wrong.... getting to a good hospital on time would be a challenge.

Going from your post elective CS is still coming out tops

Thank you user1496604328