Why is midwife putting me off induction?

[myfavouritetractor]

I'm nearing the end of my pregnancy and have an appointment with my consultant soon to discuss final birth plan. Previous birth with dc1 was induced after my waters broke and no sign of labour starting after 24 hours. The labour was 3.5 hours total from when I was induced. I did have a bad 3rd degree tear and needed surgery afterwards, I also haemorrhaged.

Consultant has said he's happy to do whatever I want, he will be happy to do a c section because of the damage caused last time or try natural.

I mentioned at a routine appointment with her I was hoping to be induced in hospital seeings as DH works anywhere from an hour to 3 hours away (without traffic) and I'm seriously stressed that I'll go into labour with no one nearby to help take care of dc1 without at least a delay of 45 minutes to an hour and get to the hospital which is 45 minutes drive away in time to safely give birth in case I haemorrhage again like last time. She seemed to dismiss this, didn't write anything down and said well baby can still arrive at any time when you're induced and you're probably better off with natural. Which I'm obviously aware that baby can arrive whenever, but at least I'll hopefully be in a hospital setting from the start of the labour if I'm induced a week or so early.

Is there a reason why she'd be so dismissive of induction?

Induction can cause complications. Therefore the NHS don't induce for convenience, only when it's for the well-being of baby.

Other than the tear and hemorrhage the other issues could apply to anyone and wouldn't warrant induction, if you're really worried why not consider the c-section so you have a set date?

I had a long drip induction 24 hours after my waters went and wouldn't wish for another.

Have you considered ELCS?

Thanks for the replies.

I have considered elective c section but would rather try a vaginal birth if I can. I understand things like childcare and no DH nearby are standard things most people have to worry about but my main concern is another quick labour (possibly faster than last time) and struggling to get to hospital quickly and end up haemorrhaging outside of hospital.

In that case could DH begin his paternity leave earlier? It might mean less time off work when baby is here but might assuage your fears.

I wouldn't necessarily say you'll have a fast labour. You can't use the last one as a guide as it was 'assisted' by the induction.

If they were to induce you - which by your reasons I really can't see them doing so - they would not need to induce you early and you would probably have to wait until after your due date anyway.

What did you think of the midwife? I ask, because an older, sensible in every other way, midwife, when she heard my history made a casual remark that she knew what she would do (induction->EMCS last time) - and she meant c-section.

I allowed myself to be persuaded by the sunny VBAC midwife, even though, she'd only glanced at my notes (rather than the thorough read/chat the other one had had)

I ended up with another EMCS, but I was very firm about never being induced again, because of my experience. It was natural, or straight to CS (and I wish I'd just gone for elective in the end - but I was having frequent, regular contractions for over a week, and no broken waters, or dilation, so it all got a bit ridiculous)

I actually found that the midwives were otherwise very pro induction, and I had to be very firm about it not happening - so my spidey sense would be tingling if they're anti-induction personally.

Not trying to minimise or belittle your fears. Realise that last post came off a bit like that.

I'd worry about having an induction again personally as it sounds like it was fairly swift for you last time which doesn't help with tears etc.

If you're (understandably) very anxious about timings maybe an elcs would be better? I didn't want one either. I had a bad third degree tear first time round (3b) and like you pushed for a vaginal birth second time until I read in the hospitals own clinical guidance (for practitioners!!) that I now had a 30% chance of faecal incontinence if I had another vaginal birth as a result of the type of tear. No one had mentioned to me and it made me change my mind very quickly!

If induction is what you want perhaps call the midwife team and discuss it - this is what I did. I find in routine appointments sometimes they are focussed on getting through the process of what has to be done for that appointment. Whereas when you call with a specific question they are more ready to listen.

Induction moves things along but can't guarantee you a specific birth date anyway. It can't really be used for the purpose you want. It sounds like your previous fast labour was caused by the induction rather than that you are a natural fast labourer....esp. as you hadn't gone into labour 24 hours after your waters broke.
I think that you are confusing what induction is for.

What everyone else said.
Inductions increase risk of complications: assisted delivery with forceps/ventouse, emergency csection, foetal distress, meconium in waters to name a few. The NHS won’t induce unless there is medical reason to do so - and the list of “medical reasons” is getting smaller and smaller. In 2015 I was induced for the same reason as you - membranes ruptured and labour didn’t begin within 48hrs. I informed the midwife in my subsequent pregnancy that I would not be induced for that reason again, and she told me that the trust are now more inclined to monitor for signs of possible infection rather than induce straight away

Honestly having had an induction with my first and then natural with my two subsequent I would 100% wait for a natural labour again! I also had a quick labour with induction 2hours and 20 minutes!! The natural labours were just as quick but the pain was so much more manageable and didn't need any interventions (had ventouse with first as he became distressed!)

Thanks again for all your replies. I'm really so confused with what to do! the consultant said he'd be happy to do anything, but did mention that the concern with c section for him would be blood loss as I haemorrhaged last time that's something for them to be concerned about. But he'd still happily do one for me so can't be that concerning?

I feel like an idiot getting so worked up about it but I just feel like no ones explaining anything to me and it's all up to me which sounds great but I'm not an expert and have no idea!

I'm not medically trained so feel free to ignore me but i would assume if you haemorrhaged(sp?) in theatre they would be better prepared to deal with it?
When I had a planned section they ordered blood products for me so were prepared iykwim. But just going into labour I don't suppose they are as prepared for that kind of thing?

What Glittery said - surely with an elective section they can be prepared for the event of haemorrhage and be better equipped to deal with it than they would be with induction.
In your situation, I would personally go for an elective section, but ultimately it’s a choice only you can make.

Induction can cause a cascade of intervention. Importantly for you it also increases the risk of a haemorrhage. I would avoid it if you can (I’m a midwife).

Hi OP. If you are having an induction you would be on delivery suite and PPH will be dealt with in the same way as in theatre as there is a set protocol on the management of a PPH regardless of mode of delivery. If you have a history of PPH you should be risk assessed when you come in and steps would be taken to reduce the risk.

As a currently pregnant midwife I’ll be doing my best to avoid induction. Once you start messing around with hormonal pathways and normal physiological processes, you make further intervention and complications much more likely. Induction also means continuous monitoring (so being strapped up to a monitor and often stuck on a bed) which can limit your ability to move around and change positions.

Having watched many many C-sections, I would only have one if I had to.