Terrified of induction - midwife saying no to C section

[BrassHorses]

I'm due to be induced at 40+10 on Monday. This is my first DC. About a week ago I asked if I could skip induction and go straight to C section. I was told outright no and C section was only available if induction fails.

I've since been reading and researching and trying to get my head around things but I'm terrified of induction and have read that up to 40% of inductions end up in C sections anyway, and it carries a much higher risk of intervention.

I really want an elective C section. Can I get one? If so how? And have I left it too late to request this? I have a midwife appointment tomorrow for a third sweep so I can discuss again but I'm worried she will just stone wall me again and say no.

What are you terrified of? Genuine question. If you could articulate your fears maybe it would help convince the midwife. Are you under a consultant at all?

It's not the midwife's decision even though some of them will try to act as gatekeepers. Ask to be referred to a doctor and request an elective section. NICE guidelines say that if the doctor doesn't grant it they have to refer you to another one who will.

Good look

Calmly and clearly explain you will not be consenting to induction for x and y reasons. Explain that you have weighed up risks and this is your INFORMED decision.

NICE guidelines say c sections SHOULD be offered at maternal request even if there is no additional medical reason.

I was induced with my DD. Granted it did take a few days to get going and it wasn't comfortable, but once I was hooked into the drip it was ok. I ended up having (insisting on an epidural early helped ha!) a really positive night of labour. My DD was born at 6.30am after 45 mins of pushing.

It was actually a really special night (in between the pain and vomiting as I had a kidney infection!)

Just wanted to say that I was also terrified of being induced because of the cascade of interventions and the possibility of having emcs. Actually in the end I was induced. It was totally fine I had a relatively quick (6 hours active one hour pushing) labour and was up and about straight away. So I hope you get the birth you want but even with induction I just want you to know you can still have a great birth xxx

Or you could ask whether you can carry on a bit longer with close monitoring and see if you go into labour naturally?

Thank you for the quick replies- have I left it too late?

My fears are around the safety of the baby, I'd rather not go into details but I have a lot of anxiety around that and the fact that with induction it could be fine but could also be very traumatic.

I'm already overdue and worried I've left this too late - I thought I would be OK doing it naturally but now induction is looming I really don't want to go down that road and I won't let myself go any more overdue than Monday because of increased risks.

It's not up to the midwife. You need to speak to the consultant or doctor .

I agree with Andhowcouldleverrefuse. The NICE Guidelines are clear on this. You have the right to discuss the pros and cons of induction vs Caesarean birth with an obstetrician and they can decline carrying out a caesarean but are supposed to refer you to a colleague who can also decline but you can keep carrying requesting.

There is a third option of course which is to decline induction and opt for expectant management. The power lies in your hands here. Don't fall into the trap blindly accepting induction because you think there is no choice. Of course even if you opt for induction at a later date, the closer to birth you are the easier the process is likely to be.

You don’t have to agree to an induction. Dates aren’t everything and if there are any concerns they can monitor you. I was 42+ 2 With DS 3 . Anything they say is advisory and the final decision is yours.

You haven't left it to late but you must get a referral to the consultant now. Be firm with the midwife that you will not consent to induction and want to discuss your options with the consultant. Good luck.

OP, you need to urgently read up on your legal/human rights here.

you don't "ask" if you can skip induction - it's a medical procedure which you have the right to accept or decline at any point. your midwife is NOT there to tell you what you must do, she's there to guide you as to the medical risks, advise, and ensure you have informed consent to any medical procedure.

She also can't just say "no" as a gatekeeper to an elective C-section. you need an urgent referral to the obs team at your medical facility (i'm assuming you're in the UK, so whichever hospital you're under the care of). she cannot block this. and when you speak to the obs, the NICe guidelines are VERY clear on this - you need to be aware of risks, etc but this is a choice, and you should be referred to a colleague if the first ob doesn't agree to the C-section.

you urgently need to adjust the balance of power in your interactions with your midwife - this is your body, your baby, and your medical decision making, from a legal/health POV.

good luck!

I agree with what’s been said above about declining induction and insisting on a referral to a consultant to discuss c-section. The sooner you do this the better so press on tomorrow morning.

That said, you may well go into labour naturally between now and c-section date. With dc1 I went into labour naturally at 40+8. I’d started to think it would never happen by that point and had been out for afternoon tea, got home at 5pm, a few twinges by 7pm and full blown labour by midnight.

I refused Induction and requested an elective section- it’s up to you not the midwife

I’m in a similar position so can only share my experience, I’m 39 weeks and it took ages for us to get an appointment with the consultant about an elective - we had it yesterday and they have put in the request (though lots of scaremongering and trying to get us to agree to inducement instead)

BUT there is no guarantee of when it could be. If they have 5 women with placenta praevia or emergency needs for example, they will take priority. So my understanding is... yes you can ask for one, yes they can say yes..... but if they are at maximum capacity and you aren’t an emergency there’s no guarantee.

I’m in central London so obviously the hospital could be busier.... but they don’t seem to be able to schedule an elective without medical need in for a couple days time....

You could just phone up the hospital number on your medical notes and ask them if your midwife is being obstructive. Tell them your wishes are not being supported and you don't consent to an induction.

Hope it works out for you. It's so hard to ask about these things. I really struggled to raise these issues. I went to the parent classes and stuff but they never speak about interventions, only the perfect birth which most people don't get. It creates an atmosphere where it's very awkward to talk about what might happen if things don't go to plan. I wished I had voiced my concerns and asked for a c section but I went along with induction instead which I will probably regret forever.

You might find it would help to work out what you’re going to say to your midwife and maybe even practice it. It also might help to take someone with you.
As has been said already, it’s not her decision, it’s up to you and the Consultant. You will be able to have a c section because you can get a second opinion and a third if necessary.
Good luck!

Some great advice on here. My only thing to add would be get yourself a birthing ball and bounce (gently!) rock back and forwards and round in a circle as much as possible. You've got a while until Monday, you could go into labour naturally before then. Do it while watching TV and whenever you sit down. It is to get your baby's head to press on the cervix and hopefully kick-start labour. It took me several hours a day for the best part of a week, but you've nothing to lose. Long walks too. Oh, and try to be relaxed. You need the oxytocin to dilte the cervix, so cuddles, happy thoughts, smiles and laughter as much as possible.

May not work of course, but can't hurt. Saying that, do check with your midwife before you start with the birthing ball. As far as I'm aware it's totally safe but still, I'm not medically trained, so best check with someone who is.

Good luck x

Great advice on here. If you do your research and still want a CS you can absolutely have one.

I had DTs and had an "elective". After some hoop jumping my consultant agreed. Then my waters broke 5 weeks early, a different consultant was on call and I had to make my case (fight my corner) all over again. When I was in a vulnerable position. I "won" and do not regret it for a moment. But I'm a bloshy cow. More timid folks would have had a different outcome.

I get really mad when folks like you OP have to really fight to get what you feel is best for you and your baby. I wish you all the very best x

Thank you this is all really helpful. DH is coming with me to the appointment tomorrow and is determined to fight my corner for a c section. What I'm afraid of though is the midwife saying I can't speak to a consultant for x number of days as there isn't one available etc, and dragging the whole process out until it gets to a point where I'm so overdue I feel induction is the only option.

I'm in central London if that affects anything.

Ring the hospital yourself if it comes to it.

And inform your midwife that you'll make a formal complaint if she fails to follow NICE guidelines.

@brasshorses - which hospital are you at? They seem so snowed under at UCLH. Keep us updated how you get on!

You don’t need to fight for a section. You simply repeat “I do not consent to induction” repeatedly. They can’t give you an induction if you don’t consent and they can’t refuse a section

Side point - induction isn’t a single process. You can consent to some parts of it and not others. Have you considered consenting to a sweep/pessary but if that doesn’t work declining the breaking of waters/syntocin drip and then going to a section?

You can refuse an induction at whatever stage then they’ll have to get a doctor to come & speak to you. I wrote down my reasons for wanting a section, gave it to the registrar and made sure I’d covered the risks I knew I was agreeing to. They showed the Consultant who came in the room & said “I can see nothing I could say is going to change your mind” then got the diary out and booked it there and then.

I've already had two sweeps which have done nothing. I've got another one tomorrow at this appointment. I'm so so anxious at the moment I can't sleep I've got myself into a real state about this. Do you think there's a chance I could speak to a consultant tomorrow about options? My appointment is at a clinic not in the hospital so there won't be any doctors there.