Induced labour - Need some guidance/reassurance pls

[AR23]

Hi there,

I'm currently 34 weeks and I have gestational diabetes and have been told by the obstetrics consultant that I will most likely be induced to go into labour at 38 weeks to reduce any effects to baby.

I've just been reading up about pain relief and inducing labour on the NHS website to familiarise myself with it all so that I'm less nervous, but I actually feel a little more nervous now and so was wondering if anyone could share their stories.

NHS website says Induced labour is usually more painful than labour that starts on its own and women are more likely to need an epidural or assisted birth (forceps of ventouse suction).

I can't offer advice but I'm in the exact same position. 30 weeks with GD being induced at 38 weeks ish. I've heard different stories for inductions, hopefully we'll have a nice quick one

I'd massively recommend the Positive Birth Company hypnobirthing digital pack - they cover inductions and exactly what happens as well as how to make it a positive, calm birth experience.

The more panicked you get the worse an experience it is likely be, there is a higher chance of intervention with an induction, largely to do with the very clinical environment and how you are out of control but remember you can deny an induction, you can still control your environment if you choose to go through with it, you and your birth partner are in control of everything. Don't just go along with everything you're told to do, do what makes you feel comfortable and if you're that way inclined and want to know, have your birth partner ask questions at every point so you FULLY understand what's happening, the benefits and the risks.

I had an induction six months ago. First pessary nothing really happened, I could feel a few contractions but the machine was saying I was having more that I just could not feel.
Second day I had the second pessary. Again nothing really happened, pain was getting worse but manageable with hot baths (tens machine did nothing for me, actually hurt worse but it's worth a go as everyone's different).
Second pessary and that's when things ramped up. Pain was getting worse, but I'd still only had paracetamol, and they broke my waters which again moved things along.
I did end up having too many contractions and they offered me an epidural to slow things down (I'd been asking for a couple of hours for pethadine or an epidural but had been refused as they thought I was too far along). I couldn't stay still for the 20 minutes needed so I just went into a downwards dog position to get the head off of my cervix as I was swelling up and losing centimetres which helped.
I then got offered gas and air which helped so much I fell asleep at 9cm dilated which was a first for the midwives! Woke up to them taking the gas and air off of me saying I needed to push and I'd want to remember this (I remember saying "I will not want to remember this!" 😂) and after an hour and a half of pushing a Doctor was called because they didn't feel things were progressing well and they only let you push for two hours. Doctor tells me to push so I did and she could see the head so I was allowed to continue labouring without help. After 2hours and ten minutes of pushing I delivered the baby.
There of course were moments where I was in loads of pain and I couldn't stay still - didn't help I was strapped up to the machine so couldn't move as much as I needed to to cope with the pain but I got through it. I also begged them to just pull her out once I'd delivered the head but I got through that, I've heard people say the shoulders can be worse than the head but I didn't even feel that bit. Also didn't feel the placenta come out.
I clearly had a good experience, and others will have had harder experiences but I think because I have nothing to compare it with I can't say if it would have been worse going into labour naturally or if I'd done hypnobirthing it would have been easier.
Good luck ☺️

I can't help with personal experience (I'm only 31 weeks), but we just covered induction on our antenatal course.

They do say induction can be more painful, but that is because it is a forced start. If you start 'naturally' then your body has time to build up and by the time you get to the active labour phase you are dilated with close and more painful contractions.

Induction forces you to go from 0-60 straightaway without that build up, so you start with the stronger contractions from 0cm dilation rather than not getting them until maybe 4 or 5 cm, so it is longer at that higher level.

The reason for being more likely to have an epidural is purely that you are having strong contractions for longer so may want to dull the pain and instrument delivery is more likely because going through the process for longer can make you more tired and needing the help at the end. It doesn't mean you will want or need to have either, but just more likely due to the sudden start.

As a pp has said, you can refuse an induction if you are worried or do not want it. You still have time so all being well your baby will just decide to come early without induction.

Hi :) I was induced with my first, about 18 months ago. First pessary worked for me, and contractions started about 3 hours after it was inserted. I managed to stay at home for the first 8 hours, keeping active and using a tens machine, then into hospital for the last 6 hours. Gas and air immediately on arrival as I was 5cm and just a few hours later they were telling me to get ready to push. The pushing stage only lasted about 45 minutes and I dont remember a huge amount - I was given an episiotomy rather than being allowed to tear, but non-instrumental delivery which I was glad of!

I will say, when it started it was a very definite 'boom, this is it now' rather than any kind of build up or questioning, but as it was my first I've nothing to compare the pain to, and I expected it to hurt!

Good luck!

@mamabear2020 interesting you were allowed to go home, I had to stay in hospital and wasn't allowed to leave until baby was two days old (issues caused by preeclampsia). Weird how different trusts operate as I'd definitely have appreciated labouring at home for a while beforehand considering how long my stay was (5 days in total)

Hi OP!

The first thing to say is that most people who are induced have a successful vaginal birth without forceps, so please try not to be anxious.

However as you say you are at increased risk of emergency c-section and instrumental delivery. I’m sure I was told that it was something like 20% section and 15% instruments - so combined it’s under 50%!

Think about your choices. Do you want a vaginal birth at all costs even if assisted? Great if so. If not, tell them. Do you want an epidural? If so, insist on it before the drip. If not, you can see how you get on. I asked this and the midwife said that although the contractions are more intense lots of people do manage without an epidural.

You are not wasting anyone’s time to ask a doctor about your options and risks if you would like to.

I was induced and baby born (sadly with forceps) within 24 hours of the pessary so I didn’t have the drip. It won’t necessarily take ages! Being induced also meant I had lots of one to one care throughout the labour and the staff were great. They will really take care of you so try not to worry.

I would also ask them about being 38 weeks, being 2 weeks “early” May mean induction less likely to be successful. I was told when they spoke to me about induction at 37 weeks that it would.

You may need CTH monitoring. I did. If you want to labour in an upright position, this is still possible - get the bed in a “sitting” position and kneel backwards on it with your hands over the upright bit of the bed if that makes sense.

The main thing is remember you have options, both birthing options and advice about not being induced (although sounds as though your doctors are concerned about you going over 38). Not everyone has a positive experience but lots of people do and I’m sure you’ll be one of them!

Good luck - please let us know how you get on!

Were you induced due to the pre-eclampsia? That could be why?

I was just overdue, and they weren't expecting induction to work so pessary went in and I was told 'come back tomorrow if nothing happens' haha.

Ooh you have my sympathies. I had one full night in hospital and that was enough - they are not good places for resting up!

I had an induced birth (full pessary dose and then the drip as pessaries fine nothing for me). I was also nil by mouth.
7 hours on the drip and I had an epidural. I was so hungry and had zero energy. Baby was struggling so I had a ventouse delivery. It was extremely painful but I had options and I took them. Still the most amazing experience of my life.

Aww thanks everyone for sharing your stories. Yes, I know I can refuse to be induced, and when I went for a hospital visit (to see the facilities and rooms etc) the lady leading the tour also told me the same, that if the baby is growing fine (i.e. not too large) then I can refuse induction.

I mentioned this at my next consultant appointment thereafter, but the consultant said that induction for ladies with gestational diabetes is not just suggested if the baby is too large, but also because there are other risk factors and that sugar levels only get worse and harder to manage after 38 weeks.

So I'm not against the induction, they are probably suggesting it for a good reason. I'm just a little nervous about the extra pain / effects on baby if assisted birth is needed, e.g damaging the baby's head/leaving permanent scars on head or something (which is probably silly of me to think like that). I read that marks etc left after using forceps/suction go away fairly soon....but yeh...just wanted to hear from those who have gone through these experiences how they (and baby) have got along.

Well, it's great to hear all your experiences, thanks again for sharing.

I've had two positive births and both were induced. Both they gave me a pessary first which worked within a few hours, then they broke my waters and contractions started. With the first they gave me a drip at the first time. Contractions were OK, nothing unbearable and then right when I started to need some pain relief (at that point I thought I'd start with paracetemol and try gas and air which didn't work) I suddenly needed to push. Both times baby came out with about 3 or 4 pushes. SO I wouldn't say induction makes it more painful or that you are likely to need assistance. Also, it didn't last long for me either time - first was hours from waters breaking, second was 2. They mentioned induction to me the other day really cautiously, I think they thought I'd be horrified but my last two births were so easy I am up for it again if the situation arises.

Should say they gave me a drip when they broke my waters and that the first birth was 4 hours. Try not to read too much that can worry you.

I think the worst pain for me started after they broke my waters. Epidural was a godsend. After I had epidural I delivered within 2 hours. No need of any other medical help for delivery.

But it all depends on the person. This was my third delivery and was after a previous c-section. Delivered my first vaginali. I went in hoping I might cope better with the pain, but realised that contraction pain it's really unbearable for me. So ended up asking again epidural.

Now pregnant again with number 4 and will ask for epidural as soon as I can have it.

But just to say, two of my sisters delivered without needing any pain relief. It's all personal and it's good to go open minded to it and take it as it comes.

Both my sons were induced (due to waters going but labour not starting). Had no problems.... Both were born naturally without an epidural or extra assistance. Both times I went in during the morning and had them before 4pm so not to long and drawn out either. Obviously, everyone is different but hope it helps to hear a positive story 😊 congratulations and hope all goes well x

In terms of asking how people got on with forceps, my baby had a mark on the cheek but it went after 48 hours and is totally fine! I suffered lasting damage but although you asked about forceps you said you wanted reassurance so I won’t go into detail unless you want me to.

@SproutMuncher thanks for sharing! did the forceps leave any marks on your baby?

Only the mark on the cheek which was gone so quickly. No lasting effects at all. Now a perfectly healthy toddler and you would never know!

I had to have forceps following induction, but it was because of shoulder dystocia so would have likely happened if I had gone into labour naturally anyway. The contractions were intense, but i think it's because there's not as much build up as such, but with the right pain management it was fine. DS did have marks from the forceps on either side of his face, but they fully dissapeared within a day or 2, and didn't seem in any discomfort (hard to tell with a newborn obviously, but cried just for milk and then settled so it seems he was okay with the forceps). I had a really bad tear and haemmoraged, but it was managed amazingly and my stitches were really well done so didn't take too long to feel 'back to normal'. None of that might happen to you of course, but hopefully it gives a bit of hope that if it does it's not too bad.

Try not to worry - I’ve been induced twice and it was fine, I had an epidural with the first (and it was fine) but none with the second. Giving birth in the UK is very safe and you and the baby will be ok in the end, the drs do this multiple times per day where you are going to give birth.

One of the reasons delivery is recommended at about 38 weeks for diabetic women is that there is a greater risk of stillbirth in diabetic women who go to full term.

I had a really great induction with DD1, pessary put in in the evening and by 10am the next day she was here. Under 4 hour labour with just gas and air.

All 3 of my labours have been induction and all very positive.

I did need an epidural in each but That didn't result in any further inventions for me. I also didn't tear or graze

I was induced at 37 weeks, 4 months ago now.

Gel pessaries got my cervix dilated just enough to break my waters. That also didn't trigger labour, so the drip was hooked up. Over the next couple hours it was turned up until I was contacting as regularly and as strongly as they wanted. Managed with paracetamol, codeine, gas & air and heat packs (seems I contract in my back) for a few hours. Decided to go for some morphine. Alongside gas & air, it got me all the way to 10cm (as with a pp, I also had the gas and air taken away for the actual pushing) and 20 minutes later I had my baby.

It might not have been the labour I wanted, but it was still a good birth imo. Good luck with it all, it's truly all worth it once you have your baby.

I've had a very positive experience with induction. Had sweeps from 38 weeks as there was a problem with my placenta, had an induction at 39 weeks. Pessary first day nothing happened, then 24 hours later I had the drip up and 2 1/2 hours later I was fully dilated, pushed and baby was out within 5 mins. Had gas and air which I loved. Yes it was intense with the contractions but knew that the intensity just meant baby was coming quickly. Good luck x