Hospital want to induce me this Friday (38+0) - help!

[worried88]

I was diagnosed with gestational diabetes at 36+0 weeks and am now 37+5. I've been monitoring my blood sugar levels at home since the diagnosis and have managed to get them under control.

At my 36 week scan the baby's weight was estimated at 7lbs 1oz and the head circumference was 35.5cm (97th centile), so the baby is already on the large side because of the GD.

My midwife rang this morning to ask how everything is going and then asked what my thoughts were on the birth. I said I was confused over whether to go for an induction or c-section due to the size of the baby's head, so she went to speak to the consultant to get his thoughts.

She rang me back 10 minutes later and said the consultant thinks an induction is the best option and that they could get me in this Friday to start the process. I was quite shocked as the phone call began as a routine chat about GD and ended with the possibility of giving birth in two days' time.

The midwife explained that the baby will just keep on growing from here on in, so it's better to induce sooner rather than later for a vaginal delivery before they get too big. She also said that if I did go for a c-section then that could be done at 39 weeks.

I said I'd think everything through and get back to her, but I'm so confused now. Should I take their advice and go in this Friday, wait another week (when I'll be 39+0) or two (when I'll be 40+0) to be induced, or ask for a c-section?

My head is spinning - if anyone has any advice it would be much appreciated.

Was everyone else given a cannula for induction? I’ve just had one fitted to my wrist and have been told I’ll need to wear it for the rest of my stay here. I hate it already - I imagine it will make labour quite a lot more difficult as it feels “in the way” and quite restrictive. And the midwife has also told me that worst case scenario I’ll be here for a week!

Apparently I’ll be going down to the labour ward this evening for a further cervix exam and potentially getting a pessary inserted.

I’m starting to really question my choice to have an induction, given the unfavourable cervix, the baby’s high up position and the mention of cord prolapse risk and am wondering whether to ask them about a c-section.

I mentioned it to the midwife just now and said a few people I know who’ve had one recently were in and out of hospital in 24 hours. She said what they don’t tell you is that recovery can take up to six months - but I know both my friends had really positive experiences. She then said to discuss it with the doctors on the labour ward this evening. Do you think it’s too late?

Tbh OP they haven't even tried induction yet. They've just admitted you to hospital and monitored you. Frankly I would be insisting on the pessary or being discharged until they decide its time to give you one.

It's not an induction if they don't give you the pessary, is it? They're just watching and waiting.

(PS I am not a medical professional!)

I looked up cord prolapse and it’s pretty scary stuff:

teachmeobgyn.com/labour/emergencies/cord-prolapse/

I’m concerned that I’m going to be taking on this risk when I could just have a c-section.

@worried88 you’ve been there since 9pm and they haven’t even given you a pessary yet? You need to ask what their plan is, that sounds ridiculous. Also, if you don’t want the cannula, tell them. What you’re seeming to forget it that this is all your choice as to what happens to you and your body. I declined plenty of stuff they wanted to do!

@NameChange30 I agree. At our hospital, for a first baby you come in for "induction" the day before you're actually going to be induced and that's when they give you the pessary. They don't actually consider the REAL induction to be happening until you're on the drip.

OP - yes, the canula is normal. It's where eventually you'll get the drip. If things go wrong, they'll give other meds through it. A key disadvantage of induction is that there is constant monitoring and potential intervention which you should know by now. Even in hospitals that have mobile monitoring, your ability to move around during labour is seriously restricted during induction (and.... in my case.... thank god. Because otherwise DD would probably be dead or brain damaged).

Hope everything is going well @worried88

Anecdotally, baby wasn't engaged and my cervix wasn't exactly favourable when my waters were broken. Second midwife had to come in to assist, as the membranes kept sliding out of the way. She sort of pushed baby right down into position. It was very uncomfortable, but nothing gas and air couldn't handle. Maybe that's what they'll do for you?

Keep doing what you're doing, asking questions to get clarity on things. It's unfortunate when doctors differ in opinion, but they all have you and your baby's best interests in mind.

The cannula won't even cross your mind when you're in the throes of labour.

Hmmm. Page 4 hadn't loaded.

Yes having a cannula is very normal as part of the induction process. It's one of the first things they do, even prior to the gels, at my trust. I was an inpatient, so I had mine the night before. If it's uncomfortable or painful, get it resited. If they're not planning on doing anything by tonight, get it removed.

Definitely ask what their plan is. It sounds like they're holding back because you're contracting gently, but they can't keep waiting and seeing forever.

Also once they ARM me I went from 3-10cm and giving birth in 2 hours. No time for epidural or pain relief. Not all Inductions take forever so Good luck!

Also once they ARM me I went from 3-10cm and giving birth in 2 hours. No time for epidural or pain relief.

This also worries me, because I know my limitations and I definitely need an epidural!

I think I’m going to ask about an ELCS tonight, as I’m now really concerned about the cord prolapse risk in addition to everything else. If only I’d been stronger and insisted on an ELCS from the start!

I had gestational diabetes with my first child and was induced at 38 weeks. As there is an increased risk of still birth with diabetes it's common to be induced at 38 weeks. Although I found induction intense she was born perfectly healthy with no underlying conditions. I'm glad I didn't take any chances with the risks.

Sorry I haven’t read the full thread but wanted to let you know my experience, incase it’s of any comfort.

Induced at 38 weeks due to GD with only my second baby and none of the others. Waited around all day in the hospital bed before the first pessary was put in. That did nothing. Second pessary the next day brought on some Very minor period pain type contractions. Nothing major. The next day they used a prostin gel which was working a bit better and contractions got a bit stronger, then finally on the third day after a higher dose of the gel, my waters broke and baby came within 15 mins of that, it seemed like it took forever from start to finish but also felt like it happened very fast at the end.

The induction process can be long and can be painful but don’t worry, it will all be worth it in the end.

Do ask what their plan is if you’re just eating around right now. It took a couple of days before anyone properly talked me through everything. And now I can see why it took so long. They don’t want to go in with a very extreme method of induction straight away as this could cause the baby distress so they like to take a gradual approach. So bear with it and your little bundle will be in your arms soon enough!

Good luck and congratulations!! Happy to answer any more questions you might have x

Waiting around not eating around!

OP, you sound very concerned about the risk of cord prolapse. It seems they have mentioned it to you without fully explaining to you. I advise you to talk to the medical professionals and ask for more information about it. If it was me I would ask a midwife and then ask to have a follow up conversation with a doctor. Some questions you might want to ask are:
What is the actual risk of cord prolapse (ie what percentage)?
Why do they think it's a risk in your case?
What can be done to reduce the risk?
How will it be monitored and identified if it is happening?
Once it happens what will they do about it?
What are the likely options?

A PP who was offering you lots of great advice (sorry forgot username) told you about BRAIN, perhaps you could go through that and see how you feel.

Could you call your partner and talk it through with them?

As PPs have said it's your body and your decision. If you're feeling stressed because you don't know what the plan is, ask for more information and demand to be involved in making the plan.

You can ask for more information about everything, all possible options including actual induction (which you haven't had yet) and ELCS, before you consent to anything.

Sorry meant to type
What are the likely outcomes?

Worried, fingers crossed it all goes well. No matter what youll meet your baby soon! Keep calm, trust your body and the professionals to guide you through it.

I had 2 pessaries after the second one I had lots of backache, they gave me 4 pills (2× paracetamol and 2x ??) and a bath. Got out the bath a couple of hours later and baby was in my arms in 15mins. All a bit WFT just happened there?
I thought my friends very similar tale of tons of backache/ period cramps and sudden appearance of baby was unusual

@NameChange30 great points - couldnt agree more. And thanks for the BRAIN reference, that was me who mentioned it! I think it's a brilliant way to help us make decisions!

It can be hard to ask questions but its so important to be informed so you can make the decisions right for you. Reading horror stories will just make the experience worse - so you need to know the facts from the medical professionals in the way they relate to your individual case.

If you are feeling scared and worried then it could be likely the induction will not progress. Fear has a HUGE impact on our ability to birth because it stops the hormones needed from flowing. However, I know the induction has synthetic hormones. But it will certainly make it more painful if you are stressed and afraid.

Best thing is to get as much info as poss, really pick their brains, then use your BRAIN (benefits, risks, alternatives, intuition, nothing) and make a decision that feels right.

Why are they just monitoring you? So strange they havent done the pessary yet.. x

@Blackbear19 sounds like a really positive induction story!

I was back driving 2 weeks after my section & caring for a disabled husband, including going to hospital to learn how to do physiotherapy at home. I had less problems from the section than from the post natal depression & pre eclampsia.

Thanks everyone - I’m feeling pretty anxious but this thread really helps. The frustrating thing is that if they’d let me have a c-section, all being well the baby would be here by now and we’d be discharged tomorrow night (24 hours for the section, then 24 hours to monitor the baby’s blood sugars). As it is, worst case scenario I’m looking at up to six more days according to the midwife!

I feel I’m clearer on what the next steps are now (down to the labour ward at 8pm, cervix exam and probable pessary) but definitely need to talk to them about the cord prolapse risk and ELCS beforehand.

@worried88 hope it goes well later! Sorry didn’t reply to your question after I posted - hopefully you can ask for some syringes to do some colostrum harvesting if you’re in for a long wait BUT don’t worry too much! The golden hour after birth get lots of skin to skin and my baby latched on in that time. I’m sure you will be fine!
Ref cannula - I was canulated because of GD and the need to potentially administer saline drip in labour if sugars drop which mine did.

The thing is I know they’re very anti ELCS at this hospital - but I feel it’s a far better and more controlled option than putting the baby at risk of cord prolapse. They say I’ll be closely monitored, but it still seems riskier than a c-section to me. It’s so hard as a first time mum trying to choose the right path through this. I can totally see why people hire a doula now!

I gather the holdup is because of lack of beds on the labour ward - hence they can’t get a space for me until 8pm.

"I can totally see why people hire a doula now!"

Yes I realised that after my first birth
If it's any consolation I don't think you'd be allowed a doula with you atm, you could have one at the end of the phone I guess but it's not quite the same!
Mumsnet will have to do