Looking for advice on induction or elcs.

[Blxo94]

So I'm basically stuck between the two choices. I've been thinking of an elcs from the start but not fully decided. I know that if I don't have an elcs that I will need induced as I have group strep B and even if I go naturally they will most likely try get me to contract quicker and have baby out quicker.

Basically my question really is if these are my both options, is there any chance at all they could do this at 38 weeks? I only ask as my baby is due on the 26th February. I lost my baby girl to anencephaly on the 23rd February 2018 and suffer from anxiety, depression and PTSD due to this which is still ongoing and as you can imagine has made pregnancy quite worrying and not enjoyable. I'm really hoping to speak to midwife as I really don't want to be pregnant for this date. My symptoms ramp up majorly around the time of my losses and I want delivery to be as calm as possible. I know what I want and what happens are two different things but I just want to do as much as I can to prevent myself having panic attacks and my mental health taking a massive dive when I'm about to meet our rainbow.

You need to speak to a consultant not the midwife, the consultant is the one who can sign off an elcs or induction.

With respect to the Group B strep it's not a reason for induction on its own. If you labour naturally then it's recommended you have antibiotics but it wouldn't be a reason to speed labour up. The risk of GBS causing problems is low when membranes are intact, and for many women the membranes don't rupture until they are labouring. If you are induced then your membranes will be ruptured before the hormone drip is started, so you are automatically increasing the risk of GBS infection.

It's understandable due to your losses that you are anxious. Have you had any support from a bereavement midwife?

Usually planned inductions/c-sections for health reasons are done before your due date to avoid you going into labour naturally. I would be asking for a consultant referral to discuss all these things and get your date booked in.

Thanks for replies!!

@pinkprawns2 not I don't see a bereavement midwife. I have been under fetal medicine until 20 weeks for scans to check thoroughly for birth defects. I only see my usual midwife and I've been referred to the metabolic clinic as my bmi is on the high side. That's the only people I see. I haven't been told about bereavement midwifes or anything... Should I be seeing someone like this? I've had 5 losses all different reasonings apart from I've had 2 anencephaly babies. I feel quite alone and I feel really anxious about bringing up anything to do with labour plans as I'm worried they will think I'm being irrational. Being told about the group strep B hasn't helped at all as for some it's not a big deal. But for me it's making me sick with worry incase baby catches it. It's made me lean even more towards an elcs. I'm jist terrified about it all and it doesn't help that obviously my due date is only 3 days after I lost my first baby girl. I think on my next midwife appointment I'm going to try speak to her about it and see my options!

Thank you honestly for both your replies I really appreciate it!

I’m sorry about your previous loss and understand why this must be very difficult for you. I agree that the best thing is to ask to see the consultant to discuss all the options. One thing to note is that - while I guess different hospitals have different policies - as I understand it it is not necessarily the case that you need to be induced because of Group B Strep. I have that and was told I need to call as soon as waters break/or I think I could be in labour so that they can start to give you the antibiotics. If for any reason you don’t get the antibiotics within 4 hours, baby gets antibiotics when born.

@Fleur405 see I didn't even know I was being tested for it, I went to hospital the other week as I wasn't well at all and had pains. They told me she was just going to have a look at my cervix. No mention of any swabs and tests. So you can imagine the fright I got when I opened the letter a week later saying I had it and if waters break to go to hospital straight away. I had a midwife appointment last week but it wasn't my usual midwife and she was being schedule so I was pretty much rushed out the door. I tried to ask her more on it and I got told its no big deal and I've just to phone hospital if waters break and that I have 24 hours after waters break to get baby out so will most likely need a induction! I was told about the antibiotics in the letter by the hospital but that was it. Obviously with someone with previous losses and mental health I just feel like I should have had a phone call atleast to discuss it as its caused nothing but more worry and stress. I just want baby out the quickest and safest way possible x

Behind schedule*

The only real difference medically with Strep B is that rather than encouraging you to stay at home for a while after your waters break and do the start of labour at home, they’ll invite you in straight away. If baby hasn’t arrived 24 hours after your waters go, they’ll discuss induction with you. They won’t induce you before your waters go for strep B.

You can still request an ELCS if you’d prefer - I don’t think they’d be likely to do it at 38 weeks, it’s usually 39 weeks at the earliest but hospitals are “marked” on their ability to schedule ELCS’ as close to 40 weeks as possible, so they’ll try that if they can. That said; you can ask a consultant - from personal experience, I’d expect them to refer you to mental health support rather than adjust your potential dates, but there’s no guarantees, you might have more luck.

Make sure your midwife is aware of the support you’ll need, now and around that date. All the best to you

@takeyourfinalposition
Thank you so much, I think I'm definitely going to call my midwife maybe even before my appointment and talk to her about it. I feel the further I get on the more worried and the more I'm not coping.

Thank you all for such lovely replies I was worried about the whole trying to be induced at 38 weeks and being judged for it! Thanks honestly ❤️

Will take all your advice and try get more support! Xx

It might be worth asking your midwife if they have a bereavement team/midwife , most hospitals do. Some have criteria which means some women are referred automatically but it may be you would benefit from that extra support. Or maybe support from the perinatal mental health team as they can help do a birth plan to help with the anxiety too.