Induction v c-section?

[TreeRoad]

I’m almost 37 weeks and my baby is on the large side, so they’re keen to deliver early.

All is well with baby’s health, and mine, but they’re worried about leaving me to go to term, so are looking at delivery around 38 weeks.

I’ve been given a choice of an induction or a section, and although I’ve researched both, I’m having a hard time deciding.

I’m lucky enough to make the decision purely on the health of myself and the baby, as I have lots of physical and practical support around for after they’re born.

Has anyone had to make this decision before? What did you go with?

I had an unplanned induction - ended up on the drip which was really difficult as I had back to back contractions for hours and then a ventouse delivery. I’ve said since that the induction was hard short term but probably better long term than a c-section for me personally as I’ve had previous abdominal surgery and didn’t want more scar tissue etc.

I would say though that I didn’t think early delivery was recommended for babies measuring big? Unless there are other health factors. This is from the NICE guidelines: www.nice.org.uk/donotdo/in-the-absence-of-any-other-indications-induction-of-labour-should-not-be-carried-out-simply-because-a-healthcare-professional-suspects-a-baby-is-large-for-gestational-age-macrosomic

I was in the same situation and was induced early because of my large baby (had a previous shoulder dystocia with a much smaller baby).

My induction took five days from start to finish and ended with an emergency c-section at 3.30am after I had got to 10cms dilated with just gas and air. I was more than ready for it to be over.

For balance, I've also had a previous induction which was less than 24 hours from start to finish. Between the two though the method changed - ie they use the 24 hour pessary now which wasn't a thing when I had my first, so the process was a LOT quicker.

Having had three babies, two vaginal deliveries, one c-section, and knowing what I know now, I would have opted for the c-section.

Definitely a c-section. Induction can take days to work and end up in an em c -section anyway. Contractions will be horribly painful and you may need epidural which is far more likely to end in assisted delivery. Also if baby is on the large side a c- section will avoid all the carnage " downstairs" that can happen when you deliver a big baby.

@StrawberrySprinkles They initially offered me the early delivery as they thought I had gestational diabetes. That’s been ruled out, but they saw on the scan that there’s more amniotic fluid around the baby and I think the current worry is cord prolapse and shoulder dystocia. Sorry, should have mentioned the fluid in my first post!

I have read that with induction you’re more likely to require ventouse/forcep input. Those back to back contractions don’t sound nice…

@CornishGem1975 Five days sounds so long! I’m not sure how I’d make it through that. Interesting that you had such different experiences from one induction to another. I think my main concern is struggling through days of contractions only to end up with a section anyway.

This is my first baby but lots of my friends already have them and the overwhelming consensus from them is to go with the section.

I have an appointment with my new consultant next week to make a decision. I’m hoping they’ll tell me one method is more clinically indicated than the other, and take the indecisiveness out of my hands a little.

@wanttomarryamillionaire You pretty much summed up my concerns in one post. The NHS website says that contractions can be worse with an induction and when I have nothing to compare it to (first baby), that’s playing on my mind.

As you mention, that may lead to an epidural, then an assisted delivery. I’m sort of thinking, should I just opt straight to a planned, calm, controlled section.

Personally I would say c section. I had elective c sections and they were great. My friends who've had inductions had a hard time during the birth and after.

I had a spontaneous labour for DC1, ELCS for breech DC2 and induction for giant DC3 as he was 10 days overdue. I know I'm in the minority here, but I totally hated my elcs - lost a lot of blood and felt really separate from the whole process. It's really difficult to do proper skin-to-skin because there are too many things in the way. My induction was really positive and great except for the last half hour where I was mainly thinking "why the f* didn't I ask for an epidural".

I meant to add that even with a giant baby I found the induction easier than my spontaneous labour.

C section.

I would go for a c section. I was induced at 37 weeks for health reasons and although labour began quite quickly, it stopped progressing and the whole experience was really drawn out, painful and traumatic. In the end it resulted in an emergency c section anyway. Given the choice I would much rather have a calm, planned c section as I think that if babies aren't quite ready to be born then there's a stronger possibility of complications. L

I had a csection at 39 weeks, baby was over 10lb. I had the choice between this and induction and I chose the csection. It felt like the safest way for me.

Recovery was long and tough, however I had another csection recently and it honestly was perfectly fine and my recovery was really quick

Haven’t had a c section but my have had one induction and one spontaneous birth.
My induction was fine, 7hrs from pessary to baby, just gas and air for the last hour.
Spontaneous labour was 6hrs from first twinge to baby, again gas and air for last hour.
Both labours intense and with back to back contractions towards the end but not notably different I don’t think. Both over due (7 & 10 days) and both reasonably sized (8lb 11oz and 8lb 7oz).
So inductions don’t have to be awful but I was induced for a different reason (prom).

I was induced. Labour within 24 hours but the induction ward can be very lonely. They check on you every 4 hours or so.
By the time they realised I was actually in labour it was too late for pain relief. 6 hours labour. Contractions all in my back. 1.5 hours pushing but no worrying about stitches on tummy and long recovery.

I've had two inductions which were the polar opposite of each other despite both starting off very similarly (cervix not favourable, no initial reaction to pessary). One was days of waiting then ARM, drip, forceps, episiotomy. The other we were home within 24 hours as everything happened very quickly, waters went on their own, no time for any decent pain relief and my partner nearly missed it as he'd gone home at end of visiting when there was very little happening, based on the first one!

My worry with an induction at the moment is that staff shortages seem to mean that there was quite a queue for having your waters broken which extended the stay for a lot of ladies that were on antenatal when I was, I was warned about this but induction was the best clinical option for us so went with it and was just glad I got to jump the queue. So definitely a question worth asking but for a big baby, early, and first one I think I'd be leaning towards a c section of your trust has the same traffic jam on the antenatal ward. Although disclaimer I've never had a big baby, an early baby, or a c section so I'm only informed about how different inductions can be. For what it's worth I actually preferred the first one in some ways as the second was a bit scary fast and bloody painful as it was too late for anything beyond gas and air, and they didn't get that to me until I was fairly well advanced, the paracetamol worked very hard!

I don't know what you should do OP.

But I had an induction at 39 weeks and it only took just over 24 hours from the pessary being in and the contractions were bearable- it's not a given it will be painful. I didn't have pain relief apart from gas and air.

Would you be on a shared ward for induction? I had a private room after the pessary and think having privacy really helped make it go smoothly.

I think the evidence for delivering earlier for big babies if you don't have diabetes is limited www.nice.org.uk/guidance/ng207/resources/appendices-a-b-and-c-10883967373/chapter/Appendix-B-Risks-and-benefits-of-induction-of-labour-compared-to-expectant-management-for-suspected-fetal-macrosomia-in-women-without-diabetes

• but not sure about the other issues you mention though. Also common for measurements to be out.

I had a 5 day induction ordeal that was made worse by staff shortages. despite being over 42 weeks pregnant with a baby over 4kg the whole process was delayed due to the hospital being on divert etc. Lots of fed up and exhausted women on the induction ward being ‘managed’ whilst emergencies were prioritised. I ended up with forceps and episiotomy (but was told if the forceps didn’t work in theatre we would go straight to c section), nerve damage and some damage to my baby’s neck from the forceps delivery as well as baby having an infection after a long slow labour so another 7 day stay after birth. I had asked for a c section halfway through the induction as it wasn’t progressing and was treated like a moron by the registrar. I now have secondary tokophobia and am having an elcs this time as need some basic level of control over the potential risks. The staff shortages aren’t getting any better and I just don’t feel safe rolling the dice and hoping for a birth without interventions

I had a section for a big baby (no GD, just very long!) and I'm glad I did as she was stuck in my pelvis and would never have come out naturally. Recovery was easy peasy.

C section without a doubt. 100%.

Me and my friend were in similar predicaments, she opted for section and me induction, she had a lovely time, recovery not too bad, I ended up with a 4 day labour, forceps delivery, tore badly and ended up in theatre anyway for retained placenta. I'm now pregnant again and if given the option for any reason I know which way I'll be going 🤣

@TreeRoad this sounds like exactly what they were doing with me - they were expecting a large baby and I ended up with a fucking enormous baby - 11lb 7oz!!!

What I would do if I could go back in time, is tell them to stop messing about and booking me appointments to “discuss options”. I’d want a scan at 39 weeks or when they wanted to induce me to see how big baby was measuring. If they’d been able to tell me we were talking about 11lb rather than 9lb as I expected then I’d requested an ELCS instead of having one at the end of two days of labour with no pain relief.

Next one I’m having an ELCS for sure!!!

Induction 100%
C-section and recovery is not the easy way out. IMO I'd rather the short term intense pain of labour and general recovery etc than the drawn out recovery and long term changes to my body post C section.

Another one here who has 5 day induction. What they don't tell you is that most inductions for ftm fail. After day 5 I was on my knees, hasn't slept and had c section because I just couldn't. The drip is horrific ans frankly the recovery to c section was no where near as bad as the induction.

Every women is different but so many of my friends have been induced and said the same thing.

Take the c section and run xxx