Birth choice- Induction or planned section?

[EllieJai44]

I know its my choice at the end of the day however would like some others opinions on birth choice.

So due to previous history I can either have a planned section or induction.

My first pregnancy was an induction at 37+1 due to growth and movements- very straightforward and to me a dream birth.

Second was induction at 37 exactly due to growth and movements again but was traumatic and ended in emergency section with neonatal time for baby (he was all fine in end, had wet lung), we were in hospital for a week in total.

The recovery from that section was hell, I hated it and I was so sore but I had spent 12 hours constantly contracting (every 2-3 mins) with no breaks before the section so my muscles were ruined!

Like mentioned above I have the choice for planned section due to previous birth or an induction and to start with I was going for the section because of knowing a date etc

However the more I think about it I keep going back to the induction- I want to try again naturally (as possible for an induction) but my biggest fear is something going wrong and not coming home with a baby- it's the only thing holding me back, however the recovery from a section is worrying me two, especially when I have 2 young children at home that after 3 weeks I will have to look after on my own when hubby goes back to work....

Those are my only two options- section is likely to be between 38-39 weeks and induction would probably be around 38 but very possible to be at 37+ weeks based on history- either way I won't be allowed past due date.

Any experiences?

Are you absolutely sure you'd need to have an induction? It's always your choice. They can't say you're not allowed to go past due date. Of course if there is a genuine medical need then it makes sense to go with one or the other, but I wonder if perhaps you'd be able to see what sort of situation you were in closer to the time and maybe let labour onset naturally? Without knowing your situation, that would be my choice, but of course I have no idea what the reasons for intervention this time round would be.

I think when a baby is vulnerable there is a large school of thought that says it's actually safer to have a section as less stress on the baby as opposed to induction. But you'd need to look a bit more into the evidence and detail around this. A doula may be helpful for you.

If you do need to be induced, could you opt for the pessary / ARM / balloon type of one, and then see how you went and maybe avoid syntocinon? Would having an early epidural help, if you did end up having syntocinon drip?

I wasn't induced and didn't have a c section but I did have a long and traumatic birth in many ways for various reasons, I was given syntocinon in the end and had an epidural too, but for a long time I laboured without any drugs, just breathing techniques, positions and the pool and it all helped me a lot for a good 3 days! I think on the whole what made me feel ok about the birth afterwards despite the stuff that went wrong is that I felt empowered and I knew what was going on and made the decisions myself so whatever you decide to do, I'd recommend getting to know all the risks and benefits, and going with your gut instinct. Good luck x

Hey there! I'm not pregnant (DC2 4 months), but if I were to go on to have a third I would be in a similar situation. I've had two 37 week inductions, with my first resulting in a regular vaginal delivery and my second being an emergency C-section. In the event I do have a third, I can imagine I'll get pre-eclampsia for the third time, so would be faced the same decision of an early induction or an elective.

Personally, I would go for the induction. The idea of an elective (unless medically needed - i.e. breech baby after failed ECV) is anathema to me. As well, the reason for my C-section (malposition) is unlikely to happen again. Do you know how likely the reason for your C-section is to reoccur? Finally, while I know there are changes to a VBAC induction to reduce the chance of uterine rupture, I know that having had a prior vaginal birth is still the best indicator of a successful VBAC. But that's me. My "emergency" was super calm, very little foetal distress, a great sized baby (big, but not huge), and no neonatal time.

On the flip side, if it's just the recovery period of an elective you're worried about, I've read loads of threads about women having extremely quick recovery periods after an elective. I imagine no labour beforehand helps! The certainty of having a set date and knowing baby will be along within minutes after the procedure starting also must have its appeal.

I'm not sure how close you are to your elective date. I know you're getting close from your previous threads, so I think you need to talk to your midwife. Work through your anxiety, or even make a different hybrid plan where you maybe start the induction, but convert to a C-section early in the process if you want. Best of both worlds sort of thing.

Best of luck no matter what you go on to choose.

@Skylark1990 my previous two pregnancies my placenta started to fail and caused issues with growth and this baby is starting to show signs of dropping in growth (currently 31 weeks) so it's very likely I will need some sort of intervention for babys sake- they have mentioned a section at 39 weeks in the early days but I am yet to have another consultant appointment to discuss changes since- they did say if any change in growth would warrant a section being brought forward, however based on my history an induction would likely be offered from 37 weeks- the reason behind the emergency section in my last labour was because my body was over contracting and causing babys heartrate to drop and not recover so we were taken in fast for the section.

@Dyra thank you for your reply! The previous section was due to my body over contracting and cause fetal distress which he wasn't recovering from- so not sure how likely this is to occur because its a different baby so may deal differently?

I'm currently 31 and half weeks so have a little bit of time left to decide, midwife and consultant in early appointments had no issues with agreeing with the section decision I first had- no set dates have been made yet as we are waiting to see what this babys growth does, which from 28 weeks to 30 weeks she has dropped already.

I see, thanks for explaining OP. I am not a doctor but perhaps if they induce they could give you less of the syntocinon so that you contracted less strongly / it builds up more slowly? And then maybe this would make the chance of you over contracting lower too? Even if that means the overall time of being in labour is slower... That might be easier on your body and baby... Wishing you luck whatever you decide.

P.s.have no idea if what I said above would work in that way but could be something to ask at least 😌

@Skylark1990 last induction the only thing I had was my waters broken straight from the start as I was already 2cm so they went straight in, the moment they broke my waters contractions started! Thinking that it may be harder to avoid- I've said C-section since I found out I was pregnant and only now debating it haha maybe I should just stick with the section 😂

My first baby was born ina foreign country after a long labour and EMCS. Recovery fine but was v traumatised.

Second was a VBAC in UK (induced on the drip). Haemorrhage and blood transfusion, tough recovery but positive experience

Third time it was my choice. I gave birth abroad in a different country once again. They don't use gas and air here and I really didn't want to be in labour in a foreign country again.

I had an ELCS. It was very 'ok'. Not the 'day spa' experience that elective sections are often hailed as being on mumsnet. I had got my vaginal birth out of my system and at that stage just wanted the baby out quickly. My recovery was unpleasant, much harder than the first c section, but still not as bad as labour.

I felt pretty rough for 3 weeks and then turned a corner. Things were managable then. I don't regret my decision at all. I didn't want to go through another drawn put, unpredictable birth again. I wanted the baby out quickly and was willing to face the recovery afterwards. If I had been in the UK I would probably have gone for the induction but I really wanted the birth over as fast as possible.

@EllieJai44 That does change things a little. Was there nothing they could do to slow/weaken your contractions? That sounds so awful. Poor both of you, that must've been rough. With the signs of placental failure, were there also any signs of abruption? I read that can be a cause of over stimulation in labours where no medications have been used to start contractions.

If your little girl continues to have slowing growth, then I would continue with the plan of the elective. Probably best to just get her out with minimal stress on her. If you do make it past 38 weeks, then her lungs would have had a chance to mature a bit more, so less likely to have the same problems. And if she needs to come a bit earlier, then at least there's a chance to get steroids to help lung maturation a bit too.

I was told in my last pregnancy that I could choose an elective section or "have a go" at a natural birth due to previous complications in pregnancy and childbirth. I went with the section in the end. I decided that, although the section came with risks, they were more predictable than the risks (for me) of attempting a natural delivery. And I felt safer being in an operating theatre in case something did happen. Probably would have been just as well looked after in the consultant-led ward but it gave me peace of mind! Plus having had an emergency C section previously I knew what to expect recovery-wise. The natural option just felt too much like unchartered territory given the particular circumstances for me.