Is it better to never be induced?

[Pianodiano]

I am doing some very early research so thought this would be a good place to ask.

Most of our local trusts maternity stats are that if someone is induced it is then most likely they will need an assisted delivery, or it’ll end in EMCS. Surely knowing this if it comes to induction it’s better to just opt for an ELCS rather than go through the stress of interventions and putting yourself at risk for a time-pressured emergency situation where a section is likely needed anyway?

I really don’t like the idea of forceps or episotomy (who does) but this is especially since a couple of relatives and friends of mine have had serious birth trauma from instrumental deliveries and interventions, one of their babies needed physio after as the forceps had injured them. I am also hearing in the news that most maternity departments are rated inadequate or requires improvement in the last 12 months.

I guess this just bothers me as I don’t want a traumatic experience and I am hearing of so many people who have had that lately!

What has your experience been and would you avoid induction? Thanks :)

Remember some people will ramp up their stories to add drama. When the time comes you will just want what is best and you make on the spot decisions based on the midwife

My induction failed and ended in EMCS.

I won't tell you the full story because delightful people like Lily above will think I have "ramped it up for drama". (Sure.)

I will simply summarise by saying I don't recommend induction (at least by synthetic oxytocin), and if you get to a situation where that is being suggested, I'd consider going straight to c section instead.

I had an induction for my third, went very smoothly and easier than the first two. But that might have been because it was a third time. Every birth is different, inductions are usually only useful if there's a risk when waiting for it to happen by itself. The most useful thing you can do is teach yourself breathing techniques and calming techniques, don't put too much pressure on how it happens.

I had two inductions and two otherwise unassisted births. I chose an epidural with my first and my second came too quickly to have anything other than gas and air. They don't have to lead to a cascade of interventions 🤷‍♀️ but even if they did, I would still prefer that to the possibility of not having a baby at the end of it

I wouldn’t be so black and white about it. Eg ‘sweeps’ can kick start labour but I don’t think there’s evidence that they lead to increased complications later.

My plan was to see what my cervix was like if I needed an induction. If it was ripe and ready, I would have an induction. If it wasn’t (as judged by the bishop’s score) I would ask for CS.

The people I know who had inductions ended in emergency c-sections. Obviously not a huge sample size but it did make me wary.
Went into labour naturally but needed forceps and an episiotomy. I still sustained a third degree tear. It healed well though and I no longer have continence issues but now have been seriously recommended getting an elective if I have more children as my risk of re-tearing goes up to 25%. If it helps I don’t remember the pain from tearing. I had no pain meds just local for the episiotomy but think contractions were so painful I wouldn’t have felt anything else anyway.
also to add I went for a birth debrief and the midwife said to me 25% of first time births end in c-sections. Another 25% end in assisted delivery with forceps like mine. I was shocked tbh. 50% needing some sort of intervention seems incredibly high to me.

I had a great experience with induction with first.It was at 37 & 6 and was done due to recurring reduce movement episodes.Pessary was inserted around 8pm and things started very quickly for me writhin the hour. Midwife had said cervix was favourable before inserting the pessary.Surges or contractions happened through the night thankfully manage to sleep a lot! 10am or so pessary was removed as surges or contractions were coming on for too long with no break inbetween. Soon as they took pessary out my body took over naturally & rest of labour & delivery was amazing. Gas & air and squatted my son out around 2pm. No drip was needed or further interventions thankfully. Hoping I have a positive experience with labour & delivery this second time round too. Good luck!

Dr Sara Wickham has some great books on induction if you want to be more informed.

There are lots of things to consider. I would decline an induction for being post dates, maternal age, babies position, IVF, BMI, ethnicity or for a suspected large baby.

I would probably accept induction for pre-eclampsia.

I also wouldn’t consider a c-section lightly especially if this is your first birth and you hope to have more children. VBAC rates vary a lot depending on the trust and unless you really wanted to push for a home birth outside of guidance you would have to give birth on the delivery suite with continuous monitoring. I don’t know of birth centers that accept VBACs

I had an induction (pessary) - was a smooth birth for me personally. Felt more painful than first birth as things progressed very fast but still was ok with just Gas and Air. No instruments used.

I don't think it's necessarily helpful to look at overall stats. Women get induced for different reasons, at different gestations, and at different pregnancy numbers, as well as from different starting points (I believe there's a score they can give based on dilation etc).

I was induced at 37 weeks with DD2 because my waters broke at 34 weeks. Statistics around inductions of second births, and inductions following PPROM would be more relevant to me than overall "inductions are most likely to end in assisted deliveries of emergency c sections".

I didn't need anything beyond the internal gel and DD was born in 9 hours. I don't know if that's unusual, or actually a more likely outcome in second vaginal births following PPROM.

in my nct class 6 out of 11 people were induced and none needed to have a c section.
family wise I can think of another 5 who have been induced and again no sections needed.

I had an induction and didn't need any assistance whatsoever. In fact he zoomed out 😆

I was induced by pessary with my second, slightly overdue. It started at midday and I had baby at 2230 in the water with no intervention or issues. I hated the thought of induction, and it was only because of my age, but it actually went way faster and smoother than my first.

I had two inductions and two normal births. Although I would prefer to go into labour naturally because the pain isn't as severe ime, I still had very safe, quick deliveries with my inducted babies. Most people I know who had inductions had safe births and healthy babies. It seems to be the unfortunate few who have failed inductions. Therefore it's not necessary to give out elective sections (more costly and invasive) without first trying to induce.

My first induction, hormone drip, was horrific and traumatic and nearly ended in a section. Forceps instead.
With my 2nd I planned a home birth but at the last minute they told me I needed and induction again and I was beside myself. I begged them just to do a section straight off. But they wouldn't. However it did turn out to be the right call as Labour was kicked off just by the pessary and no drip. Was a bit easier and shorter than first induction and no more intervention than that.
But yeah all in all im very fearful of inductions. I do think they jump to them too fast.. especially with first time mothers. I just did what I was told when I was a first timer.. but looking back I wish I'd held off.
Coming up to my 3rd birth soon and im planning a home birth but if there's medical need to speed up labour I will be demanding a section this time rather than the cascade of traumatic shit I had with my first.

I stupidly went along with an induction and had two rounds over a few days. I really should have spoken up for myself and asked for a section. I just thought they knew best and would say if it should be a section. I was induced due to being over the due date. Baby was born at 42 weeks by emergency section. Next time I went straight for an elective c-section and it seems like it was the right decision as at 37 weeks baby isn’t in a good position and I think it’s due to my pelvis as my first baby got stuck and couldn’t turn.

It is better - in my experience - to trust the advice of doctors and midwives than to seek advice from strangers on the Internet or friends. Most women do pregnancy and labour 2 or 3 times; these people are experts..

For what it's worth, I've had two fantastic inductions with no interventions and no trauma at all. They were both due to complicated fetal medical issues and if I'd refused them, my second child would probably have died in utero.

I know of people who have refused inductions up to 10 months and for serious conditions like pre-eclampsia. It is, in my opinion, insane.

But then I'm just a stranger on the Internet🤷‍♀️

I had an induction with my first (and only) at 38 weeks. My cervix wasn’t favourable when we started the induction. I only needed the pessary, I progressed well and delivered only with gas and air. I didn’t experience a cascade of interventions but I did have a 2nd degree tear which healed fine. Someone in my NCT had a spontaneous labour that ended in an episiotomy and forceps delivery. You can have instrumental with spontaneous labour and intervention free with induction.

These NICE guidelines suggest that women who had inductions, 15% had instrumental births and 22% had c-sections. These risks are increased than those who have spontaneous labour. However, inductions are recommended because of a medical need and are often accepted because the small risk of not following that advice usually isn’t a risk a woman is willing to take. The % of women having spontaneous births and not requiring further interventions or c-sections are likely the women who have no complications. If you took away induction, then the percentage of interventions and c-sections would increase for spontaneous labour because there are some babies that will never be in a good position.

Usually the hospital will tell you their process, as a first time mum it might be along the lines of pessary, gel, break waters and if labour doesn’t start within 4 hours of waters being broken then they’ll put you on the drip. This is usually over a number of days. Then you might end in c-section. Personally I wasn’t prepared to get to the drip as I felt that the drip is what really tired women out, when they’ve already been at it for several days, and so they usually don’t have the energy to push and need a c-section. This is usually when it’s a more traumatic event. For my induction, I was prepared to go with the hospital’s process until the drip and then I would refuse the drip and opt for a c-section. So you can ask for a section at any point in the process. The reason I opted for the induction over the c-section straight away is because I was being induced at 38 weeks and they like to give steroids before 39 weeks to strengthen baby’s lungs. A c-section is still also major abdominal surgery that I would like to avoid if possible.

The thought of an Induction at 37 weeks vs 42 weeks are quite different. For the former I would be much more inclined to choose a CS. I had the latter with no interventions, and almost had it again second time round again, although did consider refusing another induction.

This was the experience of three of my friends. There were varying degrees of awfulness.
two had their second via ELCS
the third couple have decided not to have any more children as the birth was so awful they both thought she was going to die.

My cousin was induced and successfully gave birth vaginally with her third. Her first two were straight forward VB.
She said she would never. Ever. accept an induction if she had a fourth.

i opted directly for ELCS as I didn’t want to be a position where I was begging for a C-section and having to wait until I was classified as an EMCS.

My induction was a dream come true. Just a bit of the gel was all that was needed. Lovely walks around the hospital garden while it kicked in. Textbook and straightforward with just a tiny bit of gas and air at the end. Pushed for 20 mins In a dinky little room with my music and no coaching. 8 hours start to finish. Yes obviously it was hard but as childbirth goes it was great and I'd do it again tomorrow if I could.

Dimly lit not dinky little 😂

I’ve had a very long birth, was induced and ended up with forceps and episiotomy.
I don’t consider it traumatic, quite the opposite I was just so happy to get the baby out ( 2 weeks after due date, and absolutely hated being pregnant)
Don’t get me wrong I can think of more pleasant things to do 😂 but epidural really helped and I was very lucky both with midwifes and doctors, felt very well looked after. Being induced it’s not necessary a bad thing but of course( as this thread shows) experiences will vary

I was induced for all three pregnancies at 37 weeks because they were all big babies (9-10lb+ at 37 wks). All three were straight forward vaginal deliveries despite their size. I had stitches with the first but none for the two youngest. My last labour lasted one hour from drip to delivery!

Had both my babies via induction.
1st one I did need an episiotomy as DS heart rate was dropping so low. He was fine and I recovered pretty quickly from the episiotomy. Needed my waters breaking as well.
2nd time no episiotomy just needed my waters breaking and then baby shot out in 3 pushes! I did had a PPH but midwives and consultant were amazing and sorted me out quickly. Recovered very quickly 2nd time round.