would you have an induction? GD and VBAC.

[ladycarlotta]

I have diet-controlled gestational diabetes that consultant and diabetes midwife are both very happy with.

However, at my 35 week growth scan my baby had an abdominal circumference on the 92nd percentile whereas yesterday at 37 weeks it measured on the 80th percentile. The 80th actually tracks her percentile from the 20 week scan so consultant did say that perhaps the 92nd was not an accurate measurement - and in fact all the baby's measurements have dropped around 5 percentiles which might be explained by a different sonographer.

They are unconvinced that this is a sign of growth restriction but obviously don't want to take the risk, and are talking about getting baby out next week or week after, whereas previously they were happy to let me go until 40+6. They have said it's my choice but that they would strongly advise getting baby out asap.

I feel a bit gutted. Original plan had been to schedule a c-section for 40+ weeks and see if I went into labour before then. I had ELCS for breech last time and would have really liked to attempt labour this time. I'd ruled out induction because anecdotally I know a lot of women who have had a bad experience with it, and/or who ultimately ended up EMCS - I think if there's a heightened chance of C-section I might as well go straight to that. There is also the risk of uterine rupture with my previous scar.

However I'm now thinking I'd still really like to try labour, and to request an induction after all rather than C-section at 38 or 39 weeks. In these circs, would you do it? This will be my last baby so I'm conscious I won't have another go at it. But I know from experience that ELCS can be a really pleasant, safe, and convenient birth - so maybe I'm stupid to not just go for that.

I guess I have two questions here.

But to clarify, the one I'm struggling with is: do I take an induction or go straight to ELCS? I'd love to hear people's experiences of induction please.

they would strongly advise getting baby out asap

why would you not take this advice and get baby out asap? Is ‘trying labour’ more important to you than your baby’s health and safety @ladycarlotta

I was in a similar situation and obviously got the baby out asap. I wouldn’t be letting some nonsense idea of ‘trying labour’ endanger my child. Parents are responsible for their children. This often means doing things we don’t want to do. There is always a risk of needing c-section when pregnant.

Obviously I haven't made myself clear enough but induction is literally an option they offered, I ruled it out. Not them. With the previous information I was happy to go to term and see if I went into labour naturally: now they want to birth early either via c section or induction. And I'm thinking if I want to "try labour", by which I mean ATTEMPT, not "dabble in", then induction is my chance to do that.

But thank you for your many assumptions about me.

Also GD here, with big baby. They've said induction or c-section at 39 weeks. I've decided ELCS because I read somewhere that induction early when your body really isn't ready for labour is something like 40-50% chance of EMCS. I just didn't want that + high risk of 3/4th degree tear, shoulder dystocia etc.

Not trying to influence your decision at all & it's not a VBAC question for me. Just weighed up pros & cons and felt safest with the section. I think if you're planning more future babies, attempting a VBAC might be good, but depends on how you feel.

They did say they'd do sweeps from 38 weeks if I wanted, to see if I go into labour before a section at 39w so potentially you could ask for that?

Best of luck- I'm sure you'll be fine either way, but it's a lot to think about!

Btw that 40-50% stat might not be reliable! I read it somewhere but can't remember if that was in context of FTM x

I've had three inductions - two worked almost instantly and one was a whole lot of waiting about, and medical teams stroking their chin and muttering about what to do next with me. I think it's really common for induction to be looooong moderately gruelling process where each shift change has a slightly different take. Disclaimer my kids are teens so it might have changed but I bet it hasn't.

Has anyone taken you through what an induction would be like for you in your circumstances? That is, how they'd start you off and how long they'd let you try for before intervening? If possible, get someone to take you through that and then I would simply make a decision based on my immediate gut feeling after that conversation. Don't agonise about it just go with what you feel in that moment. As you're aware, things don't go to plan and your options might change as you go along so don't agonise too much.

One thing I would add into the mix is how a prolonged induction might impact on the GD. You manage it well in ordinary circumstances. Would the same go for 24 hours with no sleep being sent off to walk laps of the hospital to try to start things off? Also, what would they want you to do regarding eating? Are you allowed to eat in labour if at high risk of emergency CS? If you don't eat will you feel terrible?

If you go for the induction don't be surprised if there is absolutely no provision on the ward for you to manage your GD. Plan to bring any testing strips etc you need with you.

Thank you! These are precisely my concerns, which I feel the consultant hasn't really addressed - besides shoulder dystocia which she says is highly unlikely as baby is small, her measurements very similar to my 6lb 4 first baby except her larger tummy. But yes I worry about induction being just a more traumatic pipeline to c section anyway, which is why I initially ruled it out.

I feel like I don't have good information about the attendant risks of either option. If I'm over-egging the risks surrounding induction or dismissing the risks around major surgery like C section. But they have mentioned a sweep after my 38 week blood flow scan so I'll look into it.

I really appreciate that you get it, thank you!

Not at all- in exactly the same boat where they rattled off the risks of each but didn't describe the process!

If you have a chance, I think asking about which induction methods they'd try, how long they'd let you wait for, whether you can eat & drink in labour etc would be good to help make a decision.

Best of luck. I'm 39 weeks next week & still waiting for a section date, so it might end up coming naturally after all haha!! X

I was inducted at 38 weeks due to preeclampsia and GD it was very intense I didn't know any better as was my first baby whole thing start to finish 13 hours ... I'd do it again

I don't know what you're hospital is like but the rates for emergency c-section after induction at mine are really, really high.

I'm planning an unmedicated homebirth but if I don't go into spontaneous labour I'm going for an elective c section. So from one extreme to the other! But I don't want to risk having to recover for vaginal birth AND c section, which there's a very high risk of with induction.

Induction with diet controlled gd @ 40+1.... evidently wasn't ready and resulted in v fast delivery and grade 3 tear with months of recovery. 2nd time round elcs. No medic queried decision.

Elcs all the way