Induction - for/against discussion

[Worrywort98]

Hi all
I'm 40 weeks today. Had a scan this morning, he's 8.1lb. All looks good, plenty of amniotic fluid, having a low risk pregnancy. (had been having scans to keep an eye on his weight as he was on the 10th centile for ages) but all good and caught up.

My consultant has me booked in to be induced on the 12th. I don't know how to feel about this as I was hoping for a low interference birthing experience seeing as I have no complications. I've heard stories of inductions escalating into a cascade of interventions.

Just need a hand hold and some of your experiences with being induced?

Depends on the circumstances. First child our risk of stillbirth was over 50% so when CTGs started to deteriorate and scans looked off we opted for induction and I think that was the right decision

Child 3 recommended induction at 38 weeks due to diabetes and insulin, declined. At 39+2, reduced movements and slightly polyhydramniois we decided on induction. I was 3cm so we knew would be an easy induction.

Both my inductions were easy, one just a pessary and .40 min labour and child three waters broken and born three hours later.

I think we could have hung off a bit longer with child 3 in hindsight. I think inductions also get a bad rap because babies who are late are often malpositioned hence not triggering labour so were always likely to need a high intervention birth

I'd make the decisions based on your individual risk and comfort level and remember you have choices all the way through and up until your waters break can easily back out of induction. If pessary doesn't work can simply say 'right I'll go home and come back in a couple of days. Equally you can say actually let's cut to the chase and do a c section. Induction doesn't mean opting out of all control.

@Worrywort98 the consultant was wrong to force you to schedule an induction. You also do not need to attend your induction now scheduled, you can call and say you are not planning to attend. No one can force this on you.

I was induced for other reasons and unfortunately ended up in an EMCS due to lack of progress.

Some considerations (apologies if repeating any PPs):

• Induction can take a long long time especially with a first baby
• when on the hormone drip, contractions can be more.painful and harder to cope with than in spontaneous labour.
• being on the hormone drip increases your risk of PPH due to increased risk of uterine atony
• frequent cervical checks as often done in inductions increase your risk of infection due to introduction of bacteria

Personally for 'post dates' I would wait to go into labour spontaneously until at least 41 weeks, barring any other medical issues
You could look up Dr Sara Wickham for some interesting information about choosing an induction.

@Worrywort98 after my last midwife appointment (last week) it looks like I’m facing the same dilemma. I was discussing birth options with the midwife (I’m nearly 35 weeks) and out of the blue she told me: “they won’t let you go over the due date”. I immediately saw red but I behaved myself and spent the next 30 minutes grilling her. She couldn’t answer any of my questions.
FYI my pregnancy is low risk, it’s not my first child, no diabetes, no high blood pressure, I am healthy, active, BMI 24 at 9 months pregnant. I have never been offered any extra monitoring, never seen a consultant. My only “problem” is that I am 46. I told the midwife in so many words that I was open to following the recent WHO guidelines and likely to agree to be induced after 41+0, but there was no fucking way I would be induced without a reason on my due date.

I am not in the UK and our postnatal care is nonexistent. I won’t be pushing my insides around on a wheelbarrow to make someone happy because they would be able to tick yet another box.

I understand what you're saying and how you feel. This is my first pregnancy/baby so I feel quite anxious and uncertain about what I should do. I now know that it's not illegal to be overdue by more than a week😂, but I suppose I just need to decide whether or not to accept the induction date or phone the hospital and say I'm not coming in for it. I just want to make the right decision and feel so torn

What country are you in if you don't mind me asking?

Just as an added extra; your consultant offers advice and recommendations (some of which you'll absolutely want to follow). They do not decide what happens to your body, any more than if you were being offered any other kind of medical treatment or intervention you didn't want. This isn't always obvious from the way they speak to you ime.

I’ve been induced with all of my 3 children due to medical issues with me.
all my labours were quick, straightforward and drug free.I had a great experience.

I would say though don’t let yourself be pressured into anything you don’t want. If you and you baby are happy and healthy I would consider waiting for a bit longer and see if little one makes an appearance on their own.

I am in Sweden. Our healthcare is regionalised and apparently (only found out from the national birth registry) my region is extremely trigger-happy when it comes to inductions.

In my age group (over 45) there’s a significant risk of stillbirth. This risk is however very low to start with - 1:1000. I had much higher risk of chromosomal abnormalities to start with and wasn’t offered any extra tests. I also had much higher risk of developing GD, high blood pressure and pre-eclampsia due to age alone and I wasn’t even offered low dose aspirin - I imported some myself from abroad (it’s prescription-only in Sweden) and just told the midwife that I was taking it and let her recover from the shock 😅.

This base risk of 1:1000 for me shoots up by a huge amount (100%) after going overdue. Which means that it becomes 2 in 1000, which is still way way lower than other age-related risk my healthcare providers decided to ignore, happily deciding to turn on the concerned mode for the last few days of my pregnancy.

I’ve only had low intervention births so far. Very minor injuries after the first (one stitch) and no injuries after the second. Never experienced birth trauma, was never rushed, never had to look at the clock. My second was a planned home delivery. I am not unreasonable and I will of course agree to an induction if there’s a good reason for it. So far in my particular case there are none, but of course you need to consider your own circumstances.

Just a quick update for anyone who's interested... I phoned the hospital where I plan to have baby and they are fine with me holding off on induction until 10 days past due date. They however want me to have a daily CTG, which is fine.
I'm 40+8 and still no sign of baby appearing. Induction is Sunday and I can see it happening, and honestly at this stage I'm more than happy for them to intervene as I'm getting worried haha

I told the doctors to get out and stop talking to me about induction!! Why get induced if your baby is fine?? Go to 42 weeks, your baby will come they just need time. Listen to the midwives only. One doctor told me one of the reason they push inductions is scheduling.

It's not non negotiable, it is completely your choice!

Hi OP. I found this thread a bit late but wanted to share my experience. I was induced at 38 weeks. In case you do have to go through it I didn't find the induction process itself and the methods bad at all, they were fine. My problem was my little boy (first baby) just didn't want to come out, he was perfectly happy in there! The induction ended in an emergency c-section after 3 long days, classed as a 'failed induction'.

I had the pessary which was fine to have inserted. That broke some of my waters about 12 hours later. But I hadn't dilated and I still had my front waters to go. So I had two rounds of the gel. I think this dilated me by a WHOLE CENTIMETRE 😂So then I went on the drip. Having heard awful things about the drip I asked for an epidural which wasn't scary at all. The drip just didn't shift anything which is very unusual. I was just having no contractions!

He wasn't ready.

So my opinion is - baby comes when it is ready. If there are any abnormalities on the daily ctg then you can always change your mind and have induction/section at the time if things need to be sped up.

Good luck. I would never have an induction ever again simply due to how frustrating and drawn out it all was. Most draining 3 days of my life and it ended in an intervention which I was categorically trying to avoid.

Stick to your guns and remember this is YOUR birth.
If there's no reason to induce then simply don't do it, if that's not what you want.
With my first, I asked why book the induction I don't want it, midwife response 'so I don't lose track of you'. Yes really!!
Baby came at 41+2 which is actually bang on average for a first baby. Modern midwifery seems to have forgotten that.
Inductions can be smooth, can be horrendous and I really wouldn't risk going down that path if there's no real concerns for you or baby.

@Worrywort98 I just read your post again, and I see you are due for induction on Sunday if things don't progress. I wish you all the very best with your birth. You could always keep us updated if you wanted support. If your labour turns out to be a long one I'm sure there would be lots of us who can relate. Big hugs :)

Fingers crossed for you! It’s fine with the daily monitoring. What happened to me with my first - I finally agreed to an induction at 10 days past my due date and I arrived at the hospital with spontaneous labour in full swing at my scheduled appointment. Baby was fine, born 8h later without any interventions.

That was however in a country with a functioning healthcare so I also had daily monitoring and I could feel both reassured and in control.

Good luck 🍀🍀

I’ve had two inductions. Both of them were fine, I just needed a pessary to kick start the process. No drip etc. There wasn’t a cascade of intervention. All the babies were fine one set of twins, one singleton. Labour was relatively quick both times, delivered within 13 hours of pessary being inserted.

Another update..
Currently in hospital, induction started today as reduced movements. Went in with some contractions already, vaginal examination apparently was 1cm.
Tried the prostaglandin pessary at 2.30pm, by around 6pm the contractions were agonising and relentless, like less than 2 mins apart.
Baby's heart rate shot up and stayed up and then i got two shots of a medication to slow down the contractions. Vaginal examination said cervix was still closed. Tools ages for heart rate to regulate. My husband has been amazing
Now that things have stabilised they sent him home and I'm lying in bed feeling very sorry for myself 😭😂 a hand hold would be great. I feel awful

Sorry to hear you’re having a rough time of it OP. I was hyper stimulated by the pessary during my induction and they had to take it out. Like you it hadn’t worked either. Very disappointing.

The next step for me was the balloon which worked - it came out after about 5 hours and I had dilated enough for them to break my waters. Have they said what your next step would be?

Induction is super tough mentally. You’re doing great. Try not to be too upset about them sending your husband home. It’s better for him to get good sleep before the baby is here!

I had an induction last week after an uncomplicated pregnancy.

I went into it very pro having a vaginal birth but, in summary, given the choice again I would opt for a planned c-section.

I was 1-2cm dilated before starting the process but then the process still lasted 5 days, during which time I had had 7 hours sleep. From breaking waters to delivery 18 hours later I was only allowed “drink to thirst” and some toast. So by the time it came to pushing I was exhausted. Needed suction cup and an episiotomy.

Then another sleepless night on the post delivery ward.

By the time I got home I was exhausted, stressed and drained - which isn’t what you need when starting life with a newborn.

So sorry you are having a rough time OP. Inductions are so so difficult mentally and physically! Hope your husband can come back soon.

My induction was awful and I ended up having an EMCS and then hallucinating from the sleep deprivation caused by the ante-natal ward and then the dreadfulness that is the post-natal ward (get out of the post-natal ward ASAP is my tip if your hospital doesn’t have private rooms. You will recover much better at home. If everything is fine with your baby try to get out as close to 24 hours later as you can!)

Remember you can ask for a C-Section at any time. Ask the midwives to be honest about the number of first time mums in your position who need EMCS (it was sky high in my area and I wish I’d known that!).

Otherwise, have you got ear plugs? Or earphones you can listen to music through? It can help a bit to block out the endless ward noise. Hand holding from me and wishing you all the luck in the world.

Do you have names picked out?

Hang in there! During my induction mf baby's heart rate became very unstable too but he was fine. I hope they managed to make you more comfortable. It won't be long now until you meet your little one. Don't be scared of asking for pain relief if you need it, and try to have some snacks if you can bear it! You are doing a great job. Sending lots of positive thoughts x

You have my handhold, I’m thinking about you a lot. Hopefully you can get some rest and something to eat.

How are you getting on @Worrywort98 ?

Hello! Posting from the other side. My DS was born 16/02/24 at 19:45pm all 8.9lbs of him!

I was induced Sat as reduced movements. The pessary caused me to hypercontract and I was having agonising contractions every 2 mins that weren't actually doing anything, cervix was closed and baby's heart rate was high. I was medicated to bring the contractions down, had contractions all night.
Next morning was 5cm dilated and moved to labour ward. Had an oxytocin drip, epidural, waters broken, and fully dilated by 6pm. Things were fine until it came to pushing time, he got a bit stuck and stressed, and next thing I knew, I was having an out of body experience, an episiotomy and forceps situation with a room full of people. My poor husband said it looked absolutely barbaric and the visuals are gonna haunt him for a while 😅😂 we lived to tell the tale although birth and labour did not go at all how I thought it might... Thanks for asking! ❤️

Omg almost the exact scenario as me then! I just wrote above about how my whole experience went 🙈 I went from an uncomplicated pregnancy to a slightly hellish labour and delivery experience
Very slightly jealous of the lucky ones who have unmedicated, natural and positive birth experiences! Fair play ❤️

First of all, huge congratulations! You’ve made it and your DS is with you 💪.
You might be feeling weak but you have been incredibly strong, made it through a really traumatic experience and survived.

Please don’t hesitate to seek help if you need it ❤️. I think you’ve absolutely made the right decision given the circumstances and information you had available so please don’t beat yourself up. I had to make the same decision with my first and I was very lucky that she decided to be born before my induction was scheduled.

It baffles me that medical professionals deem a child high risk and then drag the mum and the child through three days of distress, falling heart rates and medical interventions that create more medical interventions.

Best of luck 🍀🍀🍀