Elective c-section or a natural birth with induction

[feelingsuperlucky]

I've just had my 20 week scan and everything is looking good and baby looks healthy, with this being an IVF pregnancy the consultant has given me the option of a elective c-section at around 39 weeks or a natural birth with induction if at around 39+5 weeks if baby obviously hasn't already arrived. Please can anyone share their opinion on what they would do? I know it's personal preference and I'll do whatever is safest for baby but interested to know other peoples thoughts x

cant say what to do - but i had an induction that went on days then resulted in an emergency c section!!

Secind time i booked an elective and it was an amazing exoerience - i wish i just went for elective first time!

I've only got my daughter who was also through IVF. I was booked to be induced at 39 weeks, was in labour for 24 hours and ended up with an emergency c section anyway... so, I wish I'd have gone straight for the c-section! Good luck whatever you decide! Xx

With the caveat that it was my second birth, my induction went totally smoothly. Born in 11hrs from the first drug (internal gel), no more painful than my first, no more interventions after the initial gel.

ETA - this was at 37 weeks.

DS1 was an induction at 35 weeks
DS2 was a planned C-section due to transverse lie

I'd take the induction every time

Inductions can be pretty awful. If you’re before 40 weeks and your body isn’t ready you’ll likely need a drip and those things are horrendous. Could very well end in c section anyway. If you have an induction on a drip I would make sure you get an epidural

I know someone very well who does birthing classes and she says a lot of inductions end up having a c section anyway.

Yes this! Mine was induction on a drip, super painful. Ended up having epidural after about 18 hours. Had spinal tap during the procedure, ended up back in hospital after being released for a blood patch because of the severe headache from leaking spinal fluid. Got released from that and then ended up back in hospital after catching covid..
All in all, it was a disaster.... and here I am, 12 weeks pregnant, hoping to go through it all again! (Maybe not exactly the same but....) we must be crazy!

Agree about getting an epidural alongside the drip.

I was induced and had the above, didn't need an emergency section though it was close and was a knackering 3 day labour.

Second baby was a planned caesarian as he was breech, I found it a walk in the park compared with first, but experiences vary.

My induction ended in an emcs. Its was lso horrible.

Is natural labour not possible with ivf?

Can't give advice because so much depends on so many things, but I had an 11 days overdue 10lbs ivf baby and had an induction, then didn't get moved to labour ward as was full (and was the consultant strikes), two days of antenatal ward later finally went over and waters broke, eight hours labour with two failed epidurals (back to back stuck baby) and then an emergency section as he was in distress. The contractions on the drip were agony and epidural not working (just went down one leg) was insult to injury 😅 It did affect mine and my husbands mental well being after, plus the hormones post partum, but you do heal and becomes a memory.

It was just a perfect storm of bad luck for me and in hindsight his size and position meant he'd really never have been pushed out, his head wasn't on my cervix at all, and I should have just had an elective but you don't know til you've been through it all. I wish they'd not left me so long after due date as most NHS trusts do as yours said for ivf pregnancies. They also never listened to me when I voiced worry about his size on scans and when I'd contracted with the induction pessary and knew he was back to back, again didn't do a positional scan or anything, just said oh it's fine he will move, bit he can't he was fairly wedged in there. Advocate for yourself all the way with whatever you choose and congratulations on your pregnancy xx

Read Sara Wickham's book about induction. Do you have other risk factors apart from it being an IVF pregnancy? I have friends who have had naturally gone into labour / vaginal delivery, with IVF pregnancy. Do consider that breastfeeding can be harder to establish following an elective C-Section, if that's important to you.

Thank you all for your comments! They really are helpful! I'm researching my options too I just thought it's good to hear other peoples experiences! I still can't believe I'm actually pregnant so I can't imagine even giving birth yet 😂

@Solost92 yes if baby comes early then a natural birth would be possible (I believe anyway!) but they won't let me go over my due date hence why they've spoke to me today about elective section xx

I'd choose an elective C-section any day (from
someone who had a failed induction resulting in an emergency C-section, then 2nd time round had a planned C-section).

we can't tell you what to do though. What might help you decide is asking your hospital the following question:

"In this hospital, when it comes to inductions for first time mums , how many result in a spontaneous vaginal birth, how many result in an intercepted birth (eg forceps, suction) and how many result in emergency C-section." Their answers might help you decide.

you could go one step further, and ask what the results are for first time mums at your hospital who are your age / in your age group.

jj

None of them will result in spontaneous vaginal births. The definition of that would be a labour starting spontaneously ie not induced.

It's hard because literally everyone is different and everyone's body is different.

Most women go into labour naturally and deliver without the need for intervention.

But if you were to have an intervention, you need to weigh up the pros and cons.

Pros of elective - very controlled, no pain, you can choose the music you want etc. Scarring tends to be manageable as they can take their time on the surgery. BUT the cons are months of recovery and reduced mobility, and a longer hospital stay.

Pros of induction - can be fine / super quick. If it all works, you likely can walk out after, the possibility of few or no injuries (though of course with vaginal you can tear). Cons are a higher rate of intervention (instrumental OR needing an emergency section in the end anyway).

Only you can make that choice.

Personally having had one induction which ended in an emergency section and another in an instrumental delivery I'd still go induction as the recovery even from an instrumental delivery was so much easier and better than recovery from section. But others wouldn't agree and found section recovery fine.

If I had a crystal ball, I’d have chosen an ELCS over an induction without question! However, I had the induction which took six days, failed and ended in an emergency section.

If I’m ever mad enough to have another child, it’ll be via ELCS. I’d have loved to experience a vaginal birth, but I am so utterly traumatised by the whole experience that I don’t think I would even want to attempt it again.

You know what I meant - ended up in a birth which didn't need any interception. Off you go.

Dc1: induction, long labour, EMCS
Dc2: induction (vbac), forceps delivery and lots of injuries
Dc3: Elective C section thank you very much!

I liked the certainty of knowing that the baby would be out by x time instead of having cervical checks every few hours only to be told I was only 4cm after 13 hours of agony.

For me, labour pain is on another level of shockingly excruciating and (seemingly) never ending and the kind of pain where I didn't know if I would survive (and was kind of hoping I wouldn't.) A kind of pain that made me absolutely lose my mind (in spite of all the hypnobirthing!). It was a kind of nightmare, horror movie style pain (for me).

C section: I didn't feel anything until the anesthetic all wore off, and even then it was just like I had had a big operation and needed to keep on top of my paracetamol and take it easy. It felt like a normal amount of pain. There was zero agony.

HOWEVER...there was a part of me that really wanted to try for a vaginal birth and experience everything, and I am glad that I did, but at the time I was like a wild wounded animal being tortured AND ended up having long recoveries on top of it!

Could you do a trial of labour and switch to the C section if you change your mind?

This. I had induction on a drip, was absolutely horrendous, but thankfully she was born within 2 hours of being on it. Took 3 days of being in hospital to get to that stage though.
Second induction I was in hospital for 5 days before going on the drip and ended with emergency c section.
I'd just take the c-section.

As many PP have already said , many inductions end in emergency c-section anyway (including my own). So personally I would go for elective c-section.

Would you consider a sweep prior to trying induction?
I had two sweeps (at 40w and 40+2), DD arrived at 40+3. Different situation but they wanted to induce ar 41w on the dot if I wasn't progressing by then, but I was keen to avoid medicated induction if possible. Thankfully the sweeps seemed to be effective for me. They were a bit uncomfortable but manageable with breathing exercises.
They also offered a non-medicated induction using rods prior to progressing to medicated induction if needed. I'm not sure if it would be an option to try sweeps and a non-medicated induction and then opt directly for a C-section if they didn't work though.

Elective! I’ve done both.

Equally. You don’t have to have either, you can choose natural if you want. But I would defo have elective if I had to do it over again😆

Are you me? Seriously! Every single thing in your post I could have written… except the third child. Right down to hypnobirthing!!

1st birth - 3-day labour, oxytocin drip (epidural before this was started as heard it was a must) fetal distress, forceps delivery, 2nd degree tears and 1.5L PPH. Shat myself in Lidl a week later and probably didn’t feel human until 3 months after.

2nd birth - Elective c-section at 39 weeks. 800ml PPH. Easy recovery and doing the school run a week later. Back at the gym 3 months after, feeling my best self.

Just to add another anecdote into the mix, no guarantees but I would always recommend elective c-section.

I made the decision not to allow an induction if I went overdue, which I knew they would push for. I therefore planned a c section in for 10 days after due date just in case. In the end I went into labour after a sweep on my due date. waters broke without contractions then I didn't progress and they would not let me wait it out, so was offered c section vs drip induction again. I chose c section due to a lot of anecdotal drip inductions ending in forceps or emergency c section. and although it was not "planned" it was very calm and not at all rushed. In the end my baby was back to back and his head was twisted so they said I would have likely needed intervention, I'm glad I chose how I did. I was out of hospital after 2 nights (would have been 1 but I picked up infection due to waters breaking) and my recovery took a few weeks, no complications.