Requesting a cesarean instead of induction

inkie

I'm a MW and would go for an induction rather than a LSCS. In fact I did. I had a shoulder dystocia with my first delivery and when coming up to term in mt second pregancy, I had a word with my colleague, the consultant, who asked what I wanted to do - I went for the Induction, and it was fine.

clairec79

You can ask but they can say no.

You can always refuse induction though, I know one woman who wanted a section and refused induction, took a stand off battle with the consultant over 3 days with her refusing induction and him refusing to section her (I think he was hoping she'd labour by herself in the mean time) - he did gave in the end though, but I think she was 15 days over in the end

RubySewSew

Hi,

I'm an antenatal teacher (diploma qualified). I work with new parents, train midwives and help write and review clinical guidelines.

You need more information and more time in order to make an informed decision and it is your midwife's responsibility to facilitate this. The way I see it you currently have 3 options: induction, caesarean or awaiting onset of spontaneous labour. Unless you have previously had a caesarean birth in which case induction should be dismissed as there is a significant risk of scar rupture.

Caesarean is a relatively safe operation although it is not risk free. Risks tend not to be to the baby but to the mother and to future pregnancies/fertility. However, with a planned (elective) caesarean the baby is more likely to need help with breathing at birth and/or special care. You also shouldn't underestimate the recovery time particularly with 2 other children. Go to https://www.caesarean.org.uk for really useful information and birth plans.

Awaiting spontaneous onset of labour is a realistic option if both you and your baby are well. You will go into spontaneous labour at some point. The evidence around increased risk to post dates babies is very poor and certainly not sufficient to recommend a national policy of induction of labour. The normal term of pregnancy is anywhere between 37 and 42 weeks. Go to https://www.nice.org and look up the induction of labour guideline. You want the Understanding NICE Guidance version.

A little known fact is that your baby needs 24 hours before labour to lay down glycogen stores to keep them going through labour. They need a picnic for the journey!
If you need more support in making a decision please ask to speak to a Supervisor of Midwives. She (usually a she!) will arrange a convenient time to sit down with you and go through all your concerns, provide you with the relevant information, help you understand it, support your decision, and communicate your wishes to the rest of the team. You could also contact your local NCT or AIMS or Association of Radical Midwives for more information or support.

A decision making tool I use with clients is use your BRAIN - Benefits, Repercussions, Alternatives, Instinct and do Nothing. I hope this helps. Remember, trust your body and trust your baby, they are perfectly designed and know exactly what to do!

tiamai_d

You don't 'have' to be induced if you go over due. There are many women who have refused an induction once they were overdue. True you do have to then go in each day for monitoring and it is a highly emotive subject. So I'm not wanting a debate, just mentioning the fact that it is an option. Given that all my 3 were brought out early I can't speak from experience.

You can also speak to your MW about your induction and why it has left you feeling uneasy about having another one. Is there a different process you could go for?

Requesting a C section is easy, convincing them that it is a better option for you than an induction is the hard part especially if there is no medical need. But all you do is ask your MW who will then refer you to speak to your consultant.

I had an induction with DS1 at 35 weeks which went amazingly well. And an em c section with DS2 which was horrid. And then an elective (under advice) with DD which wasn't as bad as I thought it would be. Out of them all, the iduction was better for me long term. The first couple weeks after the induction were not nice, I had a very bad UTI that hadn't been diagnosed and some labia tearing. The elective I was up and about next day, driving after only 2 weeks and physically very well but long term, 1 year on and I'm still numb from the belly button down. Whereas with the induction, 6 weeks on and I was fully recovered with nothing to say I had had a baby (except the actual baby and a few stretch marks).

ETA, RubySewSew, an induction is not ruled out after a previous c section. I was to have an induction with DD at 38 weeks my hospital are very big on VBAC's and will do an induction with close observation (which I would have been getting anyway). I only ended up with an elective because there was a question over whether I had had a partial abruption and she had to come out a week earlier than planned.

gorgeous_gwen

A few points in answer to people's posts.

I haven't had a c/s before, one 'normal' birth and one induction. I went over my due date by over two weeks and had refused induction before I then accepted it. I was worried about the fact conditions didn't seem favourable, I felt like they were doing it 'just because'.

I was given gel (or pessaries, can't remember which now) and I do remember them saying they wouldn't (think of) using the oxytocin drip (though can't remember why.) I was left and monitored for 18 hours before they decided to break my waters.

So I didn't go into spontaneous labour. I should say I know of experiences from friends who have also not spontaneously laboured or even laboured through induction.

I don't have a consultant as such as I've been under midwife care, the only time I've seen a consultant was after being scanned.

So if it were what I decided I wanted, I would as tiamai _d said, speak to my midwife who would then I assume refer me to a consultant? At what point would I need to do this, would it be when the midwife suggested a post dates appointment or just when I decided, if this was sooner?

Also interested in recovery times from a c/s, as people have already discussed, as I do have two children, DS is older and at primary school but my youngest is still my baby (not quite two yet) so that is a factor. All in all with my induction I spent two days in hospital, one night was after baby was born at the hospital's request. What is the minimum for a c/s, I gather three nights?

moomoomama27

Personally I wouldn't opt for a c-section, unless there was no other option. It is MAJOR surgery, the effects and healing can take months and it can hamper alot of things in the early weeks.

I had a c-section after 2 vaginal births. It was blooming horrific, and my recovery time lasted 6 months. I had 19 months between my two youngest, and pram pushing (double) was a nightmare. My husband only had 4 weeks off, and I still was not fully recovered. I ended up back in hospital as my scar reopened. I found looking after my toddler almost impossible, and it effected me being able to BF, as the drugs I had following the section dried up my milk

I had to stay in a week, but that was because I needed a transfusion! The minimum is normally 3-4 days.

I would consider the fact that the need for transfusion is higher.
Mobility is a big problem, moreso if you have a small child to look after too.
Complications with the baby being born through c-section.

pinkshoes

A friend of mine went 2 weeks over due and was induced and had her waters broken (which she wasn't overly keen on!). At some point during her attempt at natural birth (after induction obviously), the baby's heart beat became erratic, so she had to have an emergency C Section.

She said the induction was a walk in the park sort of experience compared to a C section, so would tell you to go with the natural birth/induction if possible, and save the C section for a very last resort! It's been 6 weeks now and she's still sore, and has only just been given the ok to drive again. She's also very independent, so is getting frustrated that she's still too sore to do basic things like vacuuming, and finds bathing the baby very uncomfortable.

I'm due in less than 4 weeks, so from her experience, a C section is certainly going to be a very last option for me if all else fails!

got-it-spend-it

I had a c-section after a failed induction at 15 days overdue, and while it was a million miles away from the natural birth I had planned, it wasn't that bad either.

I guess I was lucky that I am healthy otherwise, I healed quickly and had no problems breast feeding. I was out of the house and wandering round the shops with baby less than a week after, and driving four weeks after. I know I was lucky that I had a straight forward recovery and I was also determined to enjoy the first few weeks of my baby.

It is major surgery- I was told that the trauma is the same as that of a hysterectomy and after that you are told not to lit so much as a duster for six weeks, whereas after a c-section you have a newborn to look after.

I stayed in hospital two nights after mine, which is the minimum I think, but as I say it was all very straight forward for me and the other two ladies on my ward who had sections the same day as me planned to stay in another two nights as they were nowhere near as active as me so early (which I put down to attitude, but I may be being harsh).

I think you will find they are very reluctant to give you an elective, particularly as you have a young child at home already, but as you say at the moment it is all hypothetical anyway.

FWIW I will try for a VBAC next time as I do still feel that is the less traumatic option for Mum and baby, and I think I would also refuse induction next time unless there is a good reason for it as I do wonder if I just bake babies for that bit longer.

nottslass_2

Also interested in recovery times from a c/s, as people have already discussed, as I do have two children, DS is older and at primary school but my youngest is still my baby (not quite two yet) so that is a factor. All in all with my induction I spent two days in hospital, one night was after baby was born at the hospital's request. What is the minimum for a c/s, I gather three nights?

I spent 2 nights in hospital after my section. You can't drive for 6 weeks afterwoods or lift anything heavier than your baby.

I found that I couldn't [STRIKE]hobble[/STRIKE] walk much further than the car and half way round tesco for the first 2 weeks,

I really took things easy and my lovely OH did the night feeds to help me recover afterwards so I suppose it depends on how much help you have.

I can remember saying soon after my C section that I couldn't understand why anyone would ever "choose" to have a section.

C sections can obviously be the best thing if mum has medical complications and it is obviously a life savor for babies. I know being
induced isn't a particularly brilliant experience,it can feel invasive and the process can take a good couple of days, but is that reason enough to put yourself and baby through the risk of major surgery ?

tiamai_d

You do have a named consultant even if you are under MW led care

In my area, a request is procesed at 36 weeks, before 36 weeks your mw will just talk it over with you but not 'do' anything. At 36 weeks or after, you will be sent to speak to your consultant or if they have one, a MW trained in C section advice.

3 days after a C section, you can be stroppy and get home earlier but with two children at home they may be more inclined to put pressure on you to stay in longher knowing fine well you will go home and start doing too much.

It is hard after a C section, I was in for just over a week with DD (she was in SCBU not related to the section) and I made a very big effort to not do anything once I got home. Doesn't work. You do end up running about. The easy warning that you get is pain or your lochia will get heavier, the worst that can happen is that your wound can re open which will result in you possibly being re admitted and then the recovery is much worse. After the emergency one, it was 6 weeks before I was anywhere near healed. And a good year before I could hoover without pain, but there was a lot of stuff going on with that one.

If the recovery period afterward is a big issue for you, then a C section is not going to be for you. It will have a large impact on your daily life so you should consider this. I did revover amazingly quickly after my DD but I do know that I am in the minority in that sence.

An example is going out. The baby in the car seat will probably make you ache when you carry it. So you will leave the car seat in the car. That means you have to get the baby ready and carry him/her to the car then go get yourother two in the car. Pushing the pram may be painful if going up or down a hill or going over rough terrain. Walking does make you get sore after a wee while. You will have to plan your pain releif (I knew I'd be sore at night after being a mum all day so planned to take one of the stronger painkillers after dinner). Hoovering and things will ahve to be left to your OH. and it does take upto 6 months for little things like that to be completely pain free (yes you can do it but it may niggle or you may hurt later). How often does your youngest need carrying about? Carrying him upstairs to bed will be hard.

I never found that the C section affected my brest feeding ability. I had to use pillows to make it comfier but it had no effect on my milk supply.

Personally if I were you I would first speak to them about an induction using different methods than the last one.