Difficult decision...help please

[Laurans]

Hey ladies, just wondering what you would do in my situation?
What would your thought process/decision be? Or anyone with similar experience???

I'm type 1 diabetic, (well controlled- HBa1c 5.6) 34 weeks and baby boy is on 90th centile! All is well with my health!

So at my appt this morning the OB seemed in favour of planned c section....she says there is a 50% chance I will end up with one anyway as I will otherwise be induced at 38 weeks (due to diabetes)

These are the scenarios as I understand them
1. Induction at 38 weeks..with or without epididural...she thinks 50% chance will end in c section!
Note...I have been doing hypnobabies homestudy course to give me the best chance of avoiding epidural as my birth will already be very medicalised due to diabetes so will be on insulin and dextrose drips aswell as induction! I am trying to avoid the 'cascade of interventions' that comes with epidural!
2. Emergency c section ....not what I want at all as could end up being Under GA and hubby wouldn't be allowed in!
3. planned c section.....not what I want but hubby could be tbere and I would be awake at least!

I want whatever is best for baby OBVIOUSLY! But maybe having a c section may make breastfeeding harder too and it's important I feed baby ASAP as will likely have low sugars due to my diabetes!
I understand I'm classed as high risk but actually I'm controlling diabetes well and baby and I are healthy in other senses....
Another reason I'm not keen on c section is the recovery when I really need to return to Switzerland (where hubby works) ASAP and have no help there!

So would u opt for elective c section or try the induction (with 50%chance of c section and maybe emergency!)
Thanks in advance for taking the time to give me your thoughts!

 

[krissie328]

I had less controlled diabetes and wasn't induced until 39+5. I believe the recommendations changed over a year ago.

With that I had a very successful induction that lasted 10 hours from pitocin starting to giving birth. I found the experience very good. I also had a balloon catheter put in the night before so I was 4 cm the next morning before the induction.

I would personally opt for another induction before a planned c-section. But you must weigh all options and do what's right for you.

 

[krissie328]

Oh and I did have an epidural and had no other interventions. DS was born vaginally with me pushing about 30-45 mins. I cannot remember now. I did have a lot of blood loss but that is because I had a second degree tear they were struggling to sew due to its location.

Like I said I had a really good experience.

 

[mod19]

I can't give advice from the been there done that standpoint, but I will off up a quick opinion (if that's what you're looking for?): it would kill both dh and myself if there were a chance he wouldn't be able to be there for the birth. I'm breastfeeding as well, and would still opt for the planned c section for that reason alone. Now, if you don't feel as strongly a out that as I do, an induction may be your best line of action.

Good luck in whatever you decide.

 

[sippy1989]

The way I see it, a c section seems like a likely or at least probable scenario. If you have been controlling your health very well and there are no other risks to baby I think there is no harm in trying for a vaginal birth. Your biggest fear (from my understanding) is to have a section while under GA but that is used very rarely. Chances are you would be given an epidural like the other c-section scenarios. So my thoughts are there is no harm in trying for a vaginal birth. Just remember our bodies were Designed for this!!

 

[Laurans]

Thanks ladies
Krissie- good to know you had a good experience with the induction and all went well!
Mod19- yes I would also be heartbroken if my hubby couldn't be there !
Sippy- absolutely the sentiment iv been working on with the hypnobabies and all the reading iv done...that we are designed for this etc but today is the first 'anxiety/wobble' iv had over the birth because I realised I am already going against my body by having an induction at 38 weeks!

Thanks again x

 

[luz]

I understand you want a natural birth, that being said. If i were you, i would go in to be induced, but get the epidural! There are so many horror stories about epidurals but i think that a majority of them actually turn out just fine. That way, if you do have to have an emergency c-section, you are already numb, wouldn't have to be put under GA, and your husband could be there, right? Or is it the nature of 'emergency' that makes it so the hospital won't let him in?

 

[atx614]

That's hard!

If it were me, I would give induction a go! I would get he epidural with theiduction, knowing in the back of my mind I may end up having a csection.

With dd I had gestational diabetes and was induced at 37 weeks. It was a great experience! She was out in no time, I tore, but no complications.

 

[Laurans]

Thanks lux and atx, I thought exactly that! That if I had the epidural I would be ready for a c section if needed (thus avoiding an emergency c section situation)
My OB said that if u have elective c section u have a spinal block which is different to a normal epidural. The normal epidural may or may not be enough to get you through a c section it just depends how you respond to it!
Of course the downside of having an epidural is it makes the c section and/or other interventions more likely!

 

[hairftsher]

I think I would schedule so that I would know what's going to happen. I like to plan. Clearly though it's not always that easy. Go with what your gut tells you. There has to be one option that you lean to first, if only a little more favourable.

 

[alexspargo]

If you are planning on having more children I would definitely go for the induction. If you have a c section you are boxing yourself into c sections for future deliveries as well unless you fight really hard for a v bac. Since you doctor is already pushing for a c section a v bac would probably be a real uphill battle. At least with an induction you have a shot at the birth experience you want. I would also look into hiring a doula if you have the funds. That way you have an experienced advocate who can help guide you. It can be scary especially when doctors are making you feel stressed out. A 38 week induction is not typical from what I've read. Maybe you can get a second opinion?

 

[BabyCleo]

My mum was induced with me at 37 weeks due to type 1 diabetes. It ended in a c section as I got really distressed. She already had an epidural, so she was able to stay awake during the section. She told me if she didn't have the epi in they would have had to put her under GA.

Its totally up to you how you want to do it! Me personally I would have to give natural a go first.

 

[dom85]

I had gestational diabetes with my first, I was on insulin, also very well controlled and was induced at 38 weeks. I hated the induction process and mine did end up in a c section however I would still say go for the induction rather than c section and I would also recommend the epidural.

I couldn't have an epidural because of a problem with my back and I know it was my first so I don't know the difference but once the pitocin drip was on the contractions were very very painful and it was a really tough labour. You also won't have a lot of natural pain relief because you're mobility will be restricted by all the drips on you and I don't know if the protocol is the same in the US as it is here but I had to have the monitor strapped round me the entire time as well.

It is pretty rare that they have to give you GA for a c section so if it were me I would still opt for induction, even though I didn't have a great experience of induction I'm still glad I tried and like the fact that i still have some experience of labour even if I didn't get to the pushing stage.

 

[Quartz]

I have had a elective c section and a vbac.

First off with breastfeeding with DD (elcs) and DS (emcs) the only difference DS was latched straight away DD had to wait 30 mins (in this time she was doing skin to skin with DH and tried to latch to him) after that they were the same experience (except DS I knew what I was doing more) both times my milk came in two days later.

C sections under GA are very rare and are for crash c sections not emergency, there should be enough time if you try for induction that they can use a spinal and get it all ready so to speak. There is usually time to do this with emergency c sections (the really quick must get the baby out are called crash as I said).

In terms of recovery from both, the VBAC had a harder 3/4 days at the beginning, still aching a little after 2 weeks and fine after 3. The c section took around 6 weeks to feel 100%. I preferred the VBAC but the elcs was fine but a lot more clinical.

Personally I would want statistics as to the likelihood of success of induction at 38 weeks and how much intervention would be needed (epidural etc) as part of what I loved about my VBAC was that is was drug free. And what the chances were of a c section (particularly given the fact its at 38 weeks) and take it from there

 

[Cattia]

I have quite a number of friends who have had emergency C sections, including one who had a complete placental abruption during labour, and none of them have had to have a GA for a C section. I have just one friend who had to and that was a crash C section due to a blood clotting disorder and very premature labour, so I think if the induction fails there is a very good chance you would get a C section without a general. I think if it was me, I would go for the induction, with the option of the epidural there if it gets too much. In the end though, it's whatever makes you feel the most relaxed, comfortable and in control.

 

[Laurans]

So glad I asked you ladies!
Thanks so much for all ur opinions/ advice
I'm thinking stick with trying induction! It's been reassuring that a few of you ladies have had/ known people have emergency c sections and still not needed GA's. Also it's a definite consideration about any future births! Even less likely to get a vbac with my diabetes etc

Feeling much more positive about at least trying induction! Who knows maybe baby boy will come just before induction! Fingers crossed!

Thanks again ladies, wishing u all happy and healthy pregnancies/births!

 

[ssjad]

I'm curious about why there's a 50% chance of an emergency caesarian?
My last two babies were induced at 37 and 38 weeks due to gestational diabetes. No caesarian needed, or even discussed.

 

[babifever]

Like the above comment, I've never heard of this. Sounds strange to me. I'm diabetic type 2 and my doctor said we are going with things naturally, of course they would induce at 41-42. But just to assume a section, thats crazy to me.

 

[mwah_xx]

I think a lot of doctors want you to be prepared for a section with induction as there is often a chance, especially early rathre than overdue inductions, that your body isn't ready and the baby will be in distress and need to come quicker. Plus infuctions are hard on the baby!!!

I had an induction with my first and that ended in emcs my birth story

He was born in 7 minutes from them deciding he needed a c SeC. I'm not going to lie I was close to needing a GA but that was extreme circumstances and I didn't and my husband was with me throughout.

This time I thought I wouldn't want induction (and I don't think I do) I also don't want a c sec Again unless I have to. So I'm holding out for natural labour. Though my Dr said I could have induction at lower levels Even having had a c. SeC.

Apologies on the typing its my stupid phone!

 

[MrsKChicago]

Another thing to keep in mind is that you can get checked to find out whether you're favorable for induction. If you're starting to dilate and efface, you're much more likely to have a successful induction than if everything is closed up tight. A couple checks leading up to your potential induction date would give you a better idea of your specific odds of avoiding a section - you may find that your decision is easier if you're at either extreme. You could also talk to your doctor about what you can do to encourage cervical ripening - red raspberry leaf tea, evening primrose oil, etc. I wouldn't start anything like that without talking to the doctor, but they can be helpful in getting your body ready.