natural delivery following induction

[moomin_troll]

Where did you get that info?

Tina sent me a link. ile find it and post it on here

Sorry chick I mean the pp! You posted while I was faffing about!

i do that all the time hahaha

 

[Mervs Mum]

I've found this study that concluded 'Elective induction of labor was not associated with lower risk of perinatal mortality compared to expectant management'

https://www.ncbi.nlm.nih.gov/pubmed/19140042

This one seems to conclude (as the other one) there is a lower risk of meconium and CS with induction but no improvement on outcomes....youd expect more instances of meconium with expectant management as you're dealing with well cooked babies with mature bowels so that doesn't surprise me.....CS doesn't massively either if you can also assume bigger babies after 41/42 weeks.....it would be interesting to see how many of the expectantly managed labours were subsiquesntly augmented....that would be relevant to the CS element.....interesting stuff but far too late on a Sunday for me to be reading it!

https://www.annals.org/content/151/4/252.full

 

[Bumpontherun]

I've found this study that concluded 'Elective induction of labor was not associated with lower risk of perinatal mortality compared to expectant management'

https://www.ncbi.nlm.nih.gov/pubmed/19140042

This one seems to conclude (as the other one) there is a lower risk of meconium and CS with induction but no improvement on outcomes....youd expect more instances of meconium with expectant management as you're dealing with well cooked babies with mature bowels so that doesn't surprise me.....CS doesn't massively either if you can also assume bigger babies after 41/42 weeks.....it would be interesting to see how many of the expectantly managed labours were subsiquesntly augmented....that would be relevant to the CS element.....interesting stuff but far too late on a Sunday for me to be reading it!


https://www.annals.org/content/151/4/252.full

Thanks Mervs mum!

The data I looked at was from the meta analysis done for the NICE guidlines which concluded that there was a slightly higher fetal mortality rate in the expectant managment group (but still very very very low). They also concluded that there was a higher rate of meconium aspiration syndrome as your study says too -this does worry me (I assume that the babies would have been matched by gestation so this kind of takes out the overcooked bias plus just because meconium is passed doesn't mean that the baby will aspirate it) I would hate for my baby to end up in NICU/SCBU and for me to feel that this was because of a choice I had made but I do realise that these complications are still very rare.

NICE also said that there was no significant variation in C-section rate between the two groups which is reassuring as this is the outcome I most want to avoid.

Whatever I read there is still this part of me that just says I don't want to be induced - it just doesn't feel right.

I'm still not sure what I'm going to say at my appointment tomorrow. I suspect they will want to book an induction slot for the end of the week. I'm considering being bolshy and asking to speak to a consultant/reg about local failure rates/conversion to c-section etc before I consent to one.

It's so difficult as I am also in the horrible position of basically camping out in a borrowed flat in Edinburgh waiting for this baby to come as there is no facility to give birth on the island where we live. We came away at 38 weeks so me, hubby and our 20 month old are crammed into a 1 bed flat with our lives on hold and hubby is desperate to get back to work (and therefore I suspect quite keen for me to grab an induction with both hands).

 

[254]

It's a really tough situation to be in... I know a lot of how you're feeling as I was there exactly 18 months ago.

You have to follow your instincts... what's right for one person isn't right for another.

I also did a lot of reading of the research and talked to other people who'd turned down induction or been induced. Although some research said there wasn't a difference in CS rates, I know so many people who've had traumatic induced labours... a far higher proportion that have had traumatic spontaneous labours. I knew and know that's not remotely close to a scientific study, but it definitely added to the arguments I found against dates-based induction. I just couldn't find any indesputable evidence to show for sure that it's better to induce before 42 weeks... the studies that I found where fetal outcomes weren't as good after 42 weeks weren't remotely up to date. The consultant I saw concurred with this... she said many of the stats on long pregnancies leading to stillbirth were from a time when fewer serious medical issues were picked up at 20 week scans, so conditions remained undetected that ultimately led to longer than average pregnancies and stillbirth... but these were included in the stats for post-dates stillbirth, even though the long pregnancy wasn't the causal factor. Likewise, I didn't find studies clearly saying it was definitely detrimental to induce before 42 weeks... so I felt I had to follow my instincts, which told me to wait for labour to start naturally, as I don't believe in medical intervention without clear medical necessity.

Sorry, it might sound like I'm trying to 'persuade' you, but I'm really not... I just wanted to add in a different perspective and share my experiences. You have to do what feels right for you.

I turned down induction at 40+12 (after a lengthy discussion with a consultant who went through the risks and benefits of induction v expectant management with me and basically told me at the end of our conversation that I was doing the right thing and my baby was 'probably just a 42 weeker), was monitored at 40+13 (all fine!) and went into labour just past midnight at 40+15. My daughter was born at home in the birthing pool at 40+17. She was 7lb 8oz and came at just the right time for her after a tiring but amazing 53 hour labour (3.5ish hours established, teeny 10 mins second stage).

The thing is, you need to feel comfortable with your decision... if you feel you want to go for an induction, then that's the right thing for you. What makes me sad is when people are induced because they don't realise it's a choice... you clearly know that and are balancing up all the information. That's the most important thing.

Good luck and I hope that whichever route you choose, everything goes smoothly.

 

[Brookey]

i was induced and got to 9cm without pain relief at all. then just had gas and air for the last three hours whilst i pushed.xxx