Early induction because of previous fast birth

Khannie

Anyone been through this?

We've been told that they want us to come in for induction at 38 weeks because our last came quick enough that I had to deliver her myself at home (unplanned).

Now on one hand we're conscious that it's good to have all the medical help possible in case something goes wrong (specifically we're concerned with the possibility of haemorrhage). On the other hand doing the last one myself at home was actually grand. I mean it wasn't like having a cup of tea or whatever, but I'd be perfectly happy to go through it again. Midwife assured me that haemorrhage, while unlikely, is the biggest worry because it's serious business if one happens.

We also very very much want to avoid a section. We have 3 natural births and 3 kids that need looking after. A section would make looking after 4 (one of which is a newborn) incredibly difficult and induction at 38 weeks brings increased risk of a section (they were up front about this).

So yeah....anyone been in this position before? What did you do? Anyone any other thoughts? I'm all ears.

pwurple

I would ask them what the chances of section are with induction for you.

It might be tiny.

missis aggie

I'm sorry but this is the most ridiculous theory ever. Now I'm not a doctor but as far as I reserched induction should be used in emergency situations only ( where there is a risk to a baby or mothers life). Trying to bring a healthy baby to the world 2 weeks early only because of previous fast delivery - I mean did they explain why except hemorrhage ( it can happen in every labour)
I had fast home birth ( planned)- 3 hrs and could never imagine that with my next baby I would have to be induced.

January

I'm not sure I'd be biting at the 38 week point. If they did a Bishops score and the score indicated induction would go well - more info here - http://en.wikipedia.org/wiki/Bishop_score , I'd be more inclined to discuss it but not until closer to due date.

Was the last born early, was she late? (I remember the birth story super midwife!)

I've no experience, my last birth went from 3-10 centimetres in less than 20 mins and she was born not long after but I was already in hospital and it took about 4 hours to get to the 3cm stage anyway.

Is your wife going to Holles St again? Would there be any chance of going to a closer hospital?

pwurple

Was thinking more about this. I would have about a million questions for the consultant.

What method of induction do they mean? A sweep, breaking waters? I doubt they want to use oxytocin, as that speeds up slow labours.

+1 on what january said as well about the previous births... Were the others early?

haemorrhage is very serious obviously, but is it a higher risk in this case for some reason? History, position of placenta?

Ps, i think the new term for people who give birth before the midwife gets there is FreeBirthing.

Drdoc

This is actually quite a common way to deal with previous fast labours. 38 weeks may have been picked if your previous were born at 39 or so? If you went to 40 weeks before, I'd be more inclined to wait til 39 for induction.

As January said, how successful induction is depends on bishops score. Having said that, I had an induction myself for post dates and managed a vaginal delivery despite a bishops score of 0-1!

The reason haemorrhage is a concern here is that the more babies you have, the less good your uterus is at shrinking back down after the birth. The uterus not shrinking after birth is the main cause of post partum haemorrhage which can unfortunately be extremely severe and rapid. If it happens in the hospital, you're given drugs to stop it, but obviously this isn't available at home (without a midwife!)

It's a tough decision op. my own cousin went for an induction on her 3rd for the same reason and ended up having to get the full induction with oxytocin and all and thus it was the slowest labour of her 3. No section though!

Good luck

Moonbeam

How Quick?
I have had 2 very fast and naturally and as a result have considered a home birth.
As soon as I feel the 1st pain I needed to go to hospital on the last and luckily we made it:)
I would seriously hate to be induced though.
Talk to you midwife or consultant and see what they thing.

Khannie

Thanks for the replies everyone. I'll go through a few of the points / questions.

January wrote: »

I'm not sure I'd be biting at the 38 week point. If they did a Bishops score and the score indicated induction would go well - more info here - http://en.wikipedia.org/wiki/Bishop_score , I'd be more inclined to discuss it but not until closer to due date.

Wasn't aware of that. I'll read up on it. Thanks.

January wrote: »

Was the last born early, was she late? (I remember the birth story super midwife!)

Thanks. Last was a week early iirc. One before that was 2 weeks over (she went into labour on the day we were due to have waters broken / be induced). The one before that was bang on.

January wrote: »

Is your wife going to Holles St again? Would there be any chance of going to a closer hospital?

Rotunda. Drogheda is *slightly* closer, but only slightly and the difference isn't enough to change for.

Moonbeam wrote: »

How Quick?

An hour from first pain to delivery. :eek:

pwurple wrote: »

I would ask them what the chances of section are with induction for you.

It might be tiny.

We did ask. They didn't know.

Drdoc wrote: »

The reason haemorrhage is a concern here is that the more babies you have, the less good your uterus is at shrinking back down after the birth. The uterus not shrinking after birth is the main cause of post partum haemorrhage which can unfortunately be extremely severe and rapid. If it happens in the hospital, you're given drugs to stop it, but obviously this isn't available at home (without a midwife!)

That's the reason they gave us alright. We've had a few miscarriages as well and the midwife wasn't sure off the top of her head whether this would affect the risk further.

Drdoc wrote: »

It's a tough decision op. my own cousin went for an induction on her 3rd for the same reason and ended up having to get the full induction with oxytocin and all and thus it was the slowest labour of her 3. No section though!

That's a good reference point to have, thanks.

Ginny

Just for reference I was induced the day before my due date in the Rotunda. First gel at 6pm, next at 9am the next day and another at 6pm. On the third day they broke my waters at 7:30am, on drip by 9:45am. I had the full ramp up of the drip up until 3:30pm, fully dilated at 5:30pm, pushing at 6:55pm and had the baby at 7:10pm.
So it wasn't that fast at all. Could they admit her and keep her in for monitoring instead of just induction?

liliq

A fast labour is a terrible reason for induction.
That is against all best practices.
The main reason for pp hemorrhage in hospital is a managed fourth stage of delivery. After this I'm not sure what the main cause is.
If your pregnancy has not been problematic, there is no reason for an induction.
Induction with typically result in an emergency cesarean 1/3 times.
Induction before 39 weeks is now advised against, although obviously this best practice isn't being taken on board by all units.

LegacyUser

Hi OP,

I'm speaking from experience working in a maternity hospital, and I know if you've had a normal pregnancy and all your previous labours have been problem free (apart from the last one being so quick) and no haemorrhage before, there is no medical indication for an induction at 38 weeks and as previous posters have pointed out, it's against best practice and evidence.

Every labour is different and although there is a higher chance of having another quick labour this time, it could also be longer this time around.

I would say discuss the Bishop's score with the doctor who recommended induction and then go from there, obviously the better the score the better chance of having a normal delivery.

In terms of your worries about haemorrhage, your risk does increase with the more children you have, however induction itself also increases the risk, particularly if they use syntocinon for a long period of time.

Lots of things to weigh up OP, hope everything goes well whichever you both choose!

Ginny

Actually I should have added I was told twice I was going to end up with a section, they actually went off to prep the theatre before I was checked the last time for dilation. I'd do anything I could not to be induced, especially after 3 successful natural deliveries.

Synyster Shadow

I had an hour and 40 mins first labour and my doctor said they may induce me second time round and I out straight said no. If I can go natural second time that's what I'm doing. I didn't have stitches first time round the only problem was I couldn't deliver the placenta and I'd to be knocked out.

It's up to you but you can say no

Moonbeam

my 2nd and 3rd labour were extremely quick,I was in labour for 33 and 35 minutes roughly and from the 1st pain it was about an hour.
I was told if there was no one around and if I have more kids to just immediately ring an ambulance.

javagal

Can't understand why they'd want to if you had a healthy pregnancy and and a healthy labour.

Can being induced stop the risk of pph? I'm asking in a selfish reason tbh.
I was induced when I was two weeks overdue on my first baby last year. I had a very serious haemorrhage and ended up in icu for 2 days, I can't see how them bringing me in any earlier would of stopped that from happening.

Khannie

Thanks everyone. This thread has helped us with a decision. We're going to politely (but firmly) decline a week 38 induction and take it from there. I'll report back what the outcome of that is. We have our big scan in a couple of weeks.

January

Congrats btw! Hopefully you don't have to deliver this one alone

Khannie

January wrote: »

Congrats btw! Hopefully you don't have to deliver this one alone

Hehe. Wouldn't bother me actually, believe it or not. I quite enjoyed it the last time.

January

TCD have 10 places for mature students for midwifery

Das Kitty

Shur you're an expert now.

LoopyLolly88

Khannie wrote: »

Anyone been through this?

We've been told that they want us to come in for induction at 38 weeks because our last came quick enough that I had to deliver her myself at home (unplanned).

Now on one hand we're conscious that it's good to have all the medical help possible in case something goes wrong (specifically we're concerned with the possibility of haemorrhage). On the other hand doing the last one myself at home was actually grand. I mean it wasn't like having a cup of tea or whatever, but I'd be perfectly happy to go through it again. Midwife assured me that haemorrhage, while unlikely, is the biggest worry because it's serious business if one happens.

We also very very much want to avoid a section. We have 3 natural births and 3 kids that need looking after. A section would make looking after 4 (one of which is a newborn) incredibly difficult and induction at 38 weeks brings increased risk of a section (they were up front about this).

So yeah....anyone been in this position before? What did you do? Anyone any other thoughts? I'm all ears.

I had my 3rd 5 weeks ago and i was offered to be induced on my due date because of previous fast labours they were worried i wouldnt make it to the hospital on time. I decided against it & said id let him come himself. In the end i went 11 days over and had to be induced anyway lol everything went fine was very quick just had my waters broken and then onto the drip.

LoopyLolly88

Also just to add i started myself on my first & second and being induced with my 3rd was alot more painfull than my other two. If i have another ill be trying everything to avoid been induced lol

Khannie

javagal wrote: »

Can being induced stop the risk of pph?

My wife just pointed out that I didn't answer this.

The answer is no, but being in hospital would mean you have access to doctors and / or blood transfusions.