# How many of you were induced and it ended up in c-section?



## Babysaurus (Apr 20, 2012)

As the title says really. 

I was told that, at 38 weeks, there was a "60 to 70% chance of ending up needing a section" at my obs appt the other week and am now considering the various options available. 

I don't want to have 3 days of them trying to induce and then ending up frazzled, knackered and needing a section anyway, so am wondering more about the elective option, seeing as there appears to be a high chance I'd end up needing one anyway. Previously a section was the last thing I wanted but now an elective is looking far more appealing than an emergency one...

Interested to know people's views. 

For info, the baby is in the middle of the graph size wise, I am fit and healthy - although perhaps at 8 months don't feel it! - and the HbA1c's are in the low 5's but I have been told that there is a chance of still birth regardless if I don't go for the induction route, anyone else heard similar....?


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## Smit (Apr 20, 2012)

I'll let you know in a week or so honey, hoping to be induced a week on Monday. Got my last appointment on Monday and I'm going to ask about c sections figures etc then. I'm hoping I go myself before induction date, a girl can dream! X


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## rachelha (Apr 20, 2012)

Hi, I had a c-section after being induced.  Nathan was quite large and was back to back.  I got fully dilated, pushed for a while, then they tried forceps and finally ended up with the section.  With the wonders of hind sight an elective section would have been preferable.  I was absolutely exhausted, I had not slept for 48 hours and Nathan had to be fed formula on his first night as I could not stay awake to feed him.  We went on to bf successfully for 9 months though so this was not really a problem.


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## Babysaurus (Apr 21, 2012)

Rachel, its stories like yours that are pushing me towards asking for an elective!


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## Ellie Jones (Apr 21, 2012)

I had two babies induced both no problems with normal delivery.

Even though it may sound as a Elective C-section might be preferable, you do need to consider the over-all risk factors, such as Epidural going wrong, changes of infections happening, or other complications that can happen with a c-section

Yes being induced can mean a c-sec, but there again going into labour can end up this way..  And there got to be a reason behind why they go for an induction first rather straight for a c-sec!


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## Babysaurus (Apr 21, 2012)

Ellie, I am more than aware there are risks with c-sections! Previously it was what I wanted to avoid at all costs, largely due to the recovery. However, the "60/70% chance" of needing one anyway puts a whole new different light on things! 

And one of the reasons they go for induction instead of just a c-sec is cost! An emergency section also carries far more risks than a planned as it is done in a rush (my sister works in an operating theatre as an ODP) which is another reason to explore more options. 

I am thinking of asking if a cut off of, say, 24 hours for the induction is realistic or if they are keen for it to be at least 72 hours.


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## Ellie Jones (Apr 21, 2012)

I really don't think you can say what a cut off point is in a time spam as it's other factors that depict whether an emergency section is called for...

As what point do you say labour starts?

With my first daughter (I wasn't diabetic nor induced) I was in labour for 4 days, I know this has had an anti-natal on the Thursday morning, and at this point I was 2cm's dilated yet I didn't go into hospital until the early hours on Sunday morning and had her on Monday evening!

You seem to ask a question seemly with not having all the information, so when somebody points out that you need to be looking at other considerations to make a well informed judgement, You claim to have access to all sorts of information!


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## Babysaurus (Apr 21, 2012)

Ellie, I am not going to bother getting into yet another 'discussion' with you as, I have learned from experience, that you tend to assume vast amounts about myself, my circumstances and my past experiences. You also tend not to read the posts properly which doesn't help! And your last sentence doesn't make a vast amount of sense either! 

I am going to _explore_ the various options with a clear idea of what I want to avoid, and see how myself and the obs can help this become a reality (as much as these things can be predicted, which I realise it not always easy!)


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## Emmal31 (Apr 21, 2012)

Hi,

I was induced at 38 weeks but I was never told about the statistics of it ending up in a c-section I only found that out from someone on here a while after. 

I was induced on the monday morning nothing happened until the evening after my husband had left. The contractions started around 11pm and so I was up all night I was moved back down to the labour ward in the morning and by 11am I was only 4cm dialated at which point Jessica's heart rate started to dip and they said if things didn't improve then I'd be taken to have an emergency c-section. Jessica was born at 12:54 by emergency c-section. If I had known that high percentage I probably would have gone for an elective c-section. Next time I will not be letting them induce me because I don't want to go through that all again I will be having an elective c-section. 

I think that you should do what you think is the best option for you and your baby, good luck with your decision x


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## Babysaurus (Apr 21, 2012)

Thanks Emma for your reply. Its a tricky call I think. Ideally, I want to go and have a successful induction and by that I mean one which doesn't last for days and also does not involve the dreaded forceps or any other kind of intervention, including an emergency c-sec. However, statistically this is looking rather iffy! I think the apt on Weds will consist of a lot more questions about how successful things generally are the info I was given at the last time threw me somewhat (ie I am more likely to need a section than not anyway.) 

Prior to that, c-sections sounded scary but now I am wondering if an elective one will actually be the lesser of the two evils!


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## sugarfreerach (Apr 21, 2012)

I know the statistics say all sorts but in my opinion you would be missing out on the experience of labour if you went elective. Up to 32 weeks I secretly wanted to have an elective but after that my mind set changed, due to me feeling more confident and also i think hormones change etc. Also my consultant was very much against elective. 

I was induced and gave birth vaginally. I did need help with forceps but only because he got slightly stuck.  For me I  wouldn't change that at all and really hope i get to deliver vaginally next time. 

If it had ended in a csection, I would've been equally proud that id given it a go! 

I think as diabetics we can miss out on so much normality, that i really didn't want something else to be tainted by diabetes when there was no real need after my sugars were so well controlled.


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## newbs (Apr 21, 2012)

My first labour started naturally at 38 weeks on the day I was due to be induced and I had a normal vaginal delivery.  Second time I was induced at 38 weeks and immediately DD's heart rate dipped very low and I spent the next 10 hours lying on my side (best for baby) and having intense contractions.  At the end of that time DD's heartrate dropped away completely (and at that point they discovered she was back to back) and I was given a general anasethetic so they could do an emergency c-section quickly to save her life.  Scary stuff.  

Having a vaginal delivery is by far the best way to go though and if I were to go through it again I would seriously think about declining the induction at 38 weeks and maybe agreeing to it at 40 weeks if I hadn't gone into labour naturally then, rather than going for an elective c-section.  Obviously it all needs to be discussed and weighed up for you and your baby's safety.


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## RuthieG (Apr 23, 2012)

Smit said:


> I'll let you know in a week or so honey, hoping to be induced a week on Monday. Got my last appointment on Monday and I'm going to ask about c sections figures etc then. I'm hoping I go myself before induction date, a girl can dream! X



Hi Smit

Keep us posted (when you can!). Hopefully all will go smoothly and you will go into labour before they need to get their hands on you.

Good luck and looking forward to reading your updates (before and after the arrival of your little one)

Ruthie


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## Catwoman76 (Apr 23, 2012)

Hi 11 years ago I was told that it would be a vaginal delivery and I had been through that befor with my eldest daughtere, but didn't have diabetes then. At 33 weeks it all changed big time and I had to have a C section under a general anaesthetic, I was very scared, because at the age 42, I had never had an operation before. Whatever happens, you and the hospital will do everything possible for the safe delivery of your baby.  Good luck and best wishes Sheena


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## PhoebeC (Apr 24, 2012)

I was induced at 34 weeks due to pre-eclampsia 36 hours later with the help of forceps normal delivery Yes i kind of wish it had been only 1 day with a quick section but they didn't seem to want to give me one for some reason
And the fact that i did it after all that time in the state that i was with over an hours pushing makes me a little bit proud of myself  x


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## Monkey (Apr 29, 2012)

Bit late to this, but I was told that 75% of inductions in T1s at abround 38w ended in sections at my hospital.

We deliberated for ages about what to do, but went for the induction. As you know, it ended in a section, but I managed to get to 10cm and push for a couple of hours, and it was very, very positive.

For me, I was pretty aware that if I opted for a section first time, I'd have a real battle to be allowed to try a vbac in a subsequent pregnancy. It was a good decision, but a very tough one to take.


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## MrsCLH (May 2, 2012)

Just to add my experience. I was induced at 38.5 weeks and Harry was born 3 days later, forceps delivery in theatre just in case I needed a c-sec. My experience was awful, I just didn't get regular contractions even with that awful drip on full whack so ended up with diamorphine and an epidural and then a spinal block. Was exhausted, Harry was back to back and couldn't push him out. I also ended up completely out of it on all the drugs and thought I was dreaming for the first 24 hours after the birth - I honestly thought that nothing was real, it was awful. Having said all that, I don't think I'd go for an elective c-sec next time but I would definitely have an epi before they come anywhere near me with that synto drip!


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## Babysaurus (May 2, 2012)

Thanks for sharing your experience too, MrsCLH and so sorry to hear your experience was grim. I have found some research which may explain why this happens on a regular basis - here's one link here, but it is also written up in the BMJ. http://wrap.warwick.ac.uk/40859/

It is relatively recent research (ie neither obs I mentioned it to had any idea, I asked them about contractions in diabetics first and was assured that there was no difference - hmmm) so it may not have filtered down to everywhere yet - I have no idea how long these things work so may be wrong! 

I am guessing that that may also be why forceps and similar play a large part too.


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## sorcha (May 3, 2012)

I was induced with all three of mine; all were vaginal deliveries.  Certainly there's a statistical risk that any single intervention will increase the chances of further interventions being necessary, and this includes pain relief - in other words, a c-section is more probable after an epidural, for example.

In my third labour I was given three pessaries, several hours apart, and nothing was happening.  They told me they thought I would need a section and I said "Not yet." (A previous experience of medical negligence meant that spinal anaesthesia would be fairly risky for me.)  I asked to go home and come back in a day or two, but the doctors said they would prefer me to stay for the night just in case something happened, so I agreed.  Less than 90 minutes after that, my son was in my arms.

My rule of thumb was to ask if any intervention could wait half an hour.  Sometimes that's not possible, especially if there's any indication of fetal distress, but sometimes it's worth waiting it out.  

I do think induction is a dilemma for diabetics, because statistically the outcomes are significantly poorer if we go too much past dates.  But there used to be an idea that it was best to induce way before the due date, and I couldn't find much support for the practice in research.

My first was induced after labour spontaneously started - and then stopped - at 36+6; my second was induced at 40+2 and my third was induced at 39+5.  All were healthy and reasonably-sized!

Hope things go well for you.


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## Babysaurus (May 4, 2012)

Thanks Sorcha, some very good points to bear in mind! 

Sorry to be a bit thick, but what's 'Type 1.5 LADA'....?


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## Northerner (May 4, 2012)

Babysaurus said:


> Thanks Sorcha, some very good points to bear in mind!
> 
> Sorry to be a bit thick, but what's 'Type 1.5 LADA'....?



This is a slow-onset form of Type 1 diabetes. LADA stands for 'Latent Autoimmune Diabetes in Adults. It basically means that you slowly lose beta cell function, and therefore insulin production, due to an autoimmune attack. Several of our members are Type 1.5. Type 1, especially in young people and children, tends to come on very quickly.


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## Babysaurus (May 4, 2012)

Aha! Thanks Northerner!


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## beckyp (May 16, 2012)

I appreciate that I'm really late with this post and haven't read the previous posts so don't know what the general consensus is but wanted to put my bit in!

I was 38 weeks and induced which ended up with an emergency c-section.  

Throughout my pregnancy I asked for an elective but was refused.  My hospital said they don't just 'do' csections as they cost so much more money than inductions - seems ridiculous considering such a high percentage end up with them anyway - surely this costs more?  I wasn't aware of the statistics at the time and even tried blagging my way through a conversation with my obs that I knew of x many diabetics having failed inductions and why should I put myself through it etc.  I actually went through a baby forum and printed a list (much like this one) and worked out the percentage - I had waaaaaay too much time!).  My obs basically said that unless it was medically necessary to put myself through surgery (i.e. the baby being so big that it was necessary or putting myself or the baby at risk) then it wouldn't happen.  She also said that statistics are based on a hospital average - not generally on the NHS - which would explain why I could never find this information on the internet myself or through the hospital.

In hindsight I'm pleased.  I was exhausted from being induced but I really wish that it had worked.  The reason for the failed induction had nothing to do with the diabetes and it could've happened to anyone.  My daughter decided to look towards the light (I can't remember the medical term for it) and it meant that an ecs was needed.  I dilated 8cm and we were all set but unfortunately the little blighter decided to change the plan - she likes bright lights now too!

Personally I found the recovery from the cs fine - not as bad as I was told to expect at all.  You clearly already know that the recovery time is much quicker with an uncomplicated vaginal delivery and hopefully you'll be home much quicker to spend time with your baby.  Bear in mind that an cs will mean that you can't drive for 6 weeks, you can't hoover (that drove me nuts when husband went back to work!) and you'll struggle to lift your own baby in the early days - that's the hardest bit.  It complicates things when you're recovering from major surgery - lets not forget that they cut through 8 layers of skin to pull that baby out!  It also means that you'll be more likely to have a section if you have another - that's what I've been told but I don't know how true it is.

My only bit of advice to you is to pack your bag for worst case scenario and hope for the best - I would definitely opt for an induction though.

I hope the rest of your pregnancy progresses smoothly.


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## Babysaurus (May 16, 2012)

Hi Becky,
Thanks for your response. The reason I originally asked the question was due to seeing on here that so many of us seemed to end up with sections, and then I was told the stats by the obs lady about it being '60/70% likely to end up with one anyway.' 

Ideally, I would like to have a sucessful induction far more than I would a section, but I am increasingly aware of the fact that this looks more unlikely than likely. I am also concerned that I will have days of induction and therefore be exhausted and then find a section even harder to cope with in the event that I need one anyway. 

I started a similar conversation with the last obs I spoke to and she was saying that vaginal deliveries are easier for recovery etc etc (you can guess) but then I showed her a print out I found from the British Medical Journal about _why_ so many diabetics have a hard time - http://wrap.warwick.ac.uk/40859/ (this is not the one from the BMJ, but it says the same thing.) Our uterine contractions are significantly weaker due to being diabetic, which is why so many of us can only get to a certain point and this is despite all the drugs (and stronger doses make no difference.) This may hopefully shed a different light on things - what it did do at the time was get the obs to suggest that perhaps we do an examination and see where things lie (so to speak) and, if things are in a 'favourable' position try to induce, but have an early cut off point of either 12 or, at a push, 24 hours. This sounds far better to me than their initial talk of what 'normally' happened with diabetics which was 3 days of pessaries (with one 'rest day' in the middle) which get the cervix open enough for them to break the waters and then they put the drip in - this sounded bloody awful, and even more so because it still may go to section anyway. The 12 / 24 hours idea sounds far better as, like I say, I would like to give it a try but I don't want to be in there for days with them trying and trying! Esp as, now I have read, the drugs aren't as effective with me as they would be with non-diabetics. 

However, the obs I discussed this with (she knew nothing of the BMJ research, and neither did the other obs she showed it to) said they would not discuss properly until the final scan which is a week on Wednesday due to the old chestnut of the baby being the size of a small cow (not quite their words!) We shall see...


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## Babysaurus (May 16, 2012)

ps I realise the reason you ended up with a section wasn't neccessarily a diabetic one!


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## PhoebeC (May 16, 2012)

Babysaurus i think what your saying sounds great.

My labour was emergancy induction and still took 36 hours. I have never been so tired and poorly. I thought i would die.

If they would have said after 24 hours about a section id have had one. But i understand now why they didnt.

It took me a week to recover and get out of hospital as it was, so with a section i think it would have been longer. And trying to get sugars controlled in hospital is so hard. So im glad what happened happened.

However if id have been well i would have asked for section.

I think how you are going about it all is great. Im proud of you for the control you have taken.
xx


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## Babysaurus (May 16, 2012)

Blame the pregnancy hormones Phoebe, but you've just brought a tear to my eye! Thank you! 

I can't believe I have, possibly, just two weeks left. It has gone SO slowly in some ways but now also seems like it's been sprung upon me!


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## RuthieG (May 16, 2012)

Hi All

I am reading all this with interest. Babysaurus - have your growth scans up to now been all fine? I have another on Tuesday and feel (for no reason really) that the baby may have had a massive growth spurt. That will still only be 30 weeks so I hope not!

I am going to ask a few questions about what exactly 'induction' means because 3 days sounds horrendous. I am still hoping for my dream of going into spontaneous labour at 37 1/2 weeks but better not rely too heavily on that happening!

I hate the thought of a C-section but know it is a distinct possibility.

All your stories and similar feelings are a great comfort so thanks everyone


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## Babysaurus (May 16, 2012)

Last growth scan the baby had gone to close to the top line of the graph. This upset me a bit, but I have since calmed down as various HCP's have said it could be a growth spurt, or a biggish baby (as the readings are not especially accurate.) Also, hubby has a son who was 9lb's at birth and, his sister in law told me this as if it was a good thing (shudder), none of the babies born in his family have been under 8lb 8oz!

The 3 day, well four if you include the 'rest day', was what I was told as sort of the worst case scenario, but also that that was pretty likely especially considering it's my first baby (they have more success with subsequent.) Also, bear in mind that's just for the pessaries to 'ripen your cervix' and doesn't even include the drip which, I think, really kicks things off. I am also thinking that blood sugar control under those circumstances is going to be tough, and the longer you are in there the more room there is for things to awry with that too so I am interested to see how they deal with that (as I am not keen on the idea of a sliding scale for the best part of a week!!) 

Currently my bump is quite high up and I don't feel as if it (sorry - he or she!) is likely to drop down soon which I am thinking isn't all that good either, although I may be wrong there and things can change overnight...? I am very glad that the obs I spoke to last suggested an examination to see how things were looking before we even started, as it seems to me that this means she realises that there is no point trying their usual chain of events if the odds are increasingly against us before we even start. 

Ruthie, like you I hated the idea of a c-section (esp re the recovery side of things) but I am coming round to the idea now. I am also starting to think that, now I have come this far, I just want to get the baby out as quickly and 'easily' (if that is the right word) as possible with the least room for trauma, drama and / or blood sugar complications for either me or the baby. 

I will keep you all posted about how it goes next week. It should be an interesting one! I am yet to even suggest outright if a section is the better option considering so not sure of the response! I am going to ask about the ins and outs of everything they suggest, and also the success rates and why. I shall also make clear that I am not pushing for a section per se, but instead desperate to avoid an eventual section due to labour not progressing or similar as I think this would be far harder to recover from (the ladies accounts on here have also shown  me that.)


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## Monkey (May 16, 2012)

Babysaurus/Ruthie, I can only write a short reply now, but I'd heard heaps of tales about 3 day inductions, and was prepared for the worst. 

In all honesty, mine took 20hours from first (and only!) prostin pessary to him being born by c-section. In that time, I got to 10cm and pushed for 2 hours, so it was hardly slow!

I know there's no guarantee (altho my mw was convinced that my hand expressing colostrum from 37w helped ready my body) but just wanted to give a tiny glimmer of reassurance.


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## Smit (May 16, 2012)

Hi, I haven't got around to birth story yet, baby keeping me mega busy! Just want to agree with monkey, i also got told induction could take 3 days but i got the pessary at 5.30pm, cervix was unfavorable and I started contracting within half an hour. Turns out that the pessary made my cervix contract constantly and never stopped to give me a rest. Doctors said it was a bad reaction to pessary. I laboured for 24 hours and got to 7cm. But every time they put on the hormone drip, babies heart rate went way too low.  I also developed plus 2 protein in my urine and blood. In the end I needed an emergency section to get him out and to be honest by then I didn't care. I'll post full story shortly. Glad i tried induction though and know section wasn't diabetes related.Xx


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## Babysaurus (May 17, 2012)

Smit! I have been wondering how you're getting on - looking forward to an eventual update (but realise if you have other stuff currently going on!) 

Especially encouraged by the fact that your cervix was  deemed 'unfavourable' but then the pessary worked straight away. Hopefully this is not especially unusual...? Another point to add to my list of questions I think!


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## DaisyDuke (May 17, 2012)

I was induced at 38 weeks and 5 days.I had one pessery at 9.30am and another at 4.30pm. They discovered at 11.00pm they were able to break my waters, I gave birth at 11.55pm so took less than an hour for labour and birth.I didn't need forceps or anything,was supossed to go on sliding scale but there was no time.Baby was fine and had no problems.


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## PhoebeC (May 17, 2012)

DaisyDuke said:


> I was induced at 38 weeks and 5 days.I had one pessery at 9.30am and another at 4.30pm. They discovered at 11.00pm they were able to break my waters, I gave birth at 11.55pm so took less than an hour for labour and birth.I didn't need forceps or anything,was supossed to go on sliding scale but there was no time.Baby was fine and had no problems.



Oh thats nice and quick.

I had one pessarie and with the second they put me on the drip,which really started it off,  i was only 34 weeks so dont think my body was ready at all.

My poor body  xx


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