How often does an induction end in a caesarean?

[Tobily]

Depends on the type of induction but there is one statistic that is particularly frightening.

About 60% of first time mothers who are induced with syntocinon (drip) will end up with a c/s. Most of them will have also have had an epidural (combination of reasons - but in a nutshell, longer labours with first time mums becoming generally pretty unbearable on the drip if it goes on more than a few hours).

I have nothing to back this up statistically, but the number of times I've seen babies crash after syntocinon (either induction or augmentation after spontaneous labour) and an epidural is enough to make me determined to avoid either if I ever have another baby. A bit hard to have synto or epidural at home which is where next baby will be born...but if I was in hospital there is no way either would be coming anywhere near me.

The part that gets my attention every time is that it's always a baby that is doing fine and within an hour of synto and epi it just all goes downhill.

I seriously can't understand why the people who initiate this don't acknowledge that there is a link.

[MrsFabuloso]

I was induced at 37+3 with my DD after my waters began leaking. I went from no niggles or anything to full on contractions in about half an hour. I was in labour like this for almost 20hours. They wouldn't let me eat or drink, so I have the suspicion they expected my birth to end in c/s from the start. My OB threatened me with c/s a few times but was too busy with other women. By the time he was able to focus on me I was pushing and had been for 3 hours. I had had 2 shots of pethadine and was sucking the gas as much as I could. He threatened me with c/s one last time and told me I had half an hour to get baby out or we would be going to theatre.
I was absolutely petrified of a c/s and kept on refusing it. He also threatened to use the vacuume thingy to get her out. I pushed like there was no tomorrow and managed to have DD out before the OB could come back and prep me for theatreor use the vacuume. I ended up with a serious epesiotmy and very bad bruising (midwives were telling me it was some of the worst they'd ever seen) and PPH requiring blood transfusions.
The only reason my birth didn't end in a c/s is because I was so scared and kept on refusing it. The OB thought I was being brave, but it was cause I was absolutely petrified of surgery! I was absolutely exhausted and fairly traumatised from DD's birth.
It was just a cascade of interventions, since I had planned on a natural birth and ended up with artificial induction in every sense and having pain relief, (would have had an epidural if they had have offered it at the hospital) and epesiotomy. I don't think I needed to be induced and had I been more educated, I would have held off longer and tried to wait for spontaneous labour. I don't think DD was ready to be born either. And if labour had have gone any longer, or hadn't been so scared I have no doubt it would have ended in a c/s. With my DS I was more educated, I had spontaneous labour, no drugs, a completely natural birth. I rocked up to hospital at 8cm dialated and birthed him an hour later. It was beautiful.

[Inertia]

I've never been induced. I am a needlephobe so I'll hold out until absolutely necessary. But two of my sisters were induced for their first, which is relevent.

Younger sis had horribly painful birth, but no other intervention.
Older sis ended up with episiotomy and forceps due to baby in distress.

[Patooties]

I was induced with all three of my bubbas, due to high blood pressure.
I had the gel inserted, my waters broken and the drip with all three. For all three I used gas, birthed vaginally with no tears. My first labour lasted 8 hours, the second, 6 and the 3rd 4. All three were fabulous experiences

[Footsteps]

my cousins girlfriend was induced on wednesday due to the baby stopping growing. he was born at 38 weeks.
she had a 28 and half labour from start to finish i think and she had a ARM aswell.
he was born at 11.54pm on thursday weighing 5lb 4oz...hes still not home due to probs with his blood sugars..she had gas only and a small tear.
im guess shes another sucess story but good luck hun.
love rach x

[Cougar]

i was induced with #4,#5,#6,#7 baby..only due to #3 baby was only a 25 minute labour, and he was crowning as i arrived at hospital, so it was my decision to induce as i lived over an hour away from the hospital, so didnt want any roadside deliveries...all my inductions were all around 3-5 hour labours, and normal vaginal births, i was also induced around the 37-38 week mark

[Fleur]

I was induced and ended up having an emergency c/s. I think in my case it would have ended in an emergency c/s anyway, as bub's heart rate was dropping before I was even induced. They induced me to give me a chance at a vaginal birth, but told me that it was possible that it could distress bub even more - which it did. Because there was already something wrong before I was induced, my chances of ending up having a c/s were already higher.

- Exactly the same situation with my DS2, when they did get him out, he had severe cord entanglement which would have accounted for both the failure to go into labour / progress and the heart rate dropping... I can't see how he would NOT have been a CS.
Having said that, it is not an experience I am keen to repeat.

One question that continues to arise for me, is , WHY if a 'normal gestation' is 38 - 42 weeks are babies routinely being induced at 41+10? My DS1 arrived all on his own at 42+1 (I refused to go to hospital - not that I recommend that) after a 3hr labour, and he was perfectly fine.

This time around I am hoping for a VBAC, I have asked the OB to be allowed to go past 41+10, and she agreed to 41+13 , possibly with a CTG & Scan to make sure everything is ok, and I'm pretty happy with that. I also have the option at that point to elect for a CS rather than induction, and I am not sure yet how I feel about either option - I do not want another CS but I don't want to be induced either! I will be trying everything I can from 38 weeks to bring it on

and finally after re-reading all of the above, and considering some of the posts from Mums who have had inductions ending in successful VB's, I think it would be better to try the induction rather than just opt for a CS - at least to give it a chance to happen, kwim? and keeping in mind that some labours just do end in CS for whatever reason, things don't always go to plan.

Hey with a bit of luck it won't even be an issue for you..
Good Luck

[Visitor7]

I was induced with the drip with Nina after my waters broke and labour didn't start naturally. I had a 9 hour labour with no complications.
When I was induced, the OB let me know that approx 70% of women who get induced end up having an emergency c/s Pretty scary stuff.
I know of 3 other people who have been induced, all at 41+ weeks and they've all ended up having emergency c/s.

[sweetpea678]

I was induced with my first to pre date due to pre e.

1st was 17.5 hrs labour gel 3 times, arm, drip, morphine, epi, vg birth no help there.

2nd was 3.45hrs gel twice, arm, drip gas and peth vg birth no extra help

3rd post date induction, arm as was already 3cm, gas for contraction pain and peth for pelvic seperationpain, 3.5 hr labour, vg birth no extra help.



Only advice I can give if you do get induced is to stay mobile and upright as much as possible, I did even with monitors on.

[Taurean]

My two cents worth:

My sister was induced with both her boys. First one she was put on the drip as the gels alone didn't work and labour was intense but quick (about 5 hours) but she did have an epidural and forceps. Second son was induced by breaking her waters and she went on to have a completely 'natural', drug free water birth in under 4 hours. She RAVES about her wonderful second birth!

I have 4 other friends (that I can think of right now) who were also induced and only one of them had a CS which was due to complications with the bubs before she was induced. The other three all had epidurals but quick labours.

It is good to do the research early though in case you find yourself being induced (and I'm doing the same). Knowing how the hormones work in a 'natural' labour, what your options are and what to expect with an induction really help you deal with the situation as best you can IMO.

[BellyBelly]

Don't mean to nit pick... but an artificial rupture of membranes or breaking of the waters isn't officially natural... it was artificially induced. But she sounds like she had an awesome birth and is happy so thats all that matters.

Also, depends on the form of induction. Breaking of the waters is MUCH different to synto induction. Doses are different and there are other factors to consider too. First timers are also more likely to have a c/s from induction I believe. A midwife in the RWH says the scope is somewhere around 50-75% for first timers put on synto.

[Taurean]

Don't mean to nit pick... but an artificial rupture of membranes or breaking of the waters isn't officially natural... it was artificially induced. But she sounds like she had an awesome birth and is happy so thats all that matters.

I guess that is true. I personally like to think of natural as drug free. It was an incredible birth though and she was so lucky to get 'stuck' in the bath. That bit was definitely artificial as she lied to the midwife about being stuck so she could deliver in the water! Sounds like the midwife was onto her though but just agreed to 'go with the flow'. LOL!

[BellyBelly]

I know what you mean... but yeah forceps, inductions, episiotomy, vacuum, drips, machines, managed third stage (syntometrine) ... eck! Interesting how the word natural has evolved these days! Scary!

You have to take your own plug in if you want a waterbirth and tell them to get their hands off your property - they aren't allowed to touch without your permission :P

[Taurean]

I know what you mean... but yeah forceps, inductions, episiotomy, vacuum, drips, machines... eck!

You have to take your own plug in if you want a waterbirth and tell them to get their hands off your property - they aren't allowed to touch without your permission :P

LOL! My sister had been told by her gorgeous yoga instructor to tell them it would be impossible to get out so she could stay put. It worked a treat! The midwife did sound fabulous though. It was at a birthing centre so I'm guessing she was as happy to see it happen as my sister was to do it.

[Tobily]

I know what you mean... but yeah forceps, inductions, episiotomy, vacuum, drips, machines, managed third stage (syntometrine) ... eck! Interesting how the word natural has evolved these days! Scary!

You have to take your own plug in if you want a waterbirth and tell them to get their hands off your property - they aren't allowed to touch without your permission :P

Slightly OT but heard a story from someone the other day on this that was an eye opener.

Seems some hospitals are onto this tactic have taken to attaching a stick to the plug. A lady told me she laboured in the tub with this big stick poking out of the bath so that the midwife could get at the plug.

Good grief the birthing room really has become a war zone and battle lines are drawn Can you even imagine.

[Fleur]

Seems some hospitals are onto this tactic have taken to attaching a stick to the plug. A lady told me she laboured in the tub with this big stick poking out of the bath so that the midwife could get at the plug.

Good grief the birthing room really has become a war zone and battle lines are drawn Can you even imagine.

.. Is this for real? That's crazy...
FWIW I can't think of anything worse than labouring in a bath with a big stick in it!
(well I can, but ykwim )

[JellyBean]

Ohh dear - I am planning to have my 2nd in a birthing centre - and I will try my best to have it in the bath but don't want to put up with that sort of nonsense!! Mainly because I so desperately want to avoid tearing/episiotomy and the subsequent traumas that posed for me last time!

[paradise lost]

One question that continues to arise for me, is , WHY if a 'normal gestation' is 38 - 42 weeks are babies routinely being induced at 41+10? My DS1 arrived all on his own at 42+1 (I refused to go to hospital - not that I recommend that) after a 3hr labour, and he was perfectly fine.

This time around I am hoping for a VBAC, I have asked the OB to be allowed to go past 41+10, and she agreed to 41+13 , possibly with a CTG & Scan to make sure everything is ok, and I'm pretty happy with that. I also have the option at that point to elect for a CS rather than induction, and I am not sure yet how I feel about either option - I do not want another CS but I don't want to be induced either! I will be trying everything I can from 38 weeks to bring it on

There are more stillbirths in the 43rd week (i.e 42+anything) than in the 41st and the difference is therefore factored to be in the 42nd week, so they induce you in the middle of it in some places, treating it as a window of opportunity for preventative medicine. It is NOT an evidence based practice, induction at 41+10 has not been proven to reduce stillbirth rates (i.e. the level remains the same for babies born in the 41st week whether by induction or not, and there is no way to determine how many of those babies who are induced would have been born before 42 weeks anyway) and HAS been shown to increase the c-section rate and risk of injury to both mother and babe.

And FWIW unless your ob offers foley's catheter inductions i would be surprised if they offer to induce you at all. Cytotec, prostin and pitocin have all been shown to dramatically increase the uterine rupture rate in VBAC labours.

Bx