How often does an induction end in a caesarean?

[Miss E]

I'm probably way off track here, but from what I can tell talking to people and a lot of what I read here on BB, it seems that a large number of inductions end in a caesarean. Is this really the case?

[Trillian]

Unfortunately yes, some will end in a c/s. I wouldn't say a huge number, but more than should be happening. There is an actual figure somewhere in an article on here, but I can't remember what that is off the top of my head. I assume that you may be needing an induction?

Induction doesn't automatically mean you will end up with a c/s. But it is something that can happen due to a steamrolling effect of the interventions that usually follow one kwim? An induction is physically harder on your body so it is more likely that you will need further pain relief to help deal with the unrelenting contractions (and trust me - I have had 3 normal births and one induced one and induced contractions really are harder to cope with) and if that means an epidural then it can make it harder for the baby to descend and come out kwim? Plus an induction can lead to the baby getting distressed and if that gets serious enough a c/s is usually done. There are some great articles on the main BB site about induction if you want some further reading

[Glamourcide]

Well, I'm by no means an expert and I have no idea of the actual statistics on inductions leading to c-secs, but I'm one of the 'success stories', I suppose you would say. Most of my friends who have had c-secs have either been booked in *for* a c-sec, or have gone in booked for a c-sec but have tried an induction first - but mainly the intention there was just to give natural delivery a go because chances were it wasn't going to work out for them, kwim??

I was induced two days before my due date, had the gel applied twice (nothing both times, cervix stayed clammed up lol), then had my waters broken and hooked up to the drip to induce contractions. I delivered DD vaginally after a four-hour labour (going from the time my wtaers were broken, anyway) with no tears, no stitches, no episiotomy, no forceps/vacuum needed... I just needed that little push-start to get DD on her way and then it was a completely normal labour (apart from being hooked up to the drip, but ykwim).
I too wonder about the actual rates of inductions that lead to c-secs, I don't know whether my experience was unique or whether most women who are induced go on to deliver vaginally with little complication (I had a post-partum haemorrhage after delivering the placenta, and chances are that was because I was induced rather than going into labour spontaneously, but it didn't affect DD in any way so, although it was very traumatic at the time, DD was not in any danger or distress at any time so I don't think much about it).

[~Gee_Whizzy~]

I too wonder about the actual rates of inductions that lead to c-secs, I don't know whether my experience was unique or whether most women who are induced go on to deliver vaginally with little complication (I had a post-partum haemorrhage after delivering the placenta, and chances are that was because I was induced rather than going into labour spontaneously, but it didn't affect DD in any way so, although it was very traumatic at the time, DD was not in any danger or distress at any time so I don't think much about it).

Goth i agree with you on the actual rates of inductions that lead to a CS?

I too was induced due to insulin dependent GD (I had two lots of gel inserted with waters breaking on their own 2 hrs after the last lot of gels was put in. My labour then progressed normally - 7hrs in total but really only 5hrs of "active" labour as i pushed for 2 hours ) I had no further intervention (ie no drugs, no drip, no vac etc) and DD was born vaginally, no tears, no epi etc. - I delivered in a private hospital with my DH, OB and Doula all present and encouraging me. - So really i think it depends on 3 things:-
1. Your medical team and how willing they are to support YOUR wishes - my OB was FANTASTIC
2. How your Baby copes with the induction

And last, but probably the most important
3. How YOUR body copes with it.

Now my induction may have been one of the "lucky" ones, but i really do think that there are a lot of scare tactics for women who have to be induced and although yes some inductions do end up in a CS and other complications not ALL do and there are positive inductions.....

[JellyBean]

Hi Miss excited,

I don't know the exact statistics, but it is a fact that the risk of caesarian section is increased with artificial induction compared with labour which starts spontaneously (naturally).
This is because, left to nature, a baby actually releases the hormones required to trigger labour, at a time when the baby feels ready to enter the world. The natural hormones that are released generally cause the labour contractions to come on slowly, gradually building in intensity and length so that the woman is better able to cope with the pain and the baby does not become distressed.
The hormones given intravenously to trigger labour contractions catch the baby 'offguard'. They also cause the uterus to start contracting harder and faster than they would naturally - which can cause the baby to become distressed, leading to irregular heartbeat and often a subsequent caesarian. The sudden onset of contractions also increase the likelihood of a woman opting for pain relief much sooner than she would naturally, and this can lead to a cascade of intervention (ie - epidural requires a catheta to be inserted into the urethra as the bladder becomes numb and the woman is then confined to the bed, pethidine slows down the labour and causes the heart rate & breathing of the baby to slow down significantly... etc etc).

The biggest problem here is the emphasis that is placed in obstetric care on the EDD (Estimated Due Date). It is a very old fashioned method for determining the date of birth and it is an estimate at best. For example, if you planted an apple tree would you expect all the apples of the first sprout to ripen and fall off the tree at the exact same time? Of course not. Babies are exactly the same. Some need 38 weeks in the womb, others 42 - and both are perfectly normal. If women only trusted the the innate knowledge of their babies and their bodies to do what they were meant to do- instead of being pressured by some 'expert' in a white coat saying 'your baby is overdue - we need to induce' then the rate of intervention at birth would be significantly lower.
Of course there are rare circumstances where induction may be necessary, but having a baby that is 3 days or 7 days overdue is not a valid reason at all and actually poses a far greater risk to the baby. This, in my opinion is the greatest tragedy of the birthing business today - and a business it is. Over the last century or so, women's power and knowledge of their bodies and the natural birthing process have been whitewashed by the system.
Ok - I'll stop rambling now. Let your babies come when they want to!!!! Know your rights and don't allow others to make decisions for you!!! The term 'overdue' is a fallacy - your baby is due when he or she decides to come and they know far better than we do!!!!

XXXX

[Miss E]

Thanks for the replies ladies... It is an interesting area. The reason I asked the question in the first place is because I'm jotting down notes for my birth plan at the moment and have been considering how I would feel about an induction. Personally, I want to wait two weeks after my due date before considering an induction (obviously if it is medically necessary for other reasons it's a different kettle of fish). But then I can't help but wonder if you are in the position where an induction is deemed absolutely necessary are you potentially better off electing to have a caesarean...

I had a look at that article you mentioned Trillian and it interestingly quoted some different figures:

'A midwife from a large Melbourne hospital recently confided that they see many women come in for inductions where both mother and baby are well, but sadly somewhere between 50-75% of first time mothers being induced are ending up with caesareans'

and

?The Doula Book?, written by Klaus, Kennell & Kennell, contains a study on Doulas and induced labour in Cleveland, USA. The overall epidural rate for those who were induced was 81% and caesarean rate 43%. This includes women who had professional support people with them and others without.'

Of the four women I know who have been induced, all have ended up having a caesarean (mostly after a very long and very painful labor). In fact Goth Mum you're the only one I know who hasn't had what they would describe as a traumatic labor. But I didn't know that there was an increased risk of post-partum haemorrhage either.

Like Jelly Bean said, if you're having an induction bubs usually isn't ready (or wanting might be a better word) to be born. To me it seems that the odds of the birthing experience being traumatic for mum and bub are pretty high, and if after all that trauma you are likely to end up having a caesear, then maybe you and bubs are better off skipping the induction and the risks associated with it, and going straight for the caesarean... It kind of all depends on what the real rate of inductions that lead to a caesearing are.

Don't get me wrong, I'm really hoping to be able to have a natural active labor. But if that isn't possible because bubs needs to come out before they're ready for that and the odds of an induction ending in a caesar are 75% then I can't help but think we might both be better off going down that route...

[Bun]

FWIW, I am another case who was induced and ended up with an 'easy' vaginal birth after an 11 hour labour, and I was induced 2 weeks early due to high BP. It was VERY painful with no lead up at all, just instantaneous 2 min apart contractions, so I ended up having an epi, but all went well.

[TwinsMummy]

Same over here i was induced and was lucky enough to deliver naturally with the twins.... Was induced due to twin to twin transfusion ( one smaller twin) had a fabulous 5 hour labor delivery was perfect no tearing no stitches....

[mrsmac]

I was induced with my 1st due to high BP, on my due date, I had a very traumatic birth which ended up with epesiotomy (Sp?) and forceps but no c/s. With my 3rd i was induced 12 days early again high BP and I had an easy vaginal delivery.

[LucaJack'sMum]

Not sure of the stats but DS1 was induced at 37+5 (due to pre-eclampsia) and I ended up with an emergency CS due to foetal distress. He wasnt coping with B/Hicks contractions, heartrate was up and down, the decision was made pretty quickly.

[Mak]

I too was induced (syntocin) after my waters broke and I had not gone into labour 15hours later. I had a 6 hour labour, 3rd degree tears, episiotomy and PPH. DD1 also had quite severe jaundice (significant weight loss) and issues with range of movement in her neck. Whilst extremely glad I had a VB I was quite traumatised from the whole process (sorry - not intended to scare you) and was anaemic for months afterwards. I found recovery quite slow and wished I had armed myself with more information prior to her arrival. Good on you for seeking information to prepare for such an important event.

[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