Induction - does baby's position matter?

[Sagres]

This is a really interesting area, something that I certainly thought about before my induction. I guess I have thought quietly to myself that position does have an influence on how successful an induction will be but don't have anything to back that up.

I'm not sure if my situation will help you at all but here it is anyway. I was developing PE so was induced but at 40+3, not early and not 42 weeks. At my last appointment we discovered my girl had switched to posterior since my previous appointment a few days earlier. My ob set out that I'd have 2 lots of gels 8 hours apart (2 lots to give us every opportunity to get things going ourselves), then my waters broken 3 hours later. Between this appointment and my induction date I had some accupuncture to try and get my little miss to flip over again and to prepare my cervix. I have no idea whether that flipped her or she was on her way anyway but when I presented at the hospital for the induction she had flipped back. So this is why my story is probably no help to you, she was in a favourable position when I was induced and I never made my second lot of gels as my girl was already a few hours old at the time they were scheduled (vaginal delivery).

I noticed in the 2006 stats that 99% of women are having their babies in hospitals, and only 1% of women had their babies after 42 weeks. So I get the impression pretty much all women who birth in the system are induced before they get to 43 weeks.

This is an interesting one, and it depends a bit how you look at the stats. I think you would need to know what percent of women would have actually got to 43 weeks without any intervention. If it was like 2% then that makes the 1% almost too small to be significant. If however it was 12% you would say that yes, women in the hospital system are not going over 42 weeks. Also I guess you have to take into consideration that many women are quite happy to elect for an induction at 42 weeks, so not necessarily a hospital imposed situation but individuals choices.

I'm exploring some studies at the moment, some say "induction reduces c/s and does not increase the c/s rate" - some say the total opposite, that induction increases the chances of further intevention and eventual c/s. Whew. Talk about duelling research papers!

Oh this is a really interesting one. I think that both are true - but in different situations! Like my SIL who was induced at 37 weeks (due to babies size) and had a pretty unpleasant vaginal delivery, baby got very stuck, was eventually delivered, suffered a punctured lung and some other minor issues. I think had she gone to full term a vaginal delivery may have been out of the question. So induction very likely did prevent a c/s. But then with the previous poster you could easily argue the induction caused the c/s. So my very uneducated guess would be that both are correct, the very very hard part is knowing which basket a woman falls into!

[julie_ann_jules]

not sure if this helps as I wasn't overdue (i was induced due to gestational diabetes, although it was well controlled) anyway I was induced at 38 weeks, had the prostaglandin, my waters ruptured themselves and my body went straight into labour. 40 sec contrations 1.5 min apart. Terribul back pain so I had an epi. I laboured to 9cms then bubs went into distress so I was whisked into an emergency c-section. They said that bubs was prosterior.

oh when I was indued bubs wasn't engaged.

[Traveller]

My gut tells me that position matters a lot to the success of an induction, as the clock starts ticking from the first contraction which will be doing what would normally happen at home prior to labour, ie baby rotating into a nice position. This leads to more c/s for "failure to progress" and "maternal exhaustion" that IMHO could be otherwise avoided by waiting a few more weeks. I would love to see the stats on what gestation women are when they are inducted for non medical reasons as I suspect that there are a lot of inductions between 38 and 41+6 weeks which is of course term. This will skew the statistics on average gestation for Australian women.

To be honest I would like to see induction for "overdue" to be properly studied and hopefully the whole practice stopped. Induction for PET or diabetes is another matter entirely but I feel that inductions are being offered for so many reasons (maternal exhaustion, partner's holidays, childcare) without any consideration of the medical implications of this. And I do not feel women are giving informed consent, because they are not told of the likely implications of an induction.

[YoYo]

My experience with induction 2 years ago is all I can contribute to this thread!

I was induced because I was 9 days overdue, DS was posterior.....but didn't know till I was actually in labour (possibly a reason he wasn't ready to come out when I was ready for him to ). I was given gels on a Thursday night, which didn't work on me, and was induced with the drip on the Friday morning at 7am.

I went into labour hard and fast and had an epi. After they'd checked me, they knew that DS was posterior, but that didn't mean anything to me at the time (no BB wisdom!) I sat on a chair labouring which I think helped him to drop and I was quite relaxed after I'd had the epi which helped too.

The doctors thought that I wouldn't have him till six pm, but I wanted to prove them wrong. They also thought that I'd need help to get him out, either with suction or forceps. I didn't need any of that, at 3pm I was 10cm and ready to push and at 3:55pm DS was born. I had managed to turn him (well maybe he did that himself I'm not sure) and have him with his hand up against his face. The doctor was well impressed!

I'm not sure whether being a public or private patient would contribute. Had I of had a scan and seen that DS was posterior, whether that would have changed their reason to induce me, or leave me a bit longer to see if he changed position?

[onthefly]

This is my experience:

Induced at 42 weeks because...42 weeks.
Cervix was 90% thinned but not low or ripe when folley catheter thingy put in night before induction. Baby still not engaged
On morning of induction, cervix thinned, cervix still high but somewhat ripened. Baby not engaged. But still in left/anterior position.
DR says: Very high chance of ceasar (but continues anyway - never occurred to me to say, ok, we'll come back later then!)
Waters broken. 3.5 hours later, synto started. 1.5 hrs after that 8cm. 3 hrs after that 10cm, but baby in distress (and so was mum!) = forceps delivery.

Narrowly avoided caesar.
Mum regrets induction.