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?
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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?
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
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).
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
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...
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.
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....
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.
I was induced all 3 times and none of them resulted in a c-section.
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.
Glad to hear there are lots of positive induction experiences... Clearly the odds aren't nearly as bad as I thought they may be. Thanks for sharing :p
You've made some interesting points, Miss Excited. I haven't been induced before (and don't want to be if I can help it) but I think I'd rather give induction and VB a go over going straight to c/s.
There's still every chance that you can have your baby vaginally if you're induced, and to me, that's preferable to surgery and it's potential problems. JMO. All the best for your birth!
2 inductions due to failure to progress - both time my water broke on its own.
1st time resulted in Epi and Vaccum extraction = 14 hours labour
2nd time no drugs = 50minutes labour
2 completely different births but definitely give the thumbs up for birth no.2 - very full on but over in a very short time - although baby had issues with the lungs due to too fast labour
I think every birth, and every woman, is such a different experience from the next that it all really falls to fate in most cases, kwim?? Others have said that induction increases the likelihood of the mother wanting pain relief too early, or asking for more pain relief than they would otherwise have considered... I used gas and was very open to the idea of it well before being admitted to hospital (I have a great pain tolerance but I knew birthing was going to be very hard on me and I was happy to use pain relief if I felt it was needed), but although it was extremely intense and very hard on my body, I refused an epidural purely because I'm terrified of catheters lol... After going through what I did, and reading about the experiences of other mums (who weren't induced), I do realise that my experience *was* actually quite traumatic, but as it was my first baby I really had no idea what to expect so I assumed at the time it was all completely normal to feel what I felt, and I thought everybody had the same experience, kwim? If anything, the knowledge that an induction is so much harder on a mother's body has made me feel much stronger and more confident, as I know now that I got through it okay, and a perfectly healthy daughter at the end of it, so if I have my next one spontaneously I think I will handle it better than if I had gone into labour spontaneously, purely because by all accounts it will be a bit easier on my body, and I'm actually looking forward to labouring this time so I can get a taste of what it 'really' feels like.
I suppose the key here is educating yourself - I knew quite little about the risks associated with inductions until well after DD was born - I'd never even HEARD of PPH until I lost over 3L of blood within minutes and, to tell the truth, I thought *that* was normal as well until I saw my husband's face after speaking to a midwife and I knew something was going wrong. I didn't know that inductions weren't all, 'We'll just pop your waters and bub will be here soon', I didn't know that inductions had such a high rate of ending in c-sec, I didn't know exactly how they worked or what effects they had on mums and babies... I just knew that the pain in my back and hips in the weeks before having DD were so bad that I just wanted her OUT, I didn't really care how!!
I think if you're aware of the risks, the statistics, and the facts, you can make a much better-informed decision - as you've seen, some of us have had quite positive experiences with induction, some haven't, but if you know the 'tricks' to help you through it it may be an option that leads to a good outcome for you (eg, I avoided an epi for totally different reasons, by the time I started yelling for one DD was crowning lol, maybe if you know an epi ups the risk of a c-sec you could say 'no' to it, kwim?).
I'd best be sitting down to complete my birth plan too lol, all I've written so far is, 'No epidural, no episiotomy/forceps', good luck with yours, great to see you're arming yourself with as much knowledge as possible and that us BB members are able to help you in some small way :D
Naturally the figures are going to be different when you're looking at two different 'studies' and you also have to take into account the type of hospital the women are having inductions in and the reasons. Some tertiary hospitals take on many 'high risk' cases which would include inductions for medical reasons etc so it will probably be something that you would never get a truly reflective figure on. It's also slightly higher for first time mums who get induced to have a c/s in the end too.
You will hear of many inductions that go perfectly fine, but the stats make it something to be wary of and you do need to be prepared that once you succumb to it, then there could be further intervention etc.
GothMum, FYI, syncto induction can cause PPH as a side effect of the drug. I had a PPH requiring a transfusion after my one and only induction. This is an updated 'adverse reaction' list on the synctocinon from the main site JIC you haven't seen it;
So it's not something to be taken lightly as they are quite serious complications that can arrise. So it is best to avoid an induction at all costs and only used as a last resort before a c/s:
This is taken from the packaging of Syntocinon which has been recently updated:
?ADVERSE REACTIONS
The following adverse reactions have been reported in the mother: Anaphylactic reaction, Postpartum hemorrhage, Cardiac arrhythmia, Fatal afibrinogenemia, Nausea, Vomiting, Premature ventricular contractions, and Pelvic hematoma.
Excessive dosage or hypersensitivity to the drug may result in uterine hypertonicity, spasm, tetanic contraction, or rupture of the uterus.
The possibility of increased blood loss and afibrinogenemia should be kept in mind when administering the drug.
Severe water intoxication with convulsions and coma has occurred, associated with a slow oxytocin infusion over a 24-hour period. Maternal death due to oxytocin-induced water intoxication has been reported.
The following adverse reactions have been reported in the fetus or infant:
Due to induced uterine motility: Bradycardia, Premature ventricular contractions and other arrhythmias, Permanent CNS or brain damage, and Fetal death.
Due to use of oxytocin in the mother: Low Apgar scores at 5 minutes. Neonatal jaundice, and Neonatal retinal hemorrhage.?
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.....
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.
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.
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.
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.
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.
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 :)
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
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
- 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..:dance:
Good Luck
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 :o 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.
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.
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.
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.
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!:
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
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.:
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.
.. 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 :p)
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!
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.:
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 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
I'm confused! If the rate of stillbirth is higher after 42+ weeks, i can understand the wish to induce prior to this. But you say this is not evidence based, induction at 41+10 has not been proven to improve stillbirth rates?:
Probably just my mushy baby brain but I'm lost...:doh:
As for my induction, it was my understanding at my booking appt with the midwife that they would NOT induce due to it being a VBAC; this made sense as I was aware of the increased risk of rupture when inducing a VBAC.
I then heard from a lot of people who had been induced with VBACs. When I asked my Ob she said ARM would be the preference (if they knew that would definitely work)... gel is definitely out... it would most likely (from what I understand) involve synto, and I don't like that idea. Really I'm still undecided and hope it won't come to that anyway ;)
PS What is Foley's catheter induction?
The point is that it's confusing! The Ob believes the baby is more likely to be stillborn if it is born in the 43rd week, yes? So he induces it the week before, because STATISTICALLY if it's born in the 42nd week its risk is lower. Of course that has nothing to do with WHY it would have been stillborn. And babies who are induced at 41+10 and stillborn aren't in the statistic, because they were born in the 42nd week - does that make sense?
Because stillbirths often have no explanation they rely on this clumsy reasoning to try to prevent it. It is like finding out that people in brown trousers are more often hit by cars and throwing your brown trousers away - you would be better using the pedestrian crossing and wearing any trousers you like. But in this case because stillbirth often has unexplained cause there is no "pedestrian crossing" option.
TBH i think everyone has their own viewpoint on this policy. I know lots of women who were terrified of losing their baby or had already been through stillbirth and they opted for induction at term because they wanted to minimise the risk and induction is the only way possible. And i know others who had such traumatic inductions they would rather "risk" stillbirth. Personally i made the decision by looking at relative risks. 2.7 babies in every 1000 are stillborn. That's 0.27%. The same Ob who wanted to induce because of that risk offered me an amniocentesis test which carried a 1.6% chance of miscarriage. He would expose my DD to the 1.6% risk of death at 16 weeks but not allow her to face less than a quarter of that risk at the end? No thanks!
Foleys catheter induction is where they insert a foley's catheter into the cervix. A foley cath. is a catheter with a balloon on it - in normal practice they insert it into the urethra and inflate the balloon inside your bladder to stop it slipping out again. In induction they insert it into your cervix and inflate the balloon and wait. The balloon mimics the baby's head on the back of your cervix which cues your body to make prostaglandins and soften your cervix, and oxytocin which start up contractions, and then as the cervix begins to dilate the balloon falls out (by which time you're in established labour). If your cervix doesn't respond the balloon can be deflated and removed and the induction can be tried again in a few days, whereas once they do an ARM you are haing your baby, one way or another, within 24 hours (normal practice) or 96 hours (if you are strepB negative and argue with them).
Bx
Phew... ok it is confusing it's not just me ;)
Thanks for the info!
Now I have another question (may be hypothetical if no-one has an answer?).
Foleys catheter induction sounds like a much less invasive, more natural way of 'encouraging' labour rather than forcing it, kwim? So why would it not be the preferred option before ANYTHING else? Does NOT make sense to me :wall:
Because it's relatively little-used and not all Ob's are able to do it (i.e. have never done it) and because most hospitals have a policy of only inducing for medical need and thus the benefit of the foley induction (that it can be stopped and resumed days or even weeks later) make a mockery of the system - either it's medically necessary to get the baby out ASAP (in which case get the big guns out) or you don't need to do an induction of any kind. In addition it is not suitable where there is infection in the vagina or cervix or where strep B is suspected or known to be positive.
The exception to this is becoming (and will become more - talk to your Ob about foley induction (there's a WHO page with info about it here) in cases when a woman is aiming to VBAC and thus cannot have a chemical induction and declines ARM.
Bx