Induction question

myarnton1 said:

Hi all,
So I've been looking up about inductions to get more information as I come closer to being induced (even though I haven't got a date yet). I was wondering, what happens if the induction doesn't work? Or will it always work but just takes different length of times for different people? Has anyone on here experienced the induction not working?
Thanks

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If you do a Search in Pregnancy, you'll find a number of threads about induction If you search Titles Only and limit your search to the Pregnancy forum I'd think that would get you a nice selection to read through.

To answer your question, it depends what you mean by "not working". Induction generally has two parts - first a pessary to soften the cervix (that didn't do anything for me) and then the Syntocin drip to induce contractions (I didnt respond to that drug well either). However, even though I didnt respond like I was supposed to, I gave birth naturally and avoided a section. What helped me was having my waters broken.

So induction can not be textbook (like mine) but can still work. On the other hand, there are ladies who respond well to the pessary and drip yet still need a section for whatever reason.

Induction does carry a slightly increased risk of a section, but many women avoid this. You don't know how things will go until you have it, and it can vary, of course, with different pregnancies.

It all depends on how ready your body is to give birth, the position of the baby, etc, etc. If labour stalls or baby gets distressed or is in an awkward position, etc, you might need assistance - either an assisted delivery (eg Ventouse) or a section, but you won't care because your focus will be wholly on your baby However you give birth, it's nothing to,worry about. You'll be well look after

Closer to the time, perhaps have a chat to your midwife or OB about the process so you can raise any questions you might have.

Edited to,add - keeping active can help, as can keeping your mind relaxed. I recommend two books - Mindful Hypnobirthing and an old book called Active Birth that stresses the best birth positions, etc.

@myarnton1 I have a son who is almost 13 weeks. When he was born in August I agreed to try and induction as my obs was due to go on holiday for a week (and I was 39+5 at that point) and she stressed she believed that it would be easy peasy as everything looked favourable for the induction to work.
Long story short - I had a 24hr pessary which whilst inside gave me pretty strong contractions after a few hours - I couldn't sleep and had painkillers and a bath which helped. Next morning I was in really bad pain and got paracetamol and morphine and I had another bath after which every pain (and contraction was gone). When my obs removed the pessary after 24hrs it turned out that it had thinned my cervix slightly but that was it, I was 2cm dilated beforehand anyway but that hadn't progressed anymore.
I discussed with hubby whether we wanted to continue and both decided to just go home (as I initially never wanted to be induced and only said yes as obs was going on holiday). So we went home that evening and back to hospital every day for the next 3 days for CTGs and a scan on the 3rd day (that was agreed between me and my obs that I would go in every day for check ups). I went into labour naturally on the 3rd day and had the scan whilst having contractions.
I am glad I gave my baby the chance to decide himself when he wanted to pop out and as everything was medically fine and no issues my teams didn't have a problem with me doing it. I had to have an emergency section in the end unfortunately as baby was in a slightly awkward position somehow and after 48hrs of labour got distressed. He was and still is perfectly healthy. When we decided to go home after our induction failed I could have carried on with pessaries and manually breaking the waters etc but I didn't want them to force my baby out as it was clearly not ready at that point.
Good luck to you! xx

myarnton1 said:

@azure thanks for the reply! I didn't realise you could search specific topics within different forums. By "not working" I mean, Is there a limit on how long the doctor should and midwives will leave you to try and get on with the induction before deciding to do a section? I'm trying to already prepare myself for how long I will be in hospitals, I'm worried about being stuck in hospital for a long time as I'm really nervous of hospital. I have my 32 week scan in two weeks and an appointment with my general birthing consultant (who is different to my diabetic consultant) but she is very stern and doesn't seem to be bothered when I try to ask questions about my personal concerns

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It depends on what pessary they use, but the one I had was left for 24 hours initially, then I was checked, and then it was left for a further few hours (I can't remember if it was 6 hours or 12 hours). Some hospitals do a second pessary. As long as baby is ok then the pessary can be left to work (hopefully!)

After that, you would be re-assessed to see how things were. All being good, you'd then either have gone into labour (some ladies do after the pessary alone) or have a drip up.

My induction took a couple of days very roughly.

If your OB isn't very helpful, could you ask to swap? Or maybe speak to your midwife and get your questions answered?

myarnton1 said:

@kitty55 How did you get it so that they left you to Go so late? My consultant has said that I will not go past 38 weeks and they are looking at inducing me earlier towards the 37 week mark rather than closer to 38. It feels as if my consultant is not giving me choice as she hasn't even given me a chance to ask about staying on the pump vs. Sliding scale during the birth, she is adamant that I am going on the sliding scale whether I want to or not. How did you find the recovery after the section? It's good to hear that your baby was very healthy, Congratulations!

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Nobody can make you be induced @myarnton1 You could refuse induction as long as you want. However, diabetes raises the risk of stillbirth however good your control is, so most ladies accept induction as a 'necessary evil'. The NHS recommends induction between 37 and 38'6 weeks as this has been found to reduce the risk of stillbirth.

Obviously, that's just statistics and it could be that you could happily leave things alone until 42 weeks. But there's no way you'd know that in advance and for me at least the risk just isn't worth taking.

It sounds like your OB isn't very helpful. Remember you can refuse the sliding scale too if you want. I kept my pump on the whole time.

@myarnton1 My team were fantastic and I really think it's important to have a team you trust. I live in a rural area but went to a bigger hospital for my diabetic pregnancy care. Could you do that? At each of my appointments I had people from both the OB dept and the diabetes dept, and I felt extremely well looked after.

No, it wasn't difficult wearing my pump. I just tested my BS frequently, which I was doing all through pregnancy anyway. My BS stayed very good - between 3.7 and 6.5. I ate and had glucose in case I was going too low. I aimed to stay in the 5s and did the majority of the time. During the actual birth I forgot all about my pump!

Definitely make a list of questions. I asked questions at every appointment. Also, write your birth plan.

Whether you're diabetic or not, giving birth isn't something that's done to you - you do it. It's your choices and your experience.

I highly recommend reading a bit about active birth and taking control of your birth. Even if you were to need help at some point, it's important to know that you're still in charge all the way through. Your mental attitude is very important. Be confident, read up on everything so you know what will or may happen, and know that you can do this

Yes, they would need to,wait until they could physically reach to break your waters. Also, they would want to know it was the right time to do this. Breaking the waters means that the birth process has been started so they would then be counting down to birth. That is, you would need to give birth (in whatever way) by a certain time as there's a risk of infection once the waters have broken or been broken. This time varies from hospital to hospital - 24 hours, 48 hours,72 hours or whatever. They don't mean an hour, so there is a countdown but one with plenty of time

Labour is called "Labour" for a reason - it's hard work : D So yes, it can be like doing physical exercise. I made sure to have glucose so that my body had enough energy. But, on the other hand, lying around in a hospital bed can put your sugars up, as can non-carb counted hospital food, so,it can go either way. I found it useful to take some carb-counted snacks in aswell as hypo treatments.

myarnton1 said:

@kitty55 How did you get it so that they left you to Go so late? My consultant has said that I will not go past 38 weeks and they are looking at inducing me earlier towards the 37 week mark rather than closer to 38. It feels as if my consultant is not giving me choice as she hasn't even given me a chance to ask about staying on the pump vs. Sliding scale during the birth, she is adamant that I am going on the sliding scale whether I want to or not. How did you find the recovery after the section? It's good to hear that your baby was very healthy, Congratulations!

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@myarnton1 Thanks very much. He is a happy and wriggly 3 month old tomorrow . I have made my own research for facts and figures as to why diabetics usually get induced and couldn't find anything older than 10 years so I told my consultant and she confirmed that there wasn't any newer figures. I assumed this "induction due to diabetes" was based on research that was done when diabetes control was nowhere near as brilliant as it can be nowadays with all our gadgets,. And I said to her I don't want to be induced just because I am diabetic and I want to go as long as possible (basically until baby makes a move) unless there is some medical problem. In that case I'd obviously be the last person to refuse any intervention. I just didn't agree with this "oh we have to induce you at 37 weeks just because you are diabetic" and no one gave me any actual reason as to why. As in no one told me the actual percentages etc of stillbirth and stuff like that and I just didn't agree. And baby was very happy until 40+4. And I asked my consultant afterwards and she confirmed that my placenta was looking perfect which made me quite happy with the decision I had made.
Also re-sliding scale: I have had my pump on the whole time and no sliding scale anywhere near me. And I was adamant that I didn't want one unless I or my husband are for some reason unable to control my levels, And they were perfect throughout. It was easier for me as I had the libre on which made it obviously quick and easy to scan all the time,
I have had a fantastic team around me who supported me and my decisions all the way which made it easy for me. My diabetes team got grey hair I think towards the end knowing I wouldn't get induced unless I had to because they usually have ladies where it's all planned and not where they are waiting for baby to make a move. I think my DSN is dreading the next baby already

There is more recent research from Denmark @kitty55 I mentioned it in the other thread.

We all need to make our own decisions and I'm sure we all decide with our baby's best interests in mind, We all have levels of risk we're happy with and ultimately it's our decision and ours alone.

For me, the overriding thing was that if, having been warned about the increased risk of stillbirth, I went on and something happened I'd never have lived with myself. Whether the risk had been 1 in 100 or 1 in 1000 would have been no consolation.