March 2011 Moms

Induction vs. C-Section - what would you do?

Although the pregnancy had been coming along fine, and my doctor seemed willing to let me go as long as 42 weeks to try to go into labor naturally, at my last (yesterday) appointment my fluid levels were down to 6, and apparently 5 and below is considered dangerous.  

 I'll be 41 weeks on Thursday.  My baby has been head down for months but still has not dropped, and I'm 0 dilated and 0 effaced.  Not a good candidate for induction.  My doctor is unsure why the baby still hasn't dropped - at this point she's wondering if the shape of my pelvis is causing problems, but although she would clearly like to give me more time for it to happen naturally, she's concerned there's some other issue at play.

I go back today to see if I can bring my fluids up by drinking water, but if not we're going to be presented with what she describes as "not a lot of great options".  Induction - which I am not a good candidate for.  Or a c-section.

So my choice will be whether to try an induction at this stage - which will likely be long, painful and difficult with great odds of ending up in a c-section, or else just go ahead and schedule a c-section.

I'm not vehemently opposed to a c-section (for a long time I thought it was inevitable due to a giant fibroid) but I would also prefer to deliver vaginally if that's an option.  I'm also not a glutton for punishment.

I realize on occasion people do get induced a 0 dilated 0 effaced and have successful vaginal deliveries, but I think that's pretty rare.  I guess I'm just wondering what other people would opt to do in this position?   

Re: Induction vs. C-Section - what would you do?

  • I am in the same position as you...my thoughts at this point:  why go through all of the pain when you may end up with a c-section anyway...I asked my doc and he seems to think based on my situation a c-section is inevitable so I am probably just going to do that.  I've had friends who were so tired after laboring just tp have a c section. 
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  • I had a successful induction at 38w5d at just 1 cm dilated, 50% effaced with an anterior cervix. They inserted a cervical ripening agent (misoprostol) and within 12 hours, DD was born without the use of pitocin. Based on my experience, I would definitely attempt a vaginal delivery.
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  • I'd probably have the c-section if I was in your situation.

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  • Although I'm not there yet, I have a feeling this will happen to me too and I just want to go ahead with the c-section so if I were you, I'd just do that. I completely understand where you're coming from. I'd rather not labor for days to end up with one anyway. I'd rather just walk in and get it and be done.
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  • I would try the induction. I was induced with my first two, and was not dilated or effaced at all. I will most likely be induced this time too.
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  • I had a friend go through 38 hours of induction and end up with a C. Turns out, she had a tilted pelvis and her dr said he could have told her she was going to need a c-section?! 

    Even so, she has no regrets about any of it. If you are hoping to go vaginal, why not try? 

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  • I would go ahead with the c-section.  I was in a similiar situation and my dr thought I would end up with a c-section but wanted to induce.  Baby never dropped and I ended up with a c-section after a long 17 hours of labor.  The c-section wasn't bad at all.
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  • My sister was induced and she was like you, compleatly colsed tight, high and not soft at all, but the softening agent they can give you to help your cervix ripen is WONDERFULL, i would try it because A) a C-Section is a major surgery and B) personally i would want to hold her as soon as she comes out not be made to wait.
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  • As you know, I'm in your situation and am going for the induction (fully knowing that I may end up with a c-section).
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  • I would try the induction. I would also talk to the doctor about setting limits. If there is no progression after a certain amount of time request to go for the c-section. That way you aren't labouring for days and becoming exhausted before they decide to go for a c-section. That way you can try for a vaginal birth and maybe you will get lucky and it will work for you.
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  • imageperplexed59:
    I would try the induction. I would also talk to the doctor about setting limits. If there is no progression after a certain amount of time request to go for the c-section. That way you aren't labouring for days and becoming exhausted before they decide to go for a c-section. That way you can try for a vaginal birth and maybe you will get lucky and it will work for you.

    I agree with this. That way your aren't in labor for 36 hours or something before you have a c-section, but you still can labor for a bit to see if progress is being made. Some women might be closed very tight and open up quickly with a push. I would try induction first. 

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  • I just went through something similar, only I was favorable for induction.  I had a growth ultrasound at 39 weeks, and DS was estimated at 9 lbs 10 oz, and the doctor didn't feel comfortable keeping DS in any longer.  He presented me with two options - induction or c-section.  I knew I wanted to avoid abdominal surgery if at all possible, so I opted for an induction.

    I made it all the way to 10 cm, and pushed for an hour, before they realized he wasn't descending at all, and he recommended a c-section.  At that point, I knew I had done EVERYTHING that I could to do things the "natural" way, and I have absolutely no regrets about the induction OR the c-section.  When DS came out weighing 10 lbs, 15 oz, I was secretly glad I didn't have to deal with the massive  tearing that I had with DD (who was almost 3 pounds smaller than DS).

    I would suggest trying the induction, but be mentally prepared for a c-section. 

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  • I feel like I am going to have a similar decision to make.  I go back to the dr tomorrow to schedule an induction (if I am favorable for one, but so far it's not looking like it- no dilation, no effacement, baby is sky high).  I have such mixed feelings.  On one hand, I really want to deliver naturally, for my sake and the babies sake, but I also don't want to labor for 3 days, and then not have it work.  I am not afraid of a c-section, just want my lo out and healthy, however he gets here.
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  • I was not dilated or effaced when I was induced. I had a cervadil inserted the first night, and was on pitocin for a whole day, and progressed to 1 cm dilated (not sure what % effaced, but she said my cervix was still "long"). Another cervadil was inserted the next night and I ended up going into labor on my own, and delivered after 6 1/2 hours... without needing pitocin again. So it can happen! Can't hurt to give it a try! Sometimes your body just needs a jumpstart.
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  • I would try the induction first. Going through the birth canal exposes your baby to good bacteria that makes him/her less prone to allergies and sickness.  I was a C section baby and have horrible allergies.  I wasn't against having one, but I'm very happy I didn't have to.
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  • Thank you all for the good advice - a lot of what was said makes so much sense, and it's encouraging to hear stories of women in my situation who were successfully induced. 

    I'm heading to the doctor's in a few minutes, so I'll know more once they check my fluid levels again.  I'll give an update then! 

  • imageheath06:

    imageperplexed59:
    I would try the induction. I would also talk to the doctor about setting limits. If there is no progression after a certain amount of time request to go for the c-section. That way you aren't labouring for days and becoming exhausted before they decide to go for a c-section. That way you can try for a vaginal birth and maybe you will get lucky and it will work for you.

    I agree with this. That way your aren't in labor for 36 hours or something before you have a c-section, but you still can labor for a bit to see if progress is being made. Some women might be closed very tight and open up quickly with a push. I would try induction first. 

    This. If I end up in the same boat, I plan to at least try the induction, but I'm not going to keep at it for days on end. I figure 12 hours in i should have a pretty clear idea if progress is being made or not and then I can opt for the c-section at that time to avoid exhausting myself. But I'm VBACing, so I know what a c/s is like and personally I really really want to avoid another one.

  • I just went through 30 plus hours of labor that ended in a c section. Being induced after my water broke was the worst part. I never dialated past 4 cm. Looking back, I would have opted for the elective c section for certain! Good luck no matter what you choose!
  • Thanks everyone!  After drinking OBSCENE amounts of water, literally nearly making myself sick, I got my fluids up to healthy levels, so it turns out I don't need to cross this bridge just yet after all....going back to the doctor on Thursday, so we're still hoping to have some progress to labor or at least a shot at a successful induction.  

    It's a relief to not have to deal with this, but also frustrating to just be back to the endless waiting game! 

  • I would choose the c-section. Good luck, I look forward to seeing how your journey goes.
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  • I would try the induction first for sure. Since you are not dialated they will most likely start with a gel inserted into the cervix to soften it and get things going that way (hopefully). Then move on to pitocin. I had an induction, no they are not fun. They are long and they are painful, but I think much better than a c-section in the long run.

    You could also talk to your dr and have a Plan B ready. So if you haven't progressed after a certain period of time with the induction you could move directly into a section.

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  • I delivered my baby last week (40w4d) via c-section after being induced. I stayed overnight and was treated with Cervadil for 12 hours (only 2cm, 60% effaced). My water was broken and Pitocin was started the next morning. I successfully dilated to 10cm and 100% effacement, but my baby was also head down but up high and wasn't exactly centered. I turned throughout my 14 hour labor trying to get her into the correct position, but after an hour and a half of pushing, we were making no progress. So, I had to have a c-section. My doctor and I were fully aware that a c-section was very likely since I was making no progress for going into labor on my own.

    I know vaginal deliveries are supposed to be easier to recover from, but my c-section hasn't been that bad. The contractions from the Pitocin were very painful and I'm glad I got to experience labor and pushing with this one, but my next one will be a scheduled c-section. 

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