Hypothetical Scenario: Induction vs. Scheduled C/S

MomtobeNJ · August 2012

The posts below about inductions and C-sections got me thinking. So let's say, hypothetically speaking, you are 41 weeks pregnant. You and baby are healthy, but a decision needs to be made about the next step.

You are given the option of induction (let's assume they will use pitocin) and an attempt at a vaginal birth, or a scheduled C-section.

Which would you choose, and why?

hmp1 · August 2012

While the Pitocin sucked, once I got my epi I was good. If those were my options, I would start with the Pitocin and see if that worked.

ELCJet · August 2012

Induction, no doubt. I've already had a vaginal birth so "the way" has been paved. I'm already dilated and effaced, and I'm planning to get an epidural anyway. I have no doubt a 41 week induction would lead to a vaginal birth assuming there were no other complication unrelated to the induction.

terri_doula2010 · August 2012

I would do anything possible to avoid another c-section. Pitocin, cervidil (even with increased VBAC risk), external version, forceps, episiotomy, vaccuum extraction, standing on my head, and juggling knives.

You heard it here first, people: Juggling knives is the new trend in induction methods.

tlew12778 · August 2012

What's my bishop score?

First I would wait till 42 weeks.

Then I would probably try an induction (but first membrane sweep, then foley bulb, then AROM then pit) bc I had a CS already and it was a miserable experience that I don't want to repeat.

MomtobeNJ · August 2012

terri_doula2010:
You heard it here first, people: Juggling knives is the new trend in induction methods.

I'm totally putting that in my birth plan. Wink

Manx4 · August 2012

Induction - I've had it before and it wasn't that big of a deal. If it lead to a c/s then I'd deal with it then. I would always want to try vaginally if I could before surgery.

mlf625 · August 2012

I'll be in the minority on this, but I was in a situation similar to your hypothetical one and chose the scheduled c/s. My reasons were that I wasn't effaced or dilated at all, so my Bishop score was as low as you could go. My worst case scenario birth (assuming mom and baby were safe, obvi) was induction/labor AND a c/s, particularly an emergency c/s where I might have to be knocked out. I'd had two losses prior to DS and was petrified of delivery complications, so the controlled aspect of the c/s really appealed to me. DS was measuring large and while I know women deliver 9 pounders (or more) every day, I just didn't care to put my vag through that. I liked my c/s.

TAGSL710 · August 2012

tlew12778:
What's my bishop score?First I would wait till 42 weeks.Then I would probably try an induction but first membrane sweep, then foley bulb, then AROM then pit.nbsp;

Agreed but this order: accupuncture, membrane sweep, foley bulb, cervadil, pit, AROM [because the clock starts ticking then].

BPer · August 2012

Induction. Even though it increases your chance of having a c/s,I'd like to at least have a shot at a vaginal birth.

melody921 · August 2012

Definitely induction. I'd definitely want to give my body the chance to delivert vaginally again. If pitocin contractions are too intense, I can get an epidural. By 41 weeks, my body would probably remember what it was supposed to do and push out the baby. But at least if I had to have a c-section after all that, I would have made all other attempts. But I am not a fan of being sliced open unless absolutely necessary.

MomtobeNJ · August 2012

mlf625:
I'll be in the minority on this, but I was in a situation similar to your hypothetical one and chose the scheduled c/s. My reasons were that I wasn't effaced or dilated at all, so my Bishop score was as low as you could go.

I appreciate this - this is exactly why I asked. I know there are lots of factors to consider.

One of the things I find interesting is that in the post earlier today asking for the truth about c-sections, MOST responses said they were pretty good. Not too much pain, decent recovery, etc. So I was wondering if that would lead people to choose a c/s in this kind of scenario. I mean, I understand that it's major surgery with lots of risks involved...just trying to get a feel for ALL the options and understand all the factors involved.

terri_doula2010 · August 2012

TAGSL710:
tlew12778:
What's my bishop score?First I would wait till 42 weeks.Then I would probably try an induction but first membrane sweep, then foley bulb, then AROM then pit.nbsp;
Agreed but this order: accupuncture, membrane sweep, foley bulb, cervadil, pit, AROM [because the clock starts ticking then].

I like your order. With a healthy dose of nipple stim and lots of semen thrown in along the way.

jlh2716 · August 2012

Induction first. It makes no sense to me to just skip everything and go directly to surgery (unless medically indicated, of course).

EGMphoto · August 2012

Hands-down induction first. I would do anything to have another VB.

roxyttandme · August 2012

Induction.

Demedoll · August 2012

Induction of course. Why would anyone pick a major surgery with risks to the child and the mother over going the way their body was created to go and have a vaginal birth?

If the only data we are going on is 41 weeks preggo- I'd say wait another week then be induced. I would never go through a csection again if I can avoid it.

mrs.kapow · August 2012

I would induce, but with your scenario of going right to pit, I would very seriously consider the c/s.

If labor had not kick started with cervadil with DD and I had shown zero progress with it, MH and I had already discussed that the c/s was on the table. We had three friends go through traumatic labors and end up in the OR and like mlf said, that sounded terrible to me.

Pitocin still seems like the devil's juice, even after some positive stories from TB.

watercolor5 · August 2012

I'd definitely do the induction/ shot at the vaginal birth... with epi. Surgery is more dangerous for me and has a more difficult recovery, so I'll only resort to a c-section if it's what's best for my baby.

Shazzie116 · August 2012

I would try cervadil first, and depending on progress, make a decision from there. I'm not outrageously opposed to having a c/s. Pushing out my baby's 85th percentile head is already making me nervous. I will try it, but that doesn't mean I have to like it or pretend it doesn't scare me.

TAGSL710 · August 2012

terri_doula2010:
TAGSL710:
tlew12778:
What's my bishop score?First I would wait till 42 weeks.Then I would probably try an induction but first membrane sweep, then foley bulb, then AROM then pit.nbsp;

Agreed but this order: accupuncture, membrane sweep, foley bulb, cervadil, pit, AROM [because the clock starts ticking then].
I like your order. With a healthy dose of nipple stim and lots of semen thrown in along the way.

Haha with a very happy husband.

cbj09 · August 2012

I would wait another week and do everything possible to jump start labor during that time (see the PP who mentioned everything, juggling knives and all).

THEN if at 42 weeks there really was nothing happening, an induction, hands down.

sweetiebird726 · August 2012

In my current situation, I would choose to induce. I am 70 effaced and a fingertip dilated, so my body is starting the process anyway. If I made it to 41 wks with that, I would try induction.

If I was closed up tight with no signs of impending labor, I would probably wait until 42 weeks and then reevaluate.

Even though I would like to avoid a c section if at all possible, I'm not that scared of getting one/needing one. If there's any sign of baby distress and induction didn't do anything, bring on the c/s.

blindvictory · August 2012

Definitely would chose the Pitocin induction over a c/s any day. With Pit, I might still be able to accomplish a vaginal birth with no other serious interventions. I would never elect to have a serious surgery unless it was totally necessary. I've never been cut open before and I wouldn't want to if there was a chance I could get the kid out on my own.

Jams1002 · August 2012

If I HAD to choose between the two, I would try for a vaginal birth with an induction. However, like another PP said, I would wait it out until 42 weeks and only with my MW's recommendation.

mrsjenni · August 2012

I've already had to choose from these options so it's not so hypothetical to me

With DS I had pre-e and was sent over to L&D straight from my 38w0d appt to have him. They gave me the option of a c/s or an induction and I absolutely chose an induction. Thankfully I was 3cm dilated already which helped in my decision, but I would never willingly choose a c/s unless it was a last resort or emergency situation.

lindsay.lou · August 2012

If I had a favorable Bishop score, I'd go straight to pitocin at 41 weeks. I responded very well to pitocin with DS1 (he was born 7 hours after the drip was started). My OB said people who respond well to pitocin once TEND to respond well to it in subsequent pregnancies (but again, depends on the Bishop score).

If I had an unfavorable Bishop score, I'd try membrane sweep and other methods to get things going before trying pitocin.

I really can't imagine opting for a c/s without trying an induction.

freeatlast2014 · August 2012

Since I already had a c/s and they won't use pit for a VBAC, I'd end up with another c/s.

It is my worst fear to labor and end up in an emergency c/s. I know how bad the recovery can be but we had both healthy and happy baby and mama last time so I have no reason to doubt that would be the case again this time. I trust my dr. and will follow her lead!

str8outalne · August 2012

Neither. I'd say I want to wait longer and attempt natural induction methods. If it really came down to "Baby needs to be born", I would try to avoid the c-section at all costs.......for obvious reasons.

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