scheduled induction or elective c-section?

My doctor says we'll talk on Monday about scheduling a induction or elective c-section, so I need to figure out what I would prefer. I made a post on the nest to get some feedback and I'd love your feedback as well.

From: JezcaM
Date: 11/12/2007 at 5:32 PM

my doctor wants to talk to me on monday about scheduling an induction or elective c-section so i'm trying to think of the pros and cons of each. is there anything i'm forgetting?

c-section pros:
no pushing/laboring
no episiotomy (which i hear can be tough recovering from)
shorter "labor" time
won't conflict with my asthma and current bronchitis

induction pros:
more alert when baby arrives (bonding)
shorter (and easier?) recovery time
one less day in the hospital
other people (mom) can be in the room and a part of the birth
less swelling post-partum than with c-section

is one better than the other for your chances of breastfeeding successfully?
are there any pros that i'm forgetting? which would you choose, if given the choice?

he's thinking we're going to need to deliver early because 1) she's measuring huge (7 lbs 14 oz at 36 weeks) and 2) i'm not at all dialated. the type-a side of me really likes the idea of scheduling so i'm ok with this - just gotta figure out which method i'd prefer.


Replies:
From: m_and_m
Date: 11/12/2007 at 6:17 PM

No way in a million years could anybody convince me to choose an elective c-section. If there's no other option, that's one thing, but it's not the situation you describe.

I'm not afraid of surgery- I've had 10?11?12? I dunno, but alot, some of which were quite major. But I can tell you that I'd much prefer to recover from natural birth than major abdominal surgery. A tear or episiotomy is nothing compared to cutting through all those layers of muscle. Not to mention the risk of infection to you and increased risk to the baby.

I'm not saying c-sections are bad, wrong, less-than, or whatever some sensitive person might think I'm saying. I think they have a VERY important and necessary role in maternity care, but I do think it's something that should be reserved for when it is truly necessary and the risks are lower than the risks of a vaginal birth. Besides, this is only what I would do if it were a decision I had to make.


From: btrrcupbride
Date: 11/12/2007 at 6:28 PM


If you ever plan on having more kids you might want to consider how you feel about VBAC also.
My experiences:
I have had a non medicated non induced vaginal delivery, a planned induction with an epidural, and a failed induction with an epidural ending in an emergency c-section.
If I had to choose from the choices listed I would go with the induction - IF it were me.
I am still (and probably always will be) disappointed in my c-section. I think it affected Harper the first few days... she was very groggy. (But that could also be b/c I was put totally asleep for her birth). I hate that I did not get to see her for almost 4 hours. I was able to hold and nurse Lib and Jay within minutes and I loved being there for that time. I didn't get to see Harper's bath or fingerprinting and was still out of it when I did get her. I had a bad reaction waking up from my c-section too - vomitting and terrible shakes.
I personally didn't mind the pushing. I had a huge episiotomy w/ Jay and was still up and about quicker than w/ my c/s.
I was at the grocery store 2 days after having Lib vaginally.
Good luck whatever you decide.


From: JezcaM
Date: 11/12/2007 at 6:34 PM


great feedback, ladies. keep it comin'. all stuff i need to think about.

m - are the risks of infection with an epi less than with a c-section? i know you're not a doctor but i also know you've done a LOT of research - please share.

btrrcup - why weren't they able to keep you awake during your c-section?


From: Kristen&Doyle
Date: 11/12/2007 at 7:23 PM


Well, even though my view is a little one sided, at least I have experienced it. I'm not trying to say m_and_m doesn't know what she is talking about, but it is kind of hard to believe she knows what is best when she hasn't actually experienced any of it. Anyway, I would go for the c-section. If I had known how the recovery would be and not having to go through labor and suffer all that pain, just to get a c-section anyway, which if you ask me is always a possiblity, I would definately have done an elective c-section. I know everyone recovers from a c-section differently, but I think the odds are pretty good that you will have a easy recovery, sometimes better than a vaginal birth, especially later down the road, I remember quite a few moms saying how much longer it took to get everything back to normal with a vaginal birth. I've also heard a lot of bad things about inductions, but I never got one, just had my water broke, at which point it was green and I was told a c-section would be best at that point. I wasn't about to argue with them, I just wanted the pain to go away and for it all to be over with. As far as alertness goes, I really don't think it effected Colton, the IV pain meds I got, yeah, maybe a little, he was a "calm" baby when he came out, but really he has always been more on the calm side, so it's hard to say if the drugs did do anything or not. But as far as bonding goes, we were still able to do something, I think there is quite a story of it all in my bio if you want to read it, but anyway, I don't think the whole thing effected either of us enough for me not to schedule a c-sec for the next one! I hope all that helps a little. It's a hard decision to make, but in the end no matter what you choose, it will all work out and she will be here! Take care, Kristen


From: macg22
Date: 11/12/2007 at 7:32 PM


i think with anything to do with childbirth and being pregnant, everyone is different. my sister wanted to do a VBAC but refused to be induced b/c the pitocin (sp?) was really rough on her with her first baby. she ended up with a 2nd c-section b/c her baby was 10 lb 1 oz. so i think the pitocin may effect people differently which you won't know until it happens to you.
with me, i was given the choice between induction and c-section with about 10 minutes to decide (really bad pre-e). well i decided to do the c-section b/c even at 38 weeks i was not effaced or dilated at all. with all of the stories i had heard, i figured there was a good chance i would end up having a c-section anyways since my body really wasn't ready to give birth anways.
there were good and bad things about the c-section - it was really fast. i did have to wait a bit in the recovery room before i got to see brooke but i can't remember how long. my DH did get to go to the nursery with brooke after i "delivered" so it was great one of us was with her the whole time.
it is hard though that i never experienced labor... not even a contraction. i will never know if i could have successfully given birth vaginally but the odds were against it. so if i had gone thru 12+ hours of labor and ended up in a c-section anyways - it was nice skipping that labor part so i wasn't worn out for when brooke arrived.. i feel so bad for women that labor for so long and end up with a c-section.
recovery was rough - it was hard to sit up without being in tons of pain for a week or two. if you do do a c-section - make sure you've got someone or 2 to help you out that first couple of weeks. it's going to be hard enough to stand let alone getting the baby.
on a side note - if you were like me (i was gaining 3+ lbs a week at the end).... the weight/water loss is so much fun after the baby is born. i was losing 2 lbs a day for 2 weeks and could see such a difference in my swollen ankles each morning i woke up. you will love it!


From: molliedb
Date: 11/12/2007 at 7:51 PM


i had a c-section and i would have chosen an induction any day (wasn't an option since dd was breech). i will now have to make the even more difficult 'vbac' decision and it breaks my heart.

i had a decent c-section experience. no groggy baby, breastfeeding works great for us, recovery wasn't horrible, no swelling, etc. but i'd still pick induction.

i have my c-section birth story in my bio if you want to read it.

also- they estimated lily at 8lbs 5ozs, which is why they denied my request for a version and she was 6lbs 12ozs, so take their measurement estimate with a grain of salt. IF that is the only reason they are recommending an induction, i'd deny both personally.

good luck with your decision.


From: btrrcupbride
Date: 11/12/2007 at 7:56 PM


I will try to be brief...
I was not progressing w/ my induction. When Dr. S. broke my water Harper's cord came out of my cervix before her head crowned. (prolapsed cord)
The Dr. held her head up off my cervix and felt for her heartbeat while riding on my bed all the way to the OR.
They had Rich dress out b/c we were hopeful that since I had an epidural he would be able to come in the room.
BUT - seconds after I got on the operating table the Dr. said, "I have lost the babies heartbeat." The anesthisologist leaned over me and said, "You are going to sleep now."
Dr. S. said it took her less than one minute to get the baby out after the drug Dr. said that to me.
When I woke up in recovery I had no idea if she was even OK and I had serious shakes. They let the kids in to see me and I was P!SSED b/c it scared the crap out of them b/c of my reaction to the morphine.
Her cord prolapsed b/c she hadn't dropped at all. Second and subsequent babies usually don't.


From: richardslove
Date: 11/12/2007 at 8:13 PM


I had a scheduled induction due to my bp was creeping up there at the end. Never pre-e or anything, just in the area of high bp. Anyway, I ended up w/ an emergency c-section since DD heart rate kept dropping w/ contractions after 7 hours of labor. I got stuck at 7 cm, 100 % effaced...it's called failure to progress. Come to find out the cord was wrapped twice around her neck. It wasn't wrapped the day before during our u/s. I've always wondered it DD came on her own would things have been different. I don't regret the c/s, but the recovery was longer than I expected. I didn't have any problems bf'ing. I had pp bleeding that lasted 6 weeks. I'm pretty sure due to me trying to do too much too fast.

GL with your decision.


From: smatthe
Date: 11/12/2007 at 8:27 PM


long story short: I had a c-section. I healed quickly. (in fact, all the nurses were amazed that I was up and visiting my kid in the NICU like 12 hours after my c-section). I would do it again, except...

I feel like I missed out on something. I waited 9 months for baby to incubate and it is supposed to be cathartic (sp?)...a relief to push the baby out. I feel like I don't get to say, "I laboured for 20 hours with you and, finally, you popped out" to my child.

So, had I needed to explore the option the last time because I made it to term and baby was measuring big, etc., I would have chosen the induction w/ epidural.

(I don't get women who say they want to do "natural" childbirth when they just had pitocin shoved into their systems (willingly or not) and that stuff, from what I understand, makes the contractions feel worse than if you labored on your own...get the "candyman" and tell him to make is a "double"! ha! )

Now, I have the big decision of VBAC vs. another c-section...if everything progresses naturally.


-smatthe


From: molliedb
Date: 11/12/2007 at 8:31 PM


i just wanted to add you don't necessarily have less time in the hospital with an induction.

i had my c-section on friday at 5pm and was checked out of the hospital on sunday at noon. i wasnt even there 2 full days. its totally up to you, your doctor, and how you are healing.


From: JezcaM
Date: 11/12/2007 at 9:02 PM


i love you guys. this insight is wonderful. a couple of things i thought of:

i think my doctor said they'd only induce if i was 2 cm dialated - but that may have been before we were talking about scheduling and we were talking about blood pressure? can't remember. will they induce if you're not at all dialated? so far, he says i'm as closed as closed can be.

my mom induced with my sister and regrets it still, 26 years later. she felt like my sister wasn't ready to come out but they forced her anyway and it was traumatic on her - my sister had colic and my mom feels like it's her fault for inducing. probably just one of those mom paranoia things, but it's there.

induced contractions are supposed to be more intense than "regular" contractions. i'd forgotten that.

macg - where did you deliver? i'll be at seton nw and they don't have a nursery and on my hospital tour last week they said that the baby will be with me at all times unless there's a problem (like underdeveloped lungs or something). your point about laboring for hours just to end up with a c-section is a strong one with me. i've had several friends who've had to go through that - almost seems better to just cut to the chase? but you can never predict how it'll go for you.

btrrcup - holy smokes! i would have been terrified. you're a brave woman.

mollie - that's an impressive recovery!


From: jennynorene
Date: 11/12/2007 at 9:05 PM


this is a really tough decision. i was set on a (hopefully drug-free) vaginal delivery and honestly never even considered the possibility of a c-section. then at 35 weeks i found out grace was breech. i was SO upset and tried everything to get her to turn. she didn't budge. it took me a few weeks to come to terms with the fact that i would have a c-section: it didn't seem natural to me, i hated that her birthday would be "scheduled," i felt cheated to not be able to deliver vaginally, etc, etc. four days before our scheduled c-section my water broke. i had just eaten lunch so i labored for 6 hours before they would operate on me. the c-section itself was not bad - really only the getting the spinal was scary for me and the nurse was super supportive. i was crying and thinking "this isn't the way it is supposed to be" while they were putting it in. i had a great nurse during the surgery who told me what was going on (at my request) and it was very comforting. as soon as grace was born she started crying - it was the biggest relief i have ever felt in my life. they held her up for me to see right away and i can tell you honestly and with no regrets that I DID NOT CARE how she got here, i was just so glad that i was her mom. BFing went well and i was able to start right in the recovery room. i was alert but will admit i wasn't feeling great, but i'm not sure i would after pushing a baby out my lemonhole either. the first few days of recovery were pretty bad but by 10 days i felt pretty good. and my precious parts down there were preserved!

if i had delivered vaginally i think i would have wound up with an epidural and may have been disappointed about that - contractions suck! and i was so upset about the scheduled b-day but in the end grace came early so that worked itself out. i do remember thinking the day after the surgery that i can't believe anyone would choose a c-section but i now think that for #2 i will go that route.

so, this is my long-winded way of telling you that in the end i'm not sure how much it mattered which way she came out. the end result was what was important. you just have to decide what is best for you and then not second guess yourself.


From: cookie1and2
Date: 11/12/2007 at 9:14 PM


Honestly? Neither. Is the only reason you're scheduling a c-section or induction because the baby is measuring big? If that's the only reason--than I wouldn't do either. If there's another health reason, then I don't know--each one has its pros and cons. But as for measuring big--I wouldn't do it--I was always told my daughter was measuring big, and it scared the heck out of me. And she was big--9 pounds at birth, and I am what I consider to be an average sized person (5'8, size 10 pre-preg). My labor was a little over 3 hours, unmedicated.

I honestly believe that your body will be able to handle whatever size baby you have (of course within a healthy pregnancy, not counting undiagnosed gest-diabetes, etc.)

My advice is to trust your body--when your body is ready to deliver, it will. With the exception of medically necessary inductions and c-sections, I honestly believe that births are so much more uncomplicated if you work with your body and deliver when you are ready instead of fighting against something that's not working with you.

Good luck in whatever you decide!!!


From: cookie1and2
Date: 11/12/2007 at 9:16 PM


Oh--by the way--with my 2nd baby, I had my last check up 3 days before I delivered, and I wasn't dialated at all!! Unfortunately, being dialated or not is not an indication of when you will deliver.


From: JezcaM
Date: 11/12/2007 at 9:55 PM


He's not pushing scheduling early, it's just something we're talking about because:

1) i'm 5' tall and she's measuring big (fundal and ultrasound)
2) i have polyhydramnios
3) signs of borderline preeclampsia (on bedrest)
4) asthma (and, currently, bronchitis)

Since i'm measuring so big he's betting against me making it to my due date, scheduled or not. I like that I'm guaranteed to have MY doctor if scheduled....


From: macg22
Date: 11/12/2007 at 9:56 PM


i delivered at seton central - they have a nursery, it was great for middle of the night when i needed a little extra sleep.

this must be such a hard decision for you to make.... i guess i was lucky i only had 10 minutes to decide. at my 38 week appt - doc said brooke had to come out that day, no going home to get my bag - straight to the hospital. eek!

i don't think brooke had any weird side effects because of the c-section. i've heard they can sleep more the first few days b/c of the pain meds mamma is taking (if you breastfeed). breastfeeding went just fine with brooke.

i want to double a couple of the previous posts - those estimates on weight aren't always accurate. brooke was 6 lbs 14 oz and the u/s estimated she'd be at least 8 1/2 lbs.

good luck with everything! i'm sure you'll make the decision that's best for you and your baby - and that's all that matters!


From: KateAggie
Date: 11/12/2007 at 11:19 PM


Just wanted to say that I had a c-section over induction, b/c my doctor felt that if I went past my due date, induction would lead to c-section based on my pelvis/size of Marisa. If I went into labor naturally, we were going to try it and see how I progressed.

My c-section experience was a good one, and I don't feel like it took away from her birth at all. I was a little out of it after the c was finished, but who isn't a little out of it after birth anyway? I did not BF, so I can't give an assessment of that.

Without sharing too much (which delves way into TMI), there's no way Marisa would've made it through my birth canal, so I don't agree with the idea that you'll not have a bigger baby than your body can handle. However, my doc said it's really nothing to do with the height/weight of the mother so much as the pelvis/hips and how much give and movement there is in that region. :)

Good Luck with whatever you decide, and I hope you have a great birth experience!!


From: Emer
Date: 11/13/2007 at 12:11 AM


You have a lot of great responses so far. Here are my thoughts...
I was induced at 41 weeks. I went in at 1cm dilated, 75%effaced. I was given cervadil overnight which worked great. The pitocin was started early the next morning and they broke my water. I got the epi shortly after and never felt any major contractions. I felt a slight ache in my back and DH rubbed it through contractions and that is it. I made it to 8-9 cm with no problems at all. Then, during one of the checks, they realized she was breech. I was in the OR 20 minutes later for my c/s. They upped the epi, so I did not have a spinal.
Ok, so my feelings on the issue- I am glad I got to experience part of being in labor, but in the end all that mattered to me was having Katy out safely. I am her mother, I carried her for 9+ months, and the fact that she came out 6" higher than some babies does not disappoint me one bit. I know some women feel like they missed out or were cheated, but I simply don't feel that way.
After the c/s, she screamed her little head off for at least 30 minutes during her bath. My point is that she was by no means lethargic from the drugs. She was brought to me about 45 minutes after she was delivered and breastfed. I was groggy, but I will never forget when they put her in my arms. She BF'd like a pro. Dh was with her the entire time, btw. I felt loopy for 24 hours or so, but I was taking vicodin. The pain was rough during recovery, but it got better everyday. I needed help doing almost everything at home. DH was there all day everyday and I couldn't have done it without him.
Also, DD was measuring large. She ended up being 9lb, 5oz and I have to admit that part of me is glad I didn't have to push her out.
So, overall, I don't think inductions are bad. I seriously wasn't in pain during the laboring process (but I am a big believer in the epi!). My c/s was good, recovery isn't easy, but I don't think any recovery is.
I know you don't like hospitals, but to me, the extra day should be in the pro c/s column! I did not want to leave! They offered to let me go on day 3, but I stayed as long as they would let me.
I don't know which I would choose, but I am not at all upset about my c/s. It is a major surgery- don't forget that. Once you are home and able to move around, you still have months until your body is recovered. I still can't feel a section of my abdomen, for example.

Talk with your doctor, tell him your concerns. Whatever decision you make, as long as you are comfortable with it, it's the right decision.


From: mcurban
Date: 11/13/2007 at 8:07 AM


OK- honestly, I stopped reading all of the responses because I am short on time right now. But, from the early ones that I did read- you're getting some great feedback here. I'll add mine, as well.
I was borderline pre-e, as well. From around 36 weeks (I think) I had pitting up to my knees and elevated b/p- my b/p had been really low throughout the pg and then it just spiked all of a sudden. I was also given the choice of induction or scheduled c-section (as in, do you want an induction tonight or a c-section tomorrow). I asked the dr. if I could remain on bedrest for a couple more weeks and she firmly said, "You absolutely may. However, you will put yourself at significant risk of having a stroke or seizure." Well, that kind of sealed the deal for me. I say this because I saw a couple of people on here suggesting that you take neither option and hold out. That might be good for you, BUT, if you are spilling protein, and have an elevated b/p you could be causing permanent damage to yourself and Aubrey needs a healthy mommy!
My induction turned into a c-section due to Jack's cord being wrapped around his neck multiple times. We also found out, once in the c-section that my placenta was tearing so, there is a strong chance I would have hemmoraged if I had continued with vaginal birth. Jack came out extremely alert (the drs. and nurses continued to comment on that). In all of our pictures, he is awake and looking at me. Breastfeeding seemed like a challenge at the time, but as it turns out, he was eating just fine had regained his birthweight within a couple of days (vs. by the 2 week mark).
Another thing to think about (just to add more to your plate)- I remember that you were considering not doing an epidural. IF you go with a vaginal delivery without an epi and they do need to end up doing a c-section, they will probably knock you all the way out. That's what they told me, anyway. I was going as long as possible without the epi and then we noticed the fetal distress. That was when we decided to go with the epi, just in case. I wanted to be awake for the delivery.
If I had my choice and the world were perfect, I would have not needed the induction and had a vaginal birth when Jack was ready. BUT, at the end of the day, I'm sitting here watching my very talkative, very beautiful baby boy and I'm just happy he made it out ok.
In terms of healing, I was like molliedb. They were ready to release me on Sunday, but we chose to stay through Monday (I was able to get more rest in the hospital and wanted to make double sure that I had the breastfeeding thing down). At my 6 week post partum, I was back to "normal." and was told that I was an excellent canidate for VBAC.
Good luck, Jezca- whatever you decide, the end result will be little Aubrey out here with you!!!!


From: mcurban
Date: 11/13/2007 at 8:09 AM


clarification: if you end up doing a vaginal without an epi and they need to do an emergency c-section, they will end up needing to knock you all the way out. In my case, I had three sets of contractions to decide. With each set, Jack's heartrate was going lower and lower. Not a hard decision!


From: JezcaM
Date: 11/13/2007 at 10:28 AM


Y'all are so much better than any book I could read on the subject. Thank you again for all of the great, honest feedback. I'm copying it all into word so that I can highlight the different points and discuss with my husband. I'm confident I'll be able to come to a decision with which I'm happy, but I'll also be very open to things not going as planned as that seems to often be the case (especially on the nest! mamas going into labor the day before a scheduled induction...).
I'm thankful for the luxury of time to think about the different options and a doctor who's open to doing whatever makes me comfortable. And I'm thankful for YOU ladies!!! (((hugs)))


From: Tanya1975
Date: 11/13/2007 at 10:44 AM


I was induced at almost 41wks and had a large baby (9lbs 6oz) although we were expecting him to be more around 7lbs according to u/s and I'm still healing from my vaginal birth. In hind-site, if I had known how big he was going to be and the damage I would suffer, I would have had a c-section. I know none of us can tell you what is right for you, but you can take from our collective experences to help with you decision. Good luck, I know it's a hard decision to make.