Tell me how to deliver this baby, MM

[Deleted]

I'm 35 weeks and change with baby #2. DD's birth, while not-life threatening, was pretty tough and left physical damage. 48 hours of labor, broken tailbone that still causes discomfort every time I sit down, pushed for 3.5 hours and a 3rd/ 4th degree tear. DD was 8lbs 9oz at 41 weeks.

I've since moved and obviously changed Obgyns. All three docs in the practice have had a 10+ minute conversation with me about options to avoid similar physical damage again. Two of them have referred to DD's labor and delivery as traumatic, which makes me cry because it's the first time anyone in the medical field has acknowledged that it was difficult.

We live 45 minutes from the hospital I plan to deliver at. I'm due May 9 and need to make a decision in the next few weeks. They've offers an elective C-section, which is not something I'm interested in. They've also offered induction anytime after 39 weeks. Or, I could ride it out and see what happens. We have a number of options for what to do with DD when I go into labor but they are all situation dependent.

I'm not sure what to do. What would you do, MMMers?

[cricketwife]

Well, I wouldn't do the induction. I would ride it out if you don't want the c-section. (Which I wouldn't want either.)

eta: did they make a rec or just offer options?

[dancingirl21]

This is tough. I think I would try to wait to go into labor naturally and if that didn't work by just past 40 weeks, opt for the induction. Obviously if it seems like things are going poorly again, it sounds like your OBs would probably push a c-section at that point, right?

[Deleted]

Oh man, tough call. I'd not induce and wait it out, if you really want to avoid a c-section. If it were me, I'd go c-section - but that's because I've had one and recovery wasn't a big deal at all. Perspective and all.

[Deleted]

Do they think induction would make things easier due to size? Will they do the induction only if favorable?

In your case I personally would think about the C-section. The idea of rebreaking my tail bone would be scarier to me than the idea of major surgery.

I am not sure if that is logical.

[dottyblue]

oh my goodness my dear. I'm so sorry your first was such a traumatic experience. My first was difficult (24 hour labor, 2 hours pushing, internal & external tearing that required 16 weeks of healing before I wasn't in pain all the time), but my second was a cakewalk (under 2 hour labor, 3 pushes).

I would ride it out, see what happens. I was hoping to go into labor spontaneously with my 2nd, but by 39 weeks I was so uncomfortable that we scheduled my induction for 40w 2d. My hospital just needed 4-5 days from when I asked to schedule the induction until they were able to get me in. Ask your OB what the timing usually is if you opt for induction at the last minute and go from there.

Thinking fast and easy labor thoughts for you!

[simpsongal]

I had a great induction, I would be happy to go that route again, if necessary. It's interesting a few folks seem to favor an elective C section over an induction.

Can they offer you an ultrasound or something at 39 weeks so they can get a more accurate picture of the baby's size? I assume size was a contributing factor to your difficult delivery. If the baby is 8 pounds at 39 weeks, I'd be tempted to induce.

[karinothing]

What is the reason you pushed so long with your first? Was she high?  Malpositioned?

[magpie]

I would ride it out and avoid an induction, but that is colored by my not so great induction with DD. Good luck to you either way. I hope it goes more smoothly, no matter the option you choose. I feel like i will be asking similar questions when my due date grows closer.

[mainelyfoolish]

I would go for the 39 week induction if you were favorable for it.

[pinotgrig]

If I were you, I think I would wait for labor to happen on it's own. If you got to 40w or so and nada, I would start thinking induction but might give it a few days still yet.

Could you handle that mentally or do would a more solid plan make you feel more at ease? I didn't get a good read on your anxiety level from your OP regarding this given your prior experience.

[Deleted]

Do you know why you labored for so long last time? Was she too high? Drugs being weird? Too big?

I know this boards leans anti-induction but my sister had three great inductions so I've always had an open mind about them. I mean, it can't be longer than 48 hours, right?

[bdubs419]

I don't think there is a "right" answer here. I went through a somewhat similar experience. I had horrible recovery including a fourth degree tear with DS1. He came on his own at exactly 39 weeks, but was large and had a ginormous head. DS2 was measuring the same. My doctors left the decision up to me, but they said they would opt either for an elective c section OR an induction at 39 weeks. They absolutely didn't want me going past 39 weeks. A few of the OBGYNS in my practice kept on telling me that my first recovery was worse than a C-section recovery. At the end of the day, I opted for the induction at exactly 39 weeks. When I went in that day, they only had to break my water because I was progressing along on my own. I didn't end up needing any drugs. I think I got really lucky, because I have heard plenty of horrible LONG induction stories. I ended up with only a 2nd degree tear with DS2 which seemed AMAZING after my first experience.

So for me the induction was the right choice, but I had no way of knowing that that was going to be the "easy" option. I think you just need to go with your gut. If you don't want to go with a C-section, I would ride it out. Can they schedule an induction at a later date (depending on how things go)? or would that need to be scheduled soon too?

[Deleted]

Apr 8, 2016 8:30:58 GMT -5 cricketwife said:

Well, I wouldn't do the induction. I would ride it out if you don't want the c-section. (Which I wouldn't want either.)

eta: did they make a rec or just offer options?

They offered them as options.

[cricketwife]

Apr 8, 2016 8:44:29 GMT -5 @notquiteblushing said:

Do you know why you labored for so long last time? Was she too high? Drugs being weird? Too big?

I know this boards leans anti-induction but my sister had three great inductions so I've always had an open mind about them. I mean, it can't be longer than 48 hours, right?

Well sure, but do you want forceps or a c-section so that you can make that deadline? 

[Deleted]

Apr 8, 2016 8:32:35 GMT -5 dancingirl21 said:

This is tough. I think I would try to wait to go into labor naturally and if that didn't work by just past 40 weeks, opt for the induction. Obviously if it seems like things are going poorly again, it sounds like your OBs would probably push a c-section at that point, right?

I assume they would push for a c-section if things went so poorly again. I'm honestly surprised my original OB let me push for that long.

[Deleted]

Apr 8, 2016 8:34:54 GMT -5 @savestheday said:

Do they think induction would make things easier due to size? Will they do the induction only if favorable?

In your case I personally would think about the C-section. The idea of rebreaking my tail bone would be scarier to me than the idea of major surgery.

I am not sure if that is logical.

The theory is that an induction after 39 weeks would get a smaller baby and thus easier delivery. H was 8lbs 9oz and his brother was 8lbs 15oz. Not that that actually tells us anything.

[Deleted]

Apr 8, 2016 8:38:17 GMT -5 simpsongal said:

I had a great induction, I would be happy to go that route again, if necessary. It's interesting a few folks seem to favor an elective C section over an induction.

Can they offer you an ultrasound or something at 39 weeks so they can get a more accurate picture of the baby's size? I assume size was a contributing factor to your difficult delivery. If the baby is 8 pounds at 39 weeks, I'd be tempted to induce.

Good idea on the ultrasound to gather more information about baby's size.

[Deleted]

Apr 8, 2016 8:39:47 GMT -5 karinothing said:

What is the reason you pushed so long with your first? Was she high?  Malpositioned?

I think she was high and never really engaged my cervix. I was 41 weeks and only 1 dilated when I went into the hospital after my water broke. And I think I broke my water rather than DD; I bent over to put my shoes on and pop!

[Deleted]

Apr 8, 2016 8:41:11 GMT -5 @marshmallows said:

I had a similarly long pushing stage and a broken tailbone as well. My tear was only 2nd degree and I had an episiotomy due to the use of forceps. Mine was due to DD's positioning - she was sunny side up. She was 8 lbs 13 oz at 42w. Did your old OB say anything about what caused the broken tailbone? If it was positioning, then I don't see how an induction would help. I'd imagine it would be better to wait to go into labor on your own, because that ups the chances the baby's in the correct position (I was induced).

No idea what caused the broken tailbone other than a "it happens sometimes." I was delivering on my back, which obviously makes me think that the force between her head, the tailbone and the bed contributed to it. I knew what happened immediately and... Shudder. I'd like to deliver in a non-on my back position and my OBs are cool with that. But I'm afraid that pitocin induction -> epidural -> on my back.

[Deleted]

Apr 8, 2016 8:44:27 GMT -5 pinotgrig said:

If I were you, I think I would wait for labor to happen on it's own. If you got to 40w or so and nada, I would start thinking induction but might give it a few days still yet.

Could you handle that mentally or do would a more solid plan make you feel more at ease? I didn't get a good read on your anxiety level from your OP regarding this given your prior experience.

I'm not particularly anxious, mostly because I think I've buried my head in the same about it. I'm so busy at work that I can avoid thinking about it. I just don't want to make the decision, you know?

[circa1978]

Personally, I think I would wait and see what happens, especially if you are adverse to considering a c-section. Each labor can be so different and growth scans can be wildly off base.

[Deleted]

Apr 8, 2016 8:44:29 GMT -5 @notquiteblushing said:

Do you know why you labored for so long last time? Was she too high? Drugs being weird? Too big?

I know this boards leans anti-induction but my sister had three great inductions so I've always had an open mind about them. I mean, it can't be longer than 48 hours, right?

Probably too big, too high and too stubborn, like her mama.

God, even a 12 hour induction sounds better. I survived the pit contractions for 12 hours before requesting an epidural.

[karinothing]

Apr 8, 2016 8:55:33 GMT -5 @idaholakelady said:

Apr 8, 2016 8:39:47 GMT -5 karinothing said:

What is the reason you pushed so long with your first? Was she high?  Malpositioned?

I think she was high and never really engaged my cervix. I was 41 weeks and only 1 dilated when I went into the hospital after my water broke. And I think I broke my water rather than DD; I bent over to put my shoes on and pop!

Well, I can't see how old she is, but I think most OBs want you to labor down now instead of pushing if the baby is high. So hopefully you would be able to avoid pushing for 4 hours and wouldn't start pushing until the baby is engaged in the cervix. So if you want a vaginal birth I would talk about that with your doctor. I think if you induce and the baby is till high you are going to run into similar problems (or could, obviously this could be completely different and the baby be born easily too).

If I wanted a vaginal birth I would do the following. I would get an estimate of the baby's size. Although they can be inaccurate if would give me a better idea of whether or not to induce. I don't think that 8lbs 9oz at 41 weeks is overly huge. I would then work on spinning babies to get the baby in to the easiest position for birth.

[Deleted]

Apr 8, 2016 8:50:20 GMT -5 @mrsbecky said:

If you aren't interested in a C-section, then I would just wait to go into labor on your own. What is the benefit of being induced here? Is it that you don't want to go late again?

The theory is that an induction at 39 weeks rather than waiting to go into labor on my own/ be induced at 41 weeks would mean a smaller baby, thus less damage to the lady parts.

[Deleted]

Apr 8, 2016 8:47:11 GMT -5 bdubs419 said:

.

So for me the induction was the right choice, but I had no way of knowing that that was going to be the "easy" option. I think you just need to go with your gut. If you don't want to go with a C-section, I would ride it out. Can they schedule an induction at a later date (depending on how things go)? or would that need to be scheduled soon too?

Good question, if the induction needs to be scheduled soon or if we can wait and see if I'm progressing on my own before making a decision.

[londoncalling]

I would wait it out and not go for an induction. I had an induction with DD1 at 41w, was completely unfavorable, but had low fluids so she was coming out that day regardless of method. While it was successful and I delivered vaginally, I did end up with pelvic damage that persisted. DD1 was 9#. I delivered DD2 (7# 12oz) vaginally at 41w, after going into labor on my own. Easier and shorter delivery, but it exacerbated my pelvic injury and I ended up in a total of 24 weeks of pelvic therapy over the course of 18 months.

I know that you said that you aren't interested in the c-section. Me, personally - I would be considering it just to try and help control the vaginal/tailbone issues and prevent any further possible damage.

[lolo]

I thought guidelines were recently revised to say that anything under five hours (omg) of pushing was normal for a first baby?

[patbutcher]

I would consider the induction too. I had a successful induction at 41 weeks with dd and she was 8lbs 8oz. I know a lot of people are anti induction but I know a ton of people who had successful outcomes although I do think it may depend on how dilated you are at the time of the induction (I went in at 5cm).

Coincidentally, I am also due May 9 and the doctor is estimating this baby to be 9lb 2oz at 40 weeks. My H was 9lbs 11oz which is making me very nervous. I think I may also get offered an early induction and I will consider it.

[Deleted]

Apr 8, 2016 8:54:26 GMT -5 @mrsbecky said:

Apr 8, 2016 8:53:20 GMT -5 @idaholakelady said:

The theory is that an induction after 39 weeks would get a smaller baby and thus easier delivery. H was 8lbs 9oz and his brother was 8lbs 15oz. Not that that actually tells us anything.

Have you had a growth scan recently?

No. Nor has one been discussed.