Thoughts on Induction

At the Royal Sussex County Hospital in Brighton, around 20% of women choose to have their labours induced. Some will have a pessary called Propess inserted to kicks things off – and the great thing about Propess is that women then go home and wait for labour to start (known as ‘Outpatient Induction’) – although they are strongly advised to come back in to give birth.

According to the hospital’s figures, many of these women labour more quickly than ‘Inpatients’ – and go on to have a birth free of further intervention.  The trouble with Propess is that it is currently only offered to women who are 12 days passed their due date. This means that some women who would have gone into labour spontaneously by 14 days ‘post dates’ are missing out on a natural birth because they like the idea of labouring at home for as long as possible with Propess.

The MSLC wants to see the window for Propess’s availability extended to women who are two weeks ‘overdue’  – as well as to those planning a home birth – and we’ll be raising this at our next meeting.

We would also like to capture feedback from women who have used Propess for induction. Please share your story with us in confidence – email Hannah via the ‘Contact Us’ page. Thank you !

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6 thoughts on “Thoughts on Induction

  1. Thanks Hannah. This came up for one of my ladies recently and she was very unhappy at the thought of Propess at 12 days instead of 14 post dates.
    After a very easy pregnancy and no fear, after taking HypnoBirthing classes with me, she came to see me a few days after seeing her midwife at 41weeks and was given this news. She was very upset and suddenly feeling some fear about the birth. I did a hypnosis/relaxation session with her and Reflexology she also went for acupuncture she went into spontaneous labour at 11 days post dates and birth very happily at Princess Royal. I am very concerned about how women are being informed about this and the language being used to convey the information. My client was told by her midwife that the last time they let a woman go over 42 weeks the baby died!! Hence not surprisingly the massive onset of fear. I so glad this will be an item at the next MSLC meeting.
    Many thanks
    Sonia

  2. Hilary Curtis says:

    First of all, how many of the 20% of women indued actually choose their induction? How many even know they have a choice, especially with postdates induction. Sonia, I have also had experiences of women being terrified by their midwives of going ‘overdue’. I had a mum not long ago whose community midwife told her that it was her choice to accept or refuse the induction but that she (the midwife) had been to a lot of overdue baby funerals recently. And I was present with another woman who was told that she could come in for monitoring every other day but that the baby could be fine one minute and die the next. Is this informed decision making at its best? In terms of extending the propess ‘window’ – yes, I’m all for that. I’d like to see the evidence that it’s making a difference in terms of improving straightforward birth, but any opportunity for women to labour at home rather than hanging out in antenatal must be a good thing. Just anecdotally, I haven’t noticed much of an improvement in parents’ experience of induction when they tell me their birth stories at NCT reunions, but that’s hardly a scientific conclusion so I’m happy to keep an open mind! What I would love to see alongside the propess window biing extended is a ficus on giving parents just a few minutes of quality time to listen and answer their questions and concerns as individuals, helping them to come to an empowered decision (which may or may not fit hospital protocols). thanks for all the hard work Hannah.
    Hilary

    • Hi Hilary

      Thanks so much for this – if you don’t mind, I’ll share your comments with the midwives. The MSLC is focused at the moment on discussing the existence of real choice as opposed to pressurised, directed decision making – especially around induction, breech and twin birth. There will also be extra data added to the stats so we’ll be able to see the links between induction of labour and c-section. I’ll keep you posted.

      Thanks again !

      Hannah

  3. susan masini says:

    hi there, I had the Propess and can’t say I’d recommend it. Well, maybe I just would not recommend being induced in general. I was scheduled to have the Propess at term + 10 days. We were convinced the baby’s due date was not right, and went to see the registrar on term + 11 days. We decided to go ahead with the induction because we were fearful to go past being 2 weeks overdue. I had 3 sweeps and no luck getting baby to come earlier, and the scan showed the baby was healthy and placenta was fine. No one pressured us and we almost backed out three times that day!

    I had the Propess inserted and went home at about 2pm and had an uneventful evening. We repacked the hospital bag… At 3am I was up with cramps, and by 4am I was in labour. This was my first child and I was afraid to drive all the way to the hospital only to be turned back for coming too early. I was thinking these were really strong cramps! But the doula and nurse on the phone both said to get to the hospital. By 6am my waters broke, and by 7am we were at the hospital and was dilated 5cm already. The labour came on fast and hard, with little time between contractions. In the birthing pool, I was convinced things would go quickly. After a few hours, the contractions were not regular and were not increasing in strength. We moved on to epidural with drip and after a few hours was dilated to 9cm. There was some worry that the baby was unsafe – and the labour was not progressing. By 8pm, I was being prepped for a c-section and baby arrived at 9:19 that night.

    I think being induced led us down the slippery slope of more interventions. But who can say for sure. My baby is here, healthy, putting on a lot of weight, and the csection has healed up well after 9 weeks.

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