Induction vs C-section at 39 weeks
To add context, I am considered high risk due to gestational hypertension that I developed at 37+6 weeks. I am aware of the ARRIVE trial that showed that induction slightly lowered the rate of c-section compared to waiting for natural labour, but it only studied low-risk women. I am also aware of the NICE guidelines that state that mothers with gestational hypertension should deliver between 37-39 weeks, but a senior obstetrician said to me that he’s comfortable with me waiting until 40+2 (expectant management essentially). I am not feeling safe to wait that long, and I am petrified of increasing the chances of stillbirth by waiting that long given my condition.
I am currently taking 200mg of Lebetalol 2x a day. My blood pressure is stable at around 130/80. The highest blood pressure reading I had prior to getting admitted to the hospital and being put on Lebetalol was 176/91.
A cervical sweep showed that my cervix is still long and not dilated at all, but is soft.
Induction in my case would involve cervical ripening. I am aware that it’s a lengthy process, and could still end with an unplanned c-section (the chances are 18-34% according to what I read).
I am also aware of the possible complications of a c-section and the recovery process, but I do have a lot of support at home (my husband, mum and sister) and I am not worried about not having help with my baby.
It is a hard choice to make and I know it’s mine to make, but I do want advice on what would be the best decision given my circumstances. I went from planning a natural unmedicated water birth to developing gestational hypertension, so I must admit I haven’t researched induction and c-section as much as I could’ve throughout my pregnancy! I am very much a naive first-time mum, so any advice is much appreciated. :)