My pregnancy is above 42 weeks,My fear is not having a vaginal delivery after my first failed induction experience. What should I expect?

Question: My pregnancy is above 42 weeks, to be precise, going to 43 weeks, my contraction is not strong enough, it grips me briefly and that is all. This is my second pregnancy and the first one was a Caesarean Section after a failed induction. I saw my doctor yesterday and he suggested another induction of labour. My fear is not having a vaginal delivery after my first failed induction experience. What should I expect?

Doctors Response: This is obviously a prolonged pregnancy or post- term pregnancy. It affects about 10% of all pregnancies. Always associated with increased risks to both the fetus and the mother, the risks of stillbirth and perinatal death are high too. The risk of prolonged labour if it eventually occurs and risk of caesarean section are also added. The risks are far too much.

Your doctor has done well by suggesting induction of labour but fetal surveillance should be included. At this point, no tests can accurately predict fetal outcome. Ultrasound may give a consolation if the amniotic  fluids and fetal growth are normal.

Your chances of vaginal delivery reduce  with the previous caesarean scar and thus both induction of labour and delivery post date should be discussed. A labour induced post-term is more likely to require a CS. This is partly due to the reluctance of the uterus to contract properly. Post term pregnancy may turn into a case of emergency if the following takes place

• Reduction in amniotic fluids while scan

• Fetal growth is reduced

• Reduction in fetal movement

• CTG not perfect

• Very High blood pressure

At this point you should be aware that no test can guarantee the safety of your baby and your life too is at risk. Perinatal mortality is increased by two folds with pregnancy above 42 weeks.