Should I go for Induction at 40 plus 5 ??

[HelenBabyHToBe]

This is my first baby.

Saw my consultant today and she said she will be going on hols when i am 41 weeks pregant. Gave me choice of having someone else deliver baby or she suggested induction at 40 plus 5. Should I go with that if i havent delivered by then OR should I wait and let by body decide.

I also suggested that a membrane sweep around my due date and she said yes if cervix okay.

Confused and would love your advice as i am aware that inductions increase assisted delivery possibility.....
thanks :-)

[QueenyEisGotTheBall]

i am a firm believer that a baby should come when its ready i managed to get to 40+11 with DD and whilst i was anxious to meet her i really was quite reluctant to go for the induction option it all depends on how you feel yourself how far along are you? i assume you are not due yet otherwise you would have already had the mebrane sweep you may not even need the option of induction and i would be tempted to just wait and see what happens nearer the time induction does increase the risk of instrumental delivery and there has been alot of research which suggests that induction is more intense pain-wise than a naturally brought on labour. dont rush into the decision as when you are giving birth you will more than likely not be bothered either way if it is your preferred doctor or the pope delivering your baby as long as it gets the job done good luck
xx ei xx

[sushistar]

I wouldn't go for the induction,myself. What would be the problem with another dr delivering the baby? I'm sure they can all do a good job - hell, why not dispense with the dr alltogether and go for midwife-led care?

[thumbwitch]

i can only tell you my experience - I was induced at 42 weeks, DS didn't want to come out and was born 16 days overdue. The induction took a while to "take", i needed 3 pessaries but avoided the syntocin drip (thank GOD!) and was advised that if I had an epidural then I was very likely to also need further assistance, ventouse, forceps or CS. Fortunately, didn't need any of that in the end and stage 2 labour was only half an hour (I believe the HUGE amounts of raspberry leaf I had been taking contributed to that!). DS was perfect, not even wrinkly, and only had a bit of skin shedding on his hands and feet; he weighed 7lb 5oz. Basically he wasn't "cooked" until 42 weeks so that's when he came out.

The point of this ramble is that it might be better to wait longer in case your DC needs the extra time to be "just right" - and although I avoided the syntocin drip so have no experience of it, I believe it is fairly unpleasant! As is the cervical sweep (had 3 of those - ugh)

[Highlander]

45% of inductions in first-timers end up as emergency CSs.

don't know what the stats for ventouse/forceps/2nd or 3rd degree tears are.

Your baby will come when he's ready.

[lou031205]

I would go for it myself, but then I have had two successful easy inductions, one at 39+6, and one at 35+4.

[Maria2007]

sorry, just wanted to ask (because I'm interested)... where does the statistic 45% of inductions in 1st timers lead to emergency CS come from? It does seem very high, so I would be interested to know.

[wasabipeanut]

Speaking as one of them I can prob give you an idea.

Waters started to leak at 39+6 but 3 days later labour still hadn't started. Despite the fact that my cervix was still pointing the wrong way I was put onto a syntocinon drip. I couldn't understand how the drip would work if my cervix wasn't ripe and I knew my baby wasn't ready to come out.

Nobody could explain what the risk of infection actually was but I felt I should have the induction because I would never have forgiven myself if something had gone wrong.

A few hours in the pain became overwhelming because the contractions were so intense and so fast and I had only got to 4cm. Midwife receommended epidural and frankly I was in no fit state to argue. 18 or so hours later had been stuck at 8cm.....emergency cs due to failure to progress. Dh was a healthy 8 pounder who was none too pleased at being forced out before he was ready.

Tbh I still have a lot of issues. I question whether the induction was necessary and the thus the surgery that followed. We are trying for another baby but just thinking about going through that again terrifies me.

[wasabipeanut]

To the OP I'm really sorry - I don't want to scare you. But I would obviously advise avoiding an induction unless absolutely necessary!

[lulumama]

i would leave it until you are closer to 42 weeks , your baby and you rbody might not be ready , and no point being induced just to fit in with your consultants schedule.

if you are high risk then that might change things, but if your cervix is not ready, then you could be being induced for days.

i would ensure that your body is ripe for indution and not deliver at someone else's convenience

unless there are significant indications for induciton, i would leave well alone

[wasabipeanut]

Lulamama - out of interest what constitutes a significant indication for induction?

[lulumama]

well, it would depend.. signs of infection, high BP and other syptoms of pre eclampsia, bleeding, baby not growing , things like that, rather than just being overdue. bearing in mind that the due date is estimated and only 5 % or so of women give birth on their due date and many, many more delvier around 41 weeks anyway

some babies do need to be delivered earlier, some mothers need their babies delivering earlier, but many do end up being induced due to being term + 7 or whatever, whereas a normal pregnancy can be up to 42 weeks, some women are pregnant for 43 weeks.

expectant management can be used to see if baby is happy in utero post dates... but lots of women feel more comfortable being induced, which is fine, but i think women deserve to know that routine induction for simply being overdue, is not always the best route, IMHO

[mydisguise]

i just gave birth to my 3rd baby at 40+5. labour was spontaneous. I personally would wait and let your body do the talking.when it comes down to it i doubt u will really care who delivers your baby as long as its safe and healthy. hth

[zoggs]

DD induced at 40+14 (several high sweeps and then drip) and DS1 induced at 40+16 (pessaries, high sweeps then ARM) - felt traumatised physically and mentally. DS1 and I had to be treated for infection.

Vowed to avoid induction for DS2 who came when he was ready at 40+5. Totally different experience, so much better.

Please avoid induction if you can unless the safety of you or baby is at risk. Forget your consultant - she wont be there to pick up the pieces when you get home feeling like you've been hit by a steamroller.

[wasabipeanut]

Lulamama I agree 100%.

If I could turn the clock back I would have refused my induction.

[zoggs]

Ps Infection was caused by induction not the reason for doing it. Both inductions were performed because I was so "late".

[Sunshinemummy]

My story is similar to wasabipeanut which is why I wish I had tried to hold off for a little longer.

Was induced at 40+5 due to high blood pressure. Had prostoglandin gel and contractions started the following morning. They suddenly went from bearable to fast, long and strong and I had gas & air followed by an epidural at only 4cm.

After 55 hours of labour I was still stuck at 9cm and had an EMCS due to failure to progress. I wish I'd stood my ground and waited.

[lulumama]

i would have refused mine too, wasabi. i was induced at 39 + 1... had c/section for failre to progress.. long story, but anyway, i had VBAC with DD and no intervention at all, it took a long time to get over the csection though..

[zoggs]

I wish I had known I could refuse to be induced!

I believe it contributed to my PND. Is that supported statistically, Lulumama?

[lulumama]

nothing that i know of that is peer reviewed research, but through my work, and through what i do for the birth trauma association, and through friends and acquaintances and my own experience, i would say PND seems more prevalent with emergency c.sections. and a number of emergency c.sections are due to failed indcutions.

you are allowed to question medics and midwives and do your own research and challenge things, but it can be quite nerve wracking to do so.

www.aims.org.uk excellent resource for what you are 'allowed' to do

you can be advised, but ultimately, you can make an informed decision at any stage to refuse any or all treatment, from internals to induciton. as long as you are making an informed decision

never a good idea just to say 'no'. but defintely a good idea to question thing if you are unsure, or if you feel you would be at risk of more intervention

IMO

[lulumama]

i mean never a good idea just to say no, without a good reason! there is often a compromise that can be reached

[zoggs]

Yes, I wish I had been more assertive but there is always this feeling hanging over you that if something goes wrong then they will stand around, arms folded saying we told you so...

There was no clinical reason to induce me at 40+16 and I know that for a fact. It was a long time ago and I still haven't forgotten how traumatic it was. I reckon I'd have gone to 43 weeks and that would be normal for me.

To make matters worse I was an ITU nurse at the time so I was well informed (although I'm not a midwife). I think my job lulled me into a high-artificial-intervention-is-ok mode.

[HelenBabyHToBe]

PS i am 38 plus 5 days now. Up until now i have been thinking that it would be good or baby to take its time as enjoying peace and quiet (!). Now as there is this 'deadline' i am praying that it will come naturally before the 10th !! typical how life plays out hey?!
hx

[lulumama]

i know zogg, i understand.it is almost 9 years since my em c.s and it still rankles, as i know it was pretty much preventable. but then if i had not had it, i would not have had my experience with DDs birth adn do what i do now !

there is risk in everything, but it is when the 0.1 % risk is blown up out of all proportion and that stops women making informed decisions

[lulumama]

helen, there is no deadline. unless there is a distinct reason to be induced. you can go to 42 weeks or beyond.

if your cervix is not favourable for a membrane sweep, then you are unlikely to be favourable for induction IMO

[Snaf]

Helen is there a specific reason why your baby has to be delivered by a consultant? Have you had problems in this pregnancy?

As others have said, the issue is that if your body is not ready, induction can be a long, drawn-out and painful process that has a high chance of ending in a c-section.

If there is no clinical indication for an induction, I would rarely advise a woman to go for it. I would not consider your consultant's holiday plans as a good reason to induce. In the end, however, it's your body and your choice.

A membrane sweep would certainly be a sensible starting point. But babies come most easily when they are ready to, which is rarely when we think they are 'due'