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Pregnancy

40 + 10 and refused induction - given quite a hard time

77 replies

Elderberries · 27/09/2011 17:54

Hello - I just wonder if anybody could tell me if I am being very foolish as the doctor today made me feel very bad for wanting to hold out till 40 + 14 to see if I could have a natural start to child birth.

I'm 37 and have a high BMI and I had borderline pre-eclampsia in my last pregnancy which was induced at 40 + 7.

This pregnancy I've had no problems.

The doctor said that the risks of still birth go up exponentially around 42 weeks and that I was risking still birth by not having the induction. I complained that I thought she was using over the top scare tactics because my reading of the stats was that risk of still birth was about 2-3 in 30,000 at 41 weeks and 6 or 7 in 30,000 at 42 weeks so it was a small risk that went up a bit. I also said that I only wanted to delay to + 14 days which was my understanding of the outside limit of a normal pregnancy and I was prepared to come in for daily monitoring (which is what they asked me to do). Anyway after making me feel awful about the whole thing she has booked me in for induction at + 13.

I am a bit unhappy by the treatment I got but I wonder if other people think I am being overly risky?

OP posts:

Report

georgesmummy11 · 27/09/2011 18:03

Don't want to scare you but i know of 3 people that have gone 40+ and had a still born.
Also the function if the placenta starts to decline after 40 weeks and after 42 weeks can start to detach, I know they say they can leave you up till +14 days but the practise where I am is no longer than +11 and if remotely high risk no longer than +7.
I know it's your body and baby but the doctors and midwives are thinking about you and baby. Hope you don't take offence by this x

MrsJRT · 27/09/2011 18:10

You poor thing, I hate it when doctors use scare tactics like this. You've done your reading, you have weighed up your risk and accepted that based on your circumstances. Good for you where I work induction is offered at term plus 14, we don't have anymore IUDs than anywhere else.

wompoopigeon · 27/09/2011 18:12

As a matter of interest, how certain are you of your dates? The only person I know to refuse an induction was convinced her due date was wrong.

TooImmature2BDumbledore · 27/09/2011 18:14

Your risk of stillbirth rises to 1 in 200 at 42 weeks.

CheeseandGherkins · 27/09/2011 18:16

Stillbirth rates are around 1:200 for average pregnancies so you're wrong there. Any risk factors and that can, obviously, go up; as I found out in December last year when we lost our daughter at 37 weeks to stillbirth.

CheeseandGherkins · 27/09/2011 18:17

www.uk-sands.org/Research/Statistics.html

kblu · 27/09/2011 18:18

I personally wouldn't risk it. I had complications when I went into labour at 40+10 (was booked in for induction at 40+11) and my placenta had basically had it by then. My baby was in SCBU with HIE because of that and also I had severe pe. That is the reason I personally wouldn't risk it in a subsequent pregnancy.
The hospital only have your baby's best interests at heart and need to point out the risks. If they didn't and something happened and you hadn't been informed then they risk being sued I suppose.

birdsofshoreandsea · 27/09/2011 18:18

This reply has been deleted

Message withdrawn at poster's request.

TooImmature2BDumbledore · 27/09/2011 18:18

Sorry, that was a bit abrupt. What I mean to say is that as georgesmummy says, the placental function starts to drop the further along you go and your risk of stillbirth rises.

I had a stillbirth at 41+3 out of the blue of a completely normal pregnancy and for that reason I wouldn't risk it personally. Sorry if that's negative, but you did ask for opinions!

GwendolineMaryLacey · 27/09/2011 18:20

I don't understand why you'd take the risk tbh. Induction is such a little thing really, compared with what could happen and all for the sake of a few days. Your decision but it's one that I find difficult to understand.

Whatevertheweather · 27/09/2011 18:21

I really wouldn't delay it to be honest. It's just not worth the risk however small

Elderberries · 27/09/2011 18:22

I think my due date is reasonably accurate as it's the one they gave me at my early scan....unusually it moved back my due date by 4 days....but as I think I ovulate quite early in my cycle and we had sex once at day 7 of my cycle I think the scan fits in better with that picture than the idea that I ovulated 7 days after we had sex!

Could you give me the source for your statistic TooImmature2BDumbledore?

OP posts:

paranoidandroidwreckmyownlife · 27/09/2011 18:27

Sorry to be harsh but I think you're stubborn and foolish!
Having had borderline preeclampsia before you ought to know enough about this condition to not risk a failing placenta at any cost. PE can sneak up on you in a matter of hours in that situation, I was at seizure point before anyone realised what was happening. DD and I are lucky to be alive. Please think of that before you dig your heels in, you could quite possibly be putting both your lives at risk!

MsScarlettInTheLibrary · 27/09/2011 18:28

Your doctor is not being fair.

Unless of course she also explained all the risks of induction, in the interest of balance.

Whatevertheweather · 27/09/2011 18:28

Elderberries - have a look at cheeseandgherkins link to Sands research in to stillborn babies. You have to do what is right for you but the risks are there

Chandon · 27/09/2011 18:31

I went along with being induced at 40+12 (but baby decided to pop out an hour before induction was due).

I trusted the docs experience and opinion.

Elderberries · 27/09/2011 18:36

I am looking at the link to that Sands research and I am ready to be persuaded that I am in the wrong. It just happens that the doctor took such a hard line with me that she got the opposite reaction to the one she intended.

I work in statistics and what I want is a calm presentation of facts that I can make an informed decision about. I just felt bullied and patronised.

What that data tells me is still birth rates overall not the increase after 41 weeks say.

OP posts:

Elderberries · 27/09/2011 18:39

CheeseandGherkins - I am very sorry that you lost your baby. Thank you for taking the time to respond.

OP posts:

Whatevertheweather · 27/09/2011 18:55

Also and I know this is more anecdotal than statistical but my sil works in scbu as a junior consultant and she has said that it is not only stillbirth to consider but also problems that are associated with a lack of oxygen to the brain are also seen quite a lot in scbu. The placenta isn't as effective after around 41 weeks and this can have implications for the flow of oxygen to the baby.

I'm really not wishing to scare you and I'm certain there will more often be a completely positive outcome with birth at 41 + weeks than not. Good luck whatever you decide and you are right to want to be presented with all the information by your consultant and not to feel bullied.

kblu · 27/09/2011 19:07

that's what happened to my baby, HIE because of lack of oxygen due to failed placenta. Possible brain damage as a result but as it happens he seems okay at age 3 but it hasn't stopped us worrying for the last three years and he may have some learning difficulties that we still don't know about. Don't risk it.

Northernlurker · 27/09/2011 19:13

Induction has risks too of course.
Your last pregnancy was obviously sailing past 40+7 - sounds like you just cook babies on the long side. I'm like that too. When I had dd1 13 years ago induction at term plus 14 was standard. It has come down a bit but your plan seems sensible to me. Of course nobody wants to risk the health of mum or baby but it is a question of balancing brisk not that one option is risk free.

FlipFantasia · 27/09/2011 19:14

I was induced at 40+14. I did my reading and was happy with my decision. TBH I think babies in my family go late and I wish I had waited and insisted on monitoring (my mum and sisters all went overdue, some even as much as 16 days overdue). I also received a lot of pressure from the (male) registrar (who had no kids) who basically told me I was irresponsible for going past 40+10 weeks, despite scans showing good fluid levels, etc. My placenta was big and healthy when it was delivered.

Induction is a fairly major thing - I ended up with a crash section because of potential foetal hypoxia caused by hyperstimulation. I really doubt my baby would have suffered such severe distress if I had gone into labour naturally, though of course will never know. I was also 100% sure of my dates, as I had had IVF to conceive.

I also think that they expect many inductions to take days, as in you come in at 40+10 but your baby is actually born at 40+12 (my hyperstimulation was immediate and based on one pessary at the lower dose of prostaglandin, so I was definitely not a "typical" induction).

I'm pregnant again and will refuse induction and just let the baby arrive whenever he or she wants (though am obviously hoping that's before 40+14).

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Northernlurker · 27/09/2011 19:19

The placenta thing is tough because some placentas (plural?) do fail after 40 weeks and some babies are indeed delivered in the nick of time BUT also lots don't. Plenty of women have placentas which are going strong at 41 weeks plus - there seems no way to gauge which group you will fall in to.

Northernlurker · 27/09/2011 19:21

Oh and fwiw I had my post term appointment at about 40 + 4 and the midwife wanted to book me then for induction at 40 + 10 but I insisted on at least 40 +14. She had to 'go and ask the consultant' which I though was hilarious as afaik it was up to me when I showed up at hospital and not down to him

paranoidandroidwreckmyownlife · 27/09/2011 19:22

But OP has had previous PreEclampsia symptoms. She therefore has a higher risk of it again. Placental or umbilical failure is a known catalyst for PreEclampsia, and in my case sent me straight into seizures as cord began to fail.
Doc may have gone about it in the wrong way but certainly had a duty to warn OP what risks she was taking.

Flip

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