have already posted this in Childbirth, but there's more traffic over here...
Basically, I am high risk due to 'advance maternal age' in this pregnancy - I'm 40. Saw my consultant a couple of months ago when she explained the risks / their policy to me re age (I have also seen the research). I told her about my fears of induction/intervention (after last time) and she said that as long as I was aware of the risks, it was my choice and that I could have daily monitoring from 39-41w instead if I prefer. Agreed we'd discuss at 37w.
Have thought about this a lot and unless there is a real reason ie something showing as being wrong with me or the baby, I don't want to be induced unnecessarily. My midwife thinks it's over the top too and she quite rightly said that there are risks with all pregnancies/births and that I am a 'young', fit and healthy 40 - she said she's seen women in their 20's who were much less so!
Anyway, just been for my 37w appt - only it wasn't same cons I saw before, it was her registrar and he just wouldn't listen to anything I had to say. He was insistent on trying to book me in for an induction at 39w and gave me such a look when I said thanks, but no thanks.
In the end we agreed that I would see the cons again at 39w instead, to have a sweep then if favourable, and then go from there (am getting DH to come with me for that one so he can help me stand up to them as I tend to back down around medical professionals which is what happened last time).
Am really hoping I go spontaneously in the meantime though as baby is already engaged and I have had a bit of a bloody show. I really want to deliver in the birthing unit, in the pool if possible, but he said I can't if I'm induced...
Has anyone else had this?
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Pregnancy
Being pressured to have early induction due to age
curlyLJ · 26/03/2014 19:47
Are you being deemed 'high risk' just because of your 'advanced maternal age' (isn't that just a lovely label?! 
) or is there another reason?
I'm 41 and 36+1 and I've asked two midwives about this in the past week and they both confirmed it isn't the case at my particular NHS trust. In fact they looked at me like I was a bit mental and didn't seem to have heard anything about it! So I was quite reassured. But to be honest, no one has batted an eyelid about my age; I've got no other risk factors and they are just treating me as they would every other low risk preg. Bit confusing, though innit?!
I think you simply came up against somebody with not a lot of experienced just going down the 'party line' rather than having learnt to actually listen to you or whoever was sitting in front of them (there are women who might jump at the offer of an 'early' induction').
I am sorry you had this stress and hope you have a more productive conversation with your consultant.
FWIW, I had DS4 at 44, I would not have been able to have an induction (due to previous CS) so would have been offered CS again if I had not gone into labour myself. At no point was I pressured into agreeing to early intervention, although risks were pointed out to me in monotonous regularity. Thankfully DS4 appeared without drama on his due date 
. I was double relieved as my pregnancies in the past tended to go to 42+ weeks…
Good luck. Hope you can take a less-than-perfect consultation not too much to heart.
Oh, I know what you mean re 'being allowed xy and z^ 
.
There are increased risk with increasing maternal age and increasing length of pregnancy. It's all about what level of risk an individual is comfortable with once the also very real risks of early induction/elCS have been taken in to account.
Like I said above DS4 thankfully appeared spontaneously on his due date, but interestingly he was the smallest of mine (6lbs6oz) by over a pound and as I had a good pregnancy with him I can only assume that it was reduced placental function due to my age IYKWIM.
The risk is disproportionately higher in smokers btw.
It is a shame that it is not more clearly communicated to many women that early induction/CS if offered at x number of weeks, not imposed.
dats that is what I just don't get, there was one study, there was evidence that there can be a higher risk for older mothers, but this risk was still small. There is however also a lot of research re stillbirth suggesting that they don't really know what causes it in relatively healthy mothers/babies. As irishmammy mentioned above, it clearly also happens to much younger mothers so why intervene based on age alone?
If I were told there was a 'real' risk based on something on a CTG or ultrasound scan then of course I would listen to the consultant's advice, but when they are basing their recommendations on a policy rather than looking at each case individually, it just doesn't make sense to me to just blindly accept what they are saying.
I don't agree that I am putting my baby at risk - I am happy to be monitored/scanned and will make a judgement at the time. it's just that when there is such differing policies across different trusts, it doesn't make sense. Surely if I'm high risk, I'm high risk regardless of where I live?? I'm not saying I won't accept an induction, I just don't want to be bullied into it. I don't like being told what I am 'allowed' to do. My consultants response when I told him I would prefer not to go for early induction unless there was a specific problem was 'well it's out policy'
Lots of things went wrong in my previous birth, which was an induction, and I am scared of that happening again. The recovery for me was awful and I believe DD was traumatised from being yanked out of me! I think by waiting until my due date, possibly a few days after, I am giving my body the best chance of going into spontaneous labour which is surely the best for both of us.
Good point Swan about lack of data. I read something about higher mc rates in older mothers possibly being skewed in a similar sense. That sounds a bit half-arsed and anecdotal but I can't remember exactly what I read. I'll shut up
curlyLJ Yes. Exactly that! I don't want to take unnecessary risks, of course I don't, but with such sketchy evidence it's hard to look at the 'facts' and see how they fit in with your attitude to risk. Mind you, I'm saying this and no one is even talking about induction, so...! Feel free to remind me of this when I'm (even more) sleep-deprived and uncomfortable at 41+5 and counting...
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I just had an induction for maternal age - I'm also 40. I had a fast labour with no intervention and a healthy DC. In contrast, the natural labour I had DC1 I was 11 days overdue was awful - placental abruption and a long time in hospital / recovery. I am also a control freak and it was great to have a 'final date' for labour booked well in advance rather than sitting around waiting.
Obviously your previous experience of induction is a key factor here and I think you are right to look into the evidence and make a decision right for you.
There is evidence to support women being offered inductions for maternal age (40+) - that is offered NOT pressured. Women over 40 have a higher rate of stillbirth and placental failure - you need to be comfortable with the risk/benefit ratio - there's nothing wrong with consultants telling you the options but pressure shouldn't be happening. The registrar sounds like an arse.
IIRC monitoring is more likely to lead to a c-section than induction and a previous vaginal delivery is more likely to ensure you have a vaginal delivery without interventions this time but I can't find the links atm.
I wonder why you are 'high risk' for age only though - I was low risk throughout pregnancy and would have given birth in the birth centre had I gone into labour naturally.
Anyway, I hope you get the chance to go into labour naturally - the signs are promising 
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