Is it now NHS policy to induce pregnant women over 40 at 38 weeks?

[Sansarya]

I ask because a friend in her mid-forties gave birth recently and even though she was fit and well all through her pregnancy, the consultant was very insistent that she be induced at 38 weeks as apparently that is now the policy. But I'm not sure if it is NHS-wide or dependent on hospital? Her labour then lasted 48 hours and ended with ventouse and PPH.

It worries me a bit because I'm 38, and if I ever decide to have DC2 I may be over 40. DC1's birth was a straightforward water birth in an MLU and I'd definitely want the same again. I know a hospital can't force you into anything but I'm aware that they can make things bloody difficult!

[PenguinsandtheTantrumofDoom]

Not routine in my area.

[huhpuh]

No, not as far as I know. I'm 40 and had my second daughter in March. I went into labour of my own accord at 39 weeks but there had been no talk whatsoever of inducing me. My midwife and I were going to discuss options if I got to 40 weeks. Perhaps your friend had other underlying medical issues?
I wouldn't let it worry you - you don't have to be induced even if everyone is suggesting it. Your body, your baby etc.

[Sansarya]

No, no medical issues - she was probably fitter and healthier than pregnant women half her age! I guess she was just unlucky to run into a consultant who put the pressure on her.

[Sansarya]

some pregnant women half her age that is.

[christinarossetti]

There were some NICE guidelines published in the last couple of years which recommend induction before 40 weeks for women 38 and over (I think) as, statistically, it reduces the number of stillbirths and maternal complications.

A recent study indicated that Trust who had been following the Guidelines had seen a drop in their stillbirth rates.

I guess that's the framework your friend had her baby in.

[PennyJennyPie]

I'm 38 almost and under surveillance for high blood pressure as I was induced at 40+2 in my first pregnancy. I'm now 35 weeks. I was told that if I had been 40+ old then they would have induced me at 40 weeks as a standard but that is due to my medical background.

[Roseybee10]

Remember you can refuse induction of you don't feel it's in yours or baby's best interests.

[christinarossetti]

OP says that she knows that she could refuse induction.

The procedure are about reducing a statistical risk for mothers of 38 years or older and, on a large scale, have been effective. The implementation of these guidelines may have caused more difficult deliveries for some of the women who have chosen to agree to follow them if their trust is implementing them.

[IlonaRN]

I will be induced at 40 weeks if my baby has not arrived before then.
I am 41.

[Belleende]

I am 40 had a completely uneventful pregnamcy. research from 2013 showed that for women over 40, the risk of still birth past 40 weeks Increases from 1 in 1000 to 2 in 1000. This is even for women with nonother complications. They now recommend induction at 39 weeks. as my pregnancy has been so normal I successfully argued to go to 40 weeks before induction. I reallllllly want a natural birth, but having read the.research and having been through the mill to get to this point, I am not comfortable with the risks of going beyond 40 weeks. I am 38 +5 and tryind every trick in the book to get thinhs started!

[christinarossetti]

I've had 3 inductions (by choice ie me asking) and they've all been fine btw.

Just some tablets to start things off, no pain relief, no tearing and no complications.

I think it's helpful that they're starting to discuss induction before or at 40 weeks with women of 38 or older earlier in pregnancy. It gives women a chance to do some research, have a think and make a considered decision.

[sebsmummy1]

I have also been told the same by my midwife.

I had one successful pregnancy at the age of 37 then three miscarriages over a year and a half. Last ending because the baby had Downs. I am now 40 and 5 weeks pregnant. I am under the care of the consultant and taking various medications and I won't hesitate to follow their instructions if I ever get that far.

My understanding is the placenta can degrade in the late stages and there is a chance of it failing and losing the baby. I can remember being a total pain in the arse with my son's pregnancy and fighting then every step of the way regarding intervention. Now if they say jump I will ask how high.

[christinarossetti]

Hope that it goes well for you sevsmummy - this must be such a stressful time for you.

[christinarossetti]

sebsmummy - sorry.

[MuddyWellyNelly]

I'm 40 and being told induction at term ie 40 weeks. I've said I will discuss nearer the time, and a MW friend said I should insist on a Doppler of placenta before deciding - it's currently looking irrelevant as baby is breech, so unless it turns then I'm in for a CS anyway. However, if it comes to the crunch, I guess I'll go for the induction. We went through so much to get pregnant that for the sake of a possibly more medicalised labour, I'm not sure it's worth the extra risk of stillbirth.

[LongDayAlready]

Hi, another here who's been told guidelines state induction should be offered at 40 weeks if baby hasn't turned up by due date where the mother is 40 or over.

I'm 42 and due in Sep and have discussed with consultant. Am very reluctant to accept it as I have had 3 very straightforward births since I was 34, the last 3 years ago, and I know so many people who've been induced and ended up with CS which to my mind is riskier. And all of mine have been late, the 3rd was 9 days over.

Consultant was very understanding and we're going to discuss it when I see him at 38 weeks (which will be my 2nd visit). My thinking is that I need to do some research, not least because he also said it was linked to being over 40 and having small babies previously (my smallest was 8lbs 5oz) which doesn't really apply.

I've been told daily monitoring is an option instead so would probably go for that instead. Will see how it goes, I guess.

[jojo2001]

I know this is an old thread but wanted to add info I was given incase anyone else was wondering. I am 43 and also have had a very easy pregnancy but the consultant explained that as you get older then things don’t tend to last as long so the placenta will begin to deteriorate much earlier than in a younger mother. I’d rather have my little girl in my arms safe at 39 weeks than risk losing her.

[Blueberry1]

@jojo2001 - I am 42 and 32 weeks pregnant with 1st child & Dr said they will be happy that I go to 39+6 before being induced if there are no other complications. Of course it's my choice, but I've read the RCOG & Cochrane papers and still birth risk is higher in Mum's over 40s even in absence of any health problems.

[Fidgety31]

I’m 42 and have had 3 previous children, all born 1-2 weeks over due date.
I really wouldn’t want to be induced. My second son was born with saggy skin 14 days late as the placenta had started to degrade . He was still 9lb though.
I had no idea I might be asked to have induction - the likelihood is this one will go over too as my history is that way.

[holycheeseplant]

I've been told in the 39th week so up to 39+6.

Which is annoying as I'd love a vbac and went to 42 weeks with ds but hey ho. I know induction might be successful but I'm trying to work out if it's just better to do the elcs or risk an emcs with induction.

[holycheeseplant]

I'm 41