to refuse to be induced

[MagicMojito]

Just as the title suggests really.

I had mw appointment last week and was told that as I am overdue I will need to be induced in my 42nd week of pregnancy and it was pretty much presented as a done deal. I was handed a leaflet and got a date for induction and that was that.

After researching the pros and cons of induction I have decided that its really an option I'd prefer to avoid if at all possible.

I have been so so unhappy with my care throughout this whole pregnancy, I really don't feel comfortable rocking the boat as I know il be veiwed as a pita, but I just feel really strongly about this.

Aibu? Wwyd in this situation? Thanks for any replies, sorry if this post makes no sense, horrid insomnia has unfortunately frazzled brain!

Just to add my personal anecdote! I wasn't induced with my first and had a very long labour ending in forceps. I was induced with my second at 40+3 due to meconium and he was born less than 2 hours after they started the process off in the easiest birth ever.

You don't have to have anything done that you don't want. Induction is usually offered at term+10/12 because it can take a few days to work sometimes, so if you were to be induced dead on 42 weeks, it could be later than that when labour actually gets going. I've found that most inductions leading to surgical intervention are inductions that are for other reasons, before term. So the body isn't ready, small for dates at 37 weeks, spd at 38 weeks. Post maturity induction tends to go as smoothly as spontaneous labour in most cases. Obviously you do have the risk of the placenta not functioning as well after 42 weeks, so may not cope just as well in labour, which could lead to an emergency section. As someone above said, the placenta doesn't just shut up shop at 42 weeks, but research has shown that it can start deteriorating at this gestation, so regular monitoring will keep a close eye on that,and obviously plans would then have to be reviewed if there were any signs that was happening.
The hospital won't be funny with you for declining induction, we have it fairly often, they'll just book you in for the day unit for daily monitoring and arrange a provisional date for 42 weeks for induction.
All the best, hope things happen spontaneously for you x

"I will not be returning to a consultant who pulled the dead baby card to get me to tow the line."

You do realise, 43percentburns, that this is why induction is advised at 42 weeks. It is because the risk of "dead babies" increases and (bizarrely enough) doctors and midwives are keen to avoid this if possible.

(I've had a "dead baby" and it wasn't fun!")

If you are beyond the point where the drs wanted to induce I would count your kicks obsessively.

I went over and DS stopped moving. I had no idea this was a problem- I though maybe babies didn't move much after they engaged. Luckily I went into early labour v soon after he stopped moving and it was the first question the midwife on the phone asked. 2hrs later I was having an EMCS for foetal distress.

God knows what would have happened if I hadn't had a few contractions and hence had reason to phone the labour ward.

Anyway, OP, the studies on induction for post-dates are reassuring and show that C sections are actually reduced with induction compared to expectant management.

www.ncbi.nlm.nih.gov/pubmed/22696345

For my own experience, the labour and recovery I had following an induction at 39 weeks with DC3 was actually entirely uncomplicated and the recovery FAR easier than my home birth with DC1!

I was threatened with induction so I booked myself a reflexology session and it all kicked off naturally within twelve hours.

By the way I water birthed, hypnobirthed, over ran by 3 hours what is normally 'allowed'. The hospital were fab. But only cos I was a pita.

Allowed?! That's why I was keener to be at the midwife led centre I think. I was worried about some doctor putting me on a timer.

I don't think any mother would want to put her baby at risk or they wouldn't agonise over situations like these.

I do think it's wrong to deliberately leave out options and only present certain ones when the mother asks.

They can advise against if necessary but not just pretend the option not to be induced isn't there.

fairylea I'd agree with you. Induction was horrific. It took fays and I ended up nearly dying and had forceps anyway. My body just wasn't ready. The sytocin made me so ill I was being sick and had no idea what was going on. If I had another baby (which u won't after such a horrific birth) I would like 100% have a planned csection rather than rrisk induction again!!

notoasthere
Risks of stillbirth are greater at 37 weeks than 42.
Sorry, but this in an inaccurate statement.

"Dead baby card".... Omg just read this. There really are no words. How insensitive. Not having a live baby at the end of a pregnancy is always a risk and not something that ever leaves you, stop and think 43 what effect that comment could have on someone who had suffered a loss. But is all it matters getting the birth you "want"??

This is a very complex area. It's virtually impossible to get good statistics on the risks of going overdue, partly because so many women get induced (so no available data) and partly because the studies that exist often fail to separate "normal" pregnancies from ones with underlying issues.

And there is simply no way to accurately predict the issues that may cause problems late in a pregnancy such as pre-eclampsia, placental failure etc. Hence doctors go for the lower risk (of major problems) path of induction, which is unfortunately itself not a risk free procedure.

Add to that the fact that due date estimation is an imprecise science, so I think any HCP would be hard pressed to guarantee they know exactly when you go overdue anyway.

I was in a similar position to you and tried to find an evidence based reason for induction in my specific pregnancy/circumstances at 42 weeks (or not) and really struggled to get straightforward information.

I concluded that I would refuse induction and have expectant monitoring (daily) and re-assess daily based on how I felt. It ended up not being necessary, but I did get rather bullied in hospital about my decision, which nearly triggered a panic attack. Which I'm still upset about 6 months later. Thankfully I had a home birth and didn't have to go there again!

I agree with Delphiniumblue and Tinkerball. I would prefer to follow medical advice. The health of the baby is more important than the experience of the mother.

Obviously my personal experience above isn't any reason why people shouldn't be induced if it's needed, and if the result is a healthy baby and mum that's what everyone wants ultimately.

My concerns weren't that induction is bad or anything more that like you I felt the options weren't presented to me until I asked.

I was induced for DD1 due to being overdue and went into labour normally for DD2. Whilst I still was able to have a natural delivery for DD1 the induction drugs made labour so painful I had to have an epidural, was OK birth, 12 hour labour no horror stories but definitely quicker recovery and felt much better with DD2 which was 4 hour labour, no drugs at all. Also the labour pain was nowheree near as bad with DD2 I am convinced the induction drip made labour more painful, I also felt sick (and threw up) during labour with induction and this did not happen with DD2.

If we have a 3rd child I think I would refuse induction based on my experiences, however I would want the baby monitored closely after week 42.

Good luck and don't be pushed in to anything you don't want to do x

Crazeeladee - no, it's not. The stats that the whole induction at 10-14 days over theory is based on clearly states that the risk is higher at 37/38 weeks

It's your choice and I have a friend that homebirthed after being overdue and all was well.

However the story of a lady on here that followed a doulas advice and ignored medical advice on induction as "scare tactics", went over and had placental failure resulting in severe damage to her DD stayed with me soI would trust the medics perspersonally.

For every bad induction story, there's a great one - they just don't get mentioned as much. My induction was such an amazing, positive experience - and I was 37 weeks, so they were fully expecting to switch to EMCS because they doubted it would work, but it was a fast labour, not outrageously painful - I had pethidine to help me sleep, and gas and air and I was fine, but a lot of people go for epidural with induction so if it's the 'extra' pain you're worried about. I had nothing to compare it to but it wasn't as bad as I expected! I had a long induction, but once my waters went it all went pretty quickly - when it got to pushing, she was out in three contractions

I consider DD's birth as the most positive and funny experience of my life. The pain doesn't even register in my memories of it! But it is totally up to you; if they're happy to let you continue, continue! I just wanted you to know that induction doesn't always mean long labour, failure to progress and EMCS :)

Good luck, whatever you decide :)

For those saying "the health of the baby is more important than the experience of the mother" I think you're making unfounded assumptions about the reasons that some women refuse induction.

For me it absolutely WAS about the health of my baby - inductions can and do lead to a cascade of intervention that can increase the risk of fetal hypoxia and the attendant long term problems that can cause. Which I didn't want to risk unless it was necessary in my case (vs on average for the whole population).

I most certainly did not do it because of some dream of a scrummy water birth with candles and music, or whatever it is you're implying by "experience of the mother".

Risk at 38 weeks 1:730
Risk at 42 weeks 1:760

www.bmj.com/content/319/7205/287

This is a very complex area. It's virtually impossible to get good statistics on the risks of going overdue, partly because so many women get induced (so no available data) and partly because the studies that exist often fail to separate "normal" pregnancies from ones with underlying issues.

Absolutely. I felt confident in refusing because I felt the baby was getting ready to be born (cramps for a week, running to loo etc...) and I felt after all that it was a bit hard on the baby to just kick him out for taking his time

If I'd been worried nothing was happening it would have been different.

Have just remembered - I was given clary sage to take home after my sweep and DH rubbed it on my feet.

Don't know if it's just coincidence but both were born the next day. Can't say for sure if the oil was a factor or not.

I agree with trusting the Doctors.

I've been induced twice and had two naturally starting births.

I've never given the matter much thought - at least when I was being induced I didn't have to keep going up and down to the hospital whilst they decided if I was in labour or not (no 3's labour took a while to really get going).

By 42 weeks I was pretty impatient not to be pregnant any longer.

I don't think it's worth having strict plans about how a birth will go - all are different. Important outcome is a healthy baby and mum.

I felt similar that I really wanted a low intervention birth, in the end I was induced but because my waters broke at 41+5 and there was risk of infection because nothing else started naturally.

I now disagree with people saying you know your body, a recent wake up made me realise you dont know whats going on for your baby.
My good friend went into be induced as advised, she was monitored during her overdue period, the hospital asked her to go in at 6 in the evening as they had a lot of inductions that day. Luckily there was a slot and she was called to go in earlier, at mid day she got to the hospital and when they did their initial obs they saw the baby was in distress and she had an emergency c section, there was meconium present and the baby needed resuscitation, he was in special care for nearly 2 weeks, the doctor said even an hour later he would have been still born. I think I would always put a healthy baby over birth experience.

OP you might find that you have to be induced for another reason anyway. Your membranes may rupture and your contractions might not start, and then you have to be induced. Or you might get raised blood pressure and protein in your urine and get induced.

Nobody wants to be induced. It sometimes is necessary for mother and baby's safety. And it's probably best to keep an open mind. As sometimes birth is not what we imagine and hope for. The examples above were my experience and I had two inductions. My first ended in a crash situation with forceps delivery in theatre and the second an emergency c-section. I was induced with my second at 40 + 5 after monitoring on the Monday by the Thursday I was being admitted.

I have 2 healthy DC, how I gave birth to them is irrelevant.

Disclaimer - this is how I have coped with my own experience after two tough birth experiences. I don't think women's feelings on their birth are irrelevant. I think that we have to be open to all possibilities.

Notoasthere : that evidence is 15 years old, the research that has been done more recently is 1:3000 at 37 weeks and 3:3000 at 42 weeks by NICE .

www.nice.org.uk/nicemedia/live/12012/41255/41255.pdf
Pages 43-47.