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!

Another factor is that towards the end of the pregnancy I struggled to sleep, I was exhausted, very very big. I did refuse the induction and had to go to hospital every day front 40 + 12 and just ended up being induced at 40 + 15 days, I was so so so tired that I couldn't push the baby out, after a 24 hour labour. Hindsight is a great thing, isn't it. I should have been induced earlier.

I would be induced because the risks relating to going very overdue genuinely frighten me.

I think the problem is, is that it's presented as a 'done deal'. And when you question (not argue, not say that they don't know their job) that they don't like that. And I'm not talking about the midwives - in my experience it's the consultants that don't like being questioned. And if you tell them you have actually researched this, god help you.

I think if you were actually asked whether you might consider an induction, why it's a good idea, let you know of the pros and cons and let you think about it, there might not be so many complaints. It's the 'we know best' attitude (usually without supporting evidence) that gets my back up.

And as a young mother and now an older mother to be, I've seen a fair few midwives/consultants over the years. And had late spontaneous labours, an induction, almost everything apart from a CS, and the best HCPs I have come across have been the ones that have actually suggested (rather than told) different pathways of care and given me a day or two to make a decision. Nobody likes being told what to do, however well meaning.

I'm all for it's our body, our choice but sometimes it makes sense to listen to the experts.
I've been induced at 40 +5 , it wasn't horrific, I didn't need any intervention. I won't lie and say it was lovely, because it wasn't but that's mostly down to how fast everything started to happen.
If I hadn't have been unwell when I was induced earlier than usual I would have waited until the recommended 42 week stage to see if it was going to happen naturally - I wouldn't have risked going longer.

Exactly. Hospitals manage this risk really badly imvhe. Infant safety is absolutely embedded into all aspects, medical and commercial, of infant care around reducing the risk of cot death.

This risk is about 10 times LOWER than that of stillbirth in late pregnancy (usually post 40 weeks), although there is a distinct absence of the same level-headed, evidence-based risks/facts/options in this area.

I don't think the medical profession does themselves any favour with presenting a post-dates induction as a 'done deal' - of course being told what to do about something so intimate gets peoples' backs up.

Although as Charley says, many people go into over dates pregnancy with no idea of the extent of the risks, although are likely to be conversant in the risks re cot death.

"Induction definitely increases the chance of a cascade of intervention which gives you higher chances of stuff like instrumental birth or a section."

vivalabeaver, induction for post-dates does not increase the risk of a section! Induction actually reduces the risk of a section.

www.ncbi.nlm.nih.gov/pubmed/12798542

Induction raises your chance of syntocinon which means a ctg. being on a ctg raises your chance of a section. Plenty of research to back that up as well.

Except it doesn't!

If it was that simple, studies would show an increased risk of section with induction and it doesn't. Lots of research showing that induction for post-dates reduces your risk of a C-section.

It is perhaps counter-intuitive but that is the facts! If you can provide actual evidence to the contrary, I'd be interested to see it.

In france apparently you are due at 41 weeks, not 42, and almost everyone I know who's had a baby has gone to 41 weeks!

I think as long as baby is fine then it's fine, you can get those little heart rate monitors to keep check if you're worried ;p

I think all the sweeps and being induced etc. is just interfering!

apps.who.int/rhl/reviews/CD006066.pdf

Here's some research showing that being on a CTG increases your chance of a lscs.

www.ncbi.nlm.nih.gov/pubmed/22369399

Iol prior to 41 weeks nearly doubles the chance of lscs

www.ncbi.nlm.nih.gov/pubmed/15916205

Inductions increase chances of interventions and section. Neonatal outcomes unaffected.

I can find plenty more.

Dino is right that there is also plenty of evidence that women who choose expectant management are more likely to end up with a CS.

I think both options are perfectly valid, but there is a lot of misinformation peddled that induction increases your chance of CS, when lots of studies suggest exactly the opposite.

www.rcog.org.uk/news/bjog-release-induction-labour-may-reduce-risk-caesarean-sections-suggests-new-study

The risk of going too far is that the placenta has a life span so may start to deteriorate - I would ask for frequent scans to check the placenta.

Ps my dsis wanted to avoid induction after a bad first birth (dn fine :)) but in the end she went in and the first lot of gel is all it took.

You could go for sweeps too.

Not read all this but here's my two pennyworth.
I had 1 induction at 39 weeks as waters had broken 24hrs previously and I was more concerned about risks of infection.
It was my first and went pretty quickly with only minimal pain relief.
I am personally very wary of being very overdue. A friend lost a baby at 42 weeks as her placenta had started to degrade. If she'd been induced when she was advised the baby would have made it. She's never, ever forgiven herself.

I had an induction. at 39+5 my waters broke, I hated the idea of it but infection and stuff was a higher priority for me. I had an induction evening of 39+6 and she came on my due date.
I would have an induction again if I needed to. It was shockingly painful and I too did the bath thing and did have some pethidine early on in labour as you kind of go from nothing to everything in a short space of time. I only had the pessary to be induced. I did the majority of labour with gas and air as the rest had worn off by that time.
am hoping this is all a bit of a moot point as the op is in labour or cuddling a sweet newborn, after going into spontaneous labour

YANBU. Have a good read into it, look at all your options and ask lots of questions. Sometimes induction is necessary but really the majority of inductions don't need to happen in my experience and opinion.

MagicMojito - have you tried any of the things that are supposed to help bring on labour? Raspberry leaf tea is supposed to help, as are clary sage oil, fresh pineapple, curry, sex and nipple twiddling - all of which are things that you can try at home and are not medicalised interventions.

vivalabeaver, you've given a lot of (interesting but irrelevant to this) links but still aren't answering the question.

Does induction for post-dates (not before 41 weeks) increase the risk of C section? The answer in a number of studies is no. This is counter-intuitive and goes against received wisdom but the risk of a section after 41 weeks is lower with induction than with expectant management. (Evidence as above.)

Oops - I should have said you eat the curry and the fresh pineapple, but use the clary sage oil in a bath or oil burner. Champagne is supposed to help too.

I refused induction at 10 days overdue, dd arrived at term + 13. V easy birth, went in at 6.30am and was home by lunchtime.

They could not give me a sweep at 10 days over as cervix was shut. Body was not ready to give birth yet and i have no doubt that i would have ended up with interventions had i had an induction

I had my second child at 40+16, at home. She was big (10lb4) and obviously "postmature" but fine. I had daily monitoring and ultrasound to check baby's wellbeing and function of the placenta. YANBU to want to be given the option. I don't think induction is aliways a bad thing, I just feel strongly that women should be made aware of all the options. I hear so many people say, "they won't let you go more than ten days over" etc.

Just to go through your links one by one,

apps.who.int/rhl/reviews/CD006066.pdf - CTG increases C section rate without improving outcomes, other than reducing neonatal seizures based on 12 studies (only two of which were high quality) - yet despite induction for post dates, the possibility of increased CTG didn't translate into increased C sections for that group compared to expectant management

www.ncbi.nlm.nih.gov/pubmed/22369399 - Elective induction of labour increases caesarean section rate in low risk multiparous women. - So this deals with women delivering at 37-42 weeks gestation where the risk of C section is higher with induction prior to 41 weeks but "the difference was not significant when induction was performed after 41 weeks."

www.ncbi.nlm.nih.gov/pubmed/15916205 - Elective induction vs. spontaneous labor associations and outcomes. - This paper only looks at women delivering between 37-41 weeks so doesn't deal with induction post-dates.

Hope that helps.