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!

Well we ought to induce everyone at 41 weeks then.

My understanding is that being pregnant beyond 42 weeks doubles the risk of stillbirth. However the risk is incredibly small to begin with, so even when doubling it, the risk is really really low. However there is no doubt a difference between placentas at term and those that are postdates. The thing is, dating a pregnancy is not an exact science and of course everyone is different anyway - things aren't going to suddenly change when you get to 42 weeks pregnant. With regular monitoring and close observation of fetal movements, you may feel confident to continue the pregnancy. Do talk through the induction process with your midwife, and write a birth plan based on what you want if you do end up induced - eg to keep mobile, etc. Your birth partner will also need to be well clued in to your needs to keep you going and well supported. I personally think if you can avoid an epidural, then you have a better chance of a normal birth. Good luck x

The most important aspect of all this is careful fetal monitoring to assess fetal wellbeing. Some people will be absolutely fine to go to 42 weeks, another person will experience placental deterioration at 40 weeks.

As several people have said, on this thread, as long as the OP is being monitored, and is willing to accept advice based on the results of that monitoring, there is no reason why she should not carry on beyond 41 weeks.

I will never forget a woman I looked after who was being monitored daily post 41 weeks. It was clear that the placenta was not functioning, the CTG tracings were looking worse and worse. Everyone tried to persuade her - from the student nurses to the consultant. She was adamant she did not want to be induced. In the end she had an intrauterine death.
It was one of the saddest things I experienced as a midwife. It was over 30 years ago and I can remember it as clear as day.

So - I would say to the OP. Make your feelings clear, but be prepared to be monitored and listen to the advice as each day passes.

I hope that all will go well for you.

I think it's just very hard to know what to do. I was induced at term plus 14 with dd1 and she emerged perfectly fine in a vaginal delivery. However my spontaneous labour with dd2 at 40 + 7 was so much better that I was determined not to be induced with dd3. They wanted to book me for term + 10 but I refused and insisted on term + 14. It wasn't an issue in the end as I laboured myself at term + 7 and she was born three hours in to term + 8.
Since then a friend has lost a baby at 36 weeks. So nothing like my experience, nothing predictable or preventable or something that induction post term was relevant to and yet I find my attitude to this issue is fundamentally changed and I would be happier running the risks induction brings than those that expectant monitoring may bring.

Repeating a lot of what's been said here but it's your body.

There's too much 'inducing, cesarean' jumping on nowadays. They can't be 100% correct with dates and it's only a guide.

If you are ok and baby is ok then I say listen to your body.

I just wanted to add....the birthing experience is insignificant once the baby is here, healthy and well. I was induced and no, I couldn't have a drug free, hypno, water birth etc....but who cares? It was one day 2 years ago! I've had loads of happy days with my daughter, her birth is a distant, insignificant memory!

I personally wouldn't wait, I'd be too worried about the baby. But I'm also not above a highly medicalized birth so take what I say with a grain of salt.

I hear induction sucks and it sends you into hard contractions right from the get go, no building up to it. Which I personally would not have a problem skipping 6 hours of pre-labor before being at 4 cm. On the other hand, my mother who was induced ended up having an emergency c-section with me anyway. So induction can be just as risky I suppose.

I guess I'd rather my baby be at risk in a hospital with help on hand, rather than at risk in my uterus at home with no one near by.

My friend was born 3 weeks late and she's just fine. But again, make sure you keep thing monitored and count your kicks. :)

Oh echoing MummyLuce birth is just one day out of the next 6,500 days you'll be raising your baby. In the end it doesn't make a difference how your baby was born, or whether they were breastfed, it matters how you raise them and teach them to be a well adjusted and happy person. :)

Take the advice of HCP and not off the faceless posters in here.

If anything were to happen , you would never forgive yourself !

I've had 3 inductions, 3 great labours quite short with only gas and air, and plenty of freedom to move around etc in 2 of them, 3 healthy babies. Induction doesn't have to be a bad thing at all.
My placenta seems to give up about 39 weeks! With dc3 I got to 40 weeks and in the space of 12 hours wentffrom an happy baby in utero to one in distress Thankfully I had a routine midwife appt and she picked it up on my doppler and sent me straight to be induced. That drive to hospital was the longest 30 mins of my life and I felt very guilty that I wasn't aware of a problem. I don't believe we would have dc3 if I hadn't seen the midwife that day. Its obviously your baby, your decision but I don't understand why anyone would take that risk. Things can change so fast.

Yes, the risk may be small of stillbirth post dates, but who on earth wants that 1 in 760 baby that dies in utero to be theirs?

My theory was that by remaining pregnant I remained in the 'at risk' group for stillbirth. By being induced, my baby went into the 'at risk' group for cot death (as all babies statistically are), which is lower.

FWIW, I've had 3 very straightforward inductions - no pain relief, no tearing, ranging from 3-8 hours in length. Inductions that go from nothing to 100% pain are those augmented by syncotoin (sp?) drip, which I and many other women don't need.

What's more important - your baby's health or whether or not you have the best birth experience?

I suppose you'll dismiss that as "playing the dead baby card". I could equally say you're "playing the bad birth experience card". Again, what is the priority here?

I can see why a lot of people think many inductions are unnecessary. If the odds on the baby dying at 42 weeks are 0.16%, then from my crap maths 98.4% wont die. It also explains why so many feel justified in their decision to listen to their body and then go on and have a healthy baby. Presumably they were lucky and part of the 98.4%.

I guess it boils down to whether or not you think its worth trying to save that 0.16%.

Personally I think it is. Losing a baby is not a pleasant experience.

AllsFair Sun 08-Jun-14 08:03:40
The health of the baby is more important than the experience of the mother.

I've only just read this thread but I disagree with this statement. I think they are equally important. I've seen enough threads on here about how a poor experience had caused significant problems post-natally.

And for MummyLuce, many women have such a bad experience they've ended up with PSTD, they don't "just forget it".

Sorry, my maths is even worse than normal.

Anyway, whatever you go for op I hope everything goes as you want and you get to see your baby soon.

I firmly believe that a sweep (that I was basically frightened into having by the doctor) at 40+10 led to my waters breaking before they were ready and a horrendous induction and labour that resulted in forceps and major blood loose
I do want another but next time will not have any kind of intervention till i go into labour naturally unless I feel things need to start happening.

I know a friend of a friend who had a bad birth experience.

She went into hospital as she felt it was safest for her baby.

Unfortunately for her, she went in at 3am and there was only a junior doctor available. When her baby got into distress and stuck he decided to use high forceps. He made a mistake and her baby was born severely brain damaged and later died. She has permanent injuries.

Anyone can chuck around scare stories. They are not helpful. What is helpful is looking at facts and listening to experienced medics.

You can also ask "what will happen if I don't do x yet?" And "well, I'd like to wait until 42 weeks unless you think my baby is distressed?"

See what they say. Sometimes I have found it is also just a manner of speaking with medics. My consultant is quite astonishingly rude sometimes, but he actually does know what he is talking about and I trust him. If your cons or MW is a decent human being, you could try "I am feeling quite pressurised by you saying this has to happen at such a time. Can you explain the other options?"

Try working with them and not seeing it as a power struggle, as although their way of phrasing it is irritating, they almost certainly don't mean it like that.

Op has vanished, I hope that means all this talk of induction is unnecessary

Peasant if the scare stories comment was aimed at me I think I've not explained myself well. What I meant was despite being on my third full term pregnancy and despite being monitored the evening before I was unaware that my baby was in distress that morning. It can happen to anyone and it can happen quickly, that's fact not scaremongering.

My other point is that induction does not necessarily mean a terrible birth experience or surgical intervention, yes the risk is higher but it's by no means a definite.

I also think the stories are very relevant.
I'm sure no one would be monitored more often than daily, it can only confirm the baby is fine there and then, not that they will be fine in another 20 hours.
I see a lot of things on mn as neurotic sillyness but in this case I think concerns are justified.

Happy to stand corrected on stats - and good to see the stillbirth rate is lower now (although I'm sure it could be lower still) Op - NICE guidelines state you should be offered expectant management, you don't have to go down the induction route immediately

Yes, the UK stillbirth rate has some way to go as it's still one of the highest in Europe!

IMVHE, the paucity of sensible information throughout pregnancy about the risks of over term stillbirth with sensitive and thoughtful management plans offered - in the same way that discourse about cot death and how to prevent is embedded in early infant care - is a contributory factor.

I haven't RTFT but just wanted to share my good induction stories!

I was induced with DD at 40+10 (born 40+13), had 4 of the pessaries (there was no room for me upstairs so had to wait a while between 2 and 3!), waters broke naturally, went upstairs on drip and it took 65 hours in total but only 14.5 on drip. I say only, it was long and painful, had an epidural which didn't work properly but I had my baby with no intervention (forceps, cs etc), no tears (9lb 9oz!). I wouldn't have changed her birth for a second!

Induced with DS at 40+3 (born 40+4). One lot of gel, sent upstairs, had ARM, went on drip. At 3.30pm the mw said I was just 4cm, nearly in tears! At 4.15pm I was screaming that I needed to poo I was terrified that I was only going to be 5cm! She got me up on the bed, told me to carry on as I was, push push push and DS born at 4.36pm! I would take this birth over the first any day but neither were traumatic, neither required intervention, I managed to push out both no problem.

As long as you have done your research then go with what you feel is best but I personally would always go with the medical professionals opinion. My mw told me that some women might just not want to labour and need a little help. I certainly think that was my case, my two just didn't want to come out and they were both big enough! I had 4 sweeps with DS, one done by the consultant (and she really got up there, believe me!) and I didn't progress any from the first one!! I tried everything, I was on a bloody see saw at 40 weeks trying to open up my pelvis!

I had a positive induction experience (although you may disagree after reading this). I had two prostain gels one on 41 weeks 5 days the other gel inserted at 41 weeks 6 days. Nothing happened except I had painful cramps but I was only 1 cm dilated when they took me down to the labour ward at 42 weeks at 3am to break my waters and give me the syntocin drip. I had to have an epidural as I couldn't face having my waters broken without it. They couldn't give me a full dose as my blood pressure kept dropping so I could still feel and move my legs but there was no pain! My baby was constantly monitored throughout the whole induction process so I knew if anything happened they would take the correct action. In the end I needed a EMCS as my baby went into distress. There was so many people in the room when they decided to give me a csection and I was just frankly relieved to have my baby delivered. She scored 10 out of 10 on the apgar so I knew she was fine. I recovered really well after my csection so I think that helped (only spent one night in hospital after the csection). And breastfeeding was established very quickly so I think overall I chose to view the whole experience as pretty good.
One thing I would recommend (if you haven't gone into labour) is getting a tens machine. You can't get any pain relief during induction without going through an internal exam (and I found them very painful).

I refused to be induced with dd2. And im glad I did. they booked my induction for 41+4. I refused and they asked me to come in to check baby was happy. The doctor came to speak to me about risks. But I knew in myself it was going to happen soon. A snotty midwife checked me and said she didnt think it would happen in the next few days. I said id take my chances and left. I went into labour 20 minutes later driving home. I got to labour at home which is what I wanted. Dd was born a few hours later.