Wanting to tell 44 weeks and breech friend she's risking her baby?

[scottishlass43]

My friend is 44 weeks pregnant with a footling breech. She's determined to have a natural birth at home with another friend of ours who's a midwife. She's been declining all intervention till now and has no cut off point - she wants to let the baby come naturally and doesn't want scans or any monitoring. She refuses to consider a c-section.

She's older (late thirties) and has been waiting for several years for this baby. I have no idea why she'd risk it now.

AIBU wanting to tell her what I think? Am I (and other worried friends) overreacting? Does anyone know of anyone who's done this, and how it went?

Why would doctors/midwives/healthcare professionals bother to actively lie/coerce you? It’s quite paranoid if you ask me. General neglect or a poor bedside manner I can understand, but some of these posts almost suggest there is a sinister plot afoot

Why would doctors/midwives/healthcare professionals bother to actively lie/coerce you?

I always think this too. Talk about making work for themselves.

Really glad to see your update OP.

I'm so glad they are both OK, it's a miracle and I hope she comes to realise the risk she has taken. It isn't worth it.

@Teaandcakeordeath83 I knew someone who went into labour whilst waiting for an ELCS and her scar ruptured, luckily she was already in hospital and it wasn't a problem. I was put off a VBAC due to that, and I had previously had an induction where I overcontracted from the first stage with first baby and I didn't want an EMCS due to scar rupture/fetal distress due to overcontraction with the third. I knew that I would end up with an induction as I'd had issues with fetal growth previously and they wouldn't have let me go past 40 weeks (and I wouldn't have wanted to). I wouldn't have picked a homebirth because my baby very nearly died, it leads you to make a different choice. I'm not dismissing birth trauma, I have been there and there are few things more scary than waking up after an EMCS and asking if your baby is alive, as you think they had probably died.

With women feeling lied to/coerced, I think the understaffing does not help as they don't have time to explain. They also work on probability, they pick the option which is statistically safest to keep the mother and baby alive and this doesn't always correlate with the mother's wishes. Postnatal care is even worse.

@Glassofshloer

Why would doctors/midwives/healthcare professionals bother to actively lie/coerce you? It’s quite paranoid if you ask me. General neglect or a poor bedside manner I can understand, but some of these posts almost suggest there is a sinister plot afoot

I don't think there's a plot at all. I think there's a patriarchal mentality to maternity care that's basically "do as you're told little woman" and that's it. You only have to read any of the maternity care failings reports to see that echoed time and time again. I was told ridiculous things by consultants who wanted me to just agree to their lies (because that's what they were) and book a third section. "You can't physically give birth". "You will die in labour or kill your baby". "The risk of you dying in a home birth is 50%". Actual plucked out of their arse bs which when challenged was ignored and more lies brought up. If you were in a relationship and someone was treating you that way you'd be right to think it was coercive and abusive. I've watched midwives say to other women in the waiting room after growth scans that "the doctor won't let you go past 39 weeks with this scan measurement". Won't let you. Language matters. Facts matter for women to make informed choices- not just have over egged figures, meaningless risk statistics and random bs thrown at them to make them comply with whatever a HCP thinks is the correct course of action. The right course of action is what a mentally competent and fully informed woman thinks is the right course of action. Period.

@Glassofshloer

Why would doctors/midwives/healthcare professionals bother to actively lie/coerce you? It’s quite paranoid if you ask me. General neglect or a poor bedside manner I can understand, but some of these posts almost suggest there is a sinister plot afoot

I don't think there's a plot at all. I think there's a patriarchal mentality to maternity care that's basically "do as you're told little woman" and that's it. You only have to read any of the maternity care failings reports to see that echoed time and time again. I was told ridiculous things by consultants who wanted me to just agree to their lies (because that's what they were) and book a third section. "You can't physically give birth". "You will die in labour or kill your baby". "The risk of you dying in a home birth is 50%". Actual plucked out of their arse bs which when challenged was ignored and more lies brought up. If you were in a relationship and someone was treating you that way you'd be right to think it was coercive and abusive. I've watched midwives say to other women in the waiting room after growth scans that "the doctor won't let you go past 39 weeks with this scan measurement". Won't let you. Language matters. Facts matter for women to make informed choices- not just have over egged figures, meaningless risk statistics and random bs thrown at them to make them comply with whatever a HCP thinks is the correct course of action. The right course of action is what a mentally competent and fully informed woman thinks is the right course of action. Period.

@Glassofshloer

Why would doctors/midwives/healthcare professionals bother to actively lie/coerce you? It’s quite paranoid if you ask me. General neglect or a poor bedside manner I can understand, but some of these posts almost suggest there is a sinister plot afoot

I don't think there's a plot at all. I think there's a patriarchal mentality to maternity care that's basically "do as you're told little woman" and that's it. You only have to read any of the maternity care failings reports to see that echoed time and time again. I was told ridiculous things by consultants who wanted me to just agree to their lies (because that's what they were) and book a third section. "You can't physically give birth". "You will die in labour or kill your baby". "The risk of you dying in a home birth is 50%". Actual plucked out of their arse bs which when challenged was ignored and more lies brought up. If you were in a relationship and someone was treating you that way you'd be right to think it was coercive and abusive. I've watched midwives say to other women in the waiting room after growth scans that "the doctor won't let you go past 39 weeks with this scan measurement". Won't let you. Language matters. Facts matter for women to make informed choices- not just have over egged figures, meaningless risk statistics and random bs thrown at them to make them comply with whatever a HCP thinks is the correct course of action. The right course of action is what a mentally competent and fully informed woman thinks is the right course of action. Period.

I understand wanting to wait, even potentially as long as she is but no way would I be refusing constant scans and monitoring!

@Awwlookatmybabyspider

I didn't think the Hospital let you go that far over your due date.

The hospital have no say whatsoever when it comes to that. They do not like it and will encourage you to be induced or have c-section but that is all they can do. I guess they could intervene if your own life was at imminent risk but a foetus, even fully developed does not have any 'rights' until it takes its first breath.

I normally would be pretty supportive of someone delaying medical intervention and I went to 42 weeks when I was expecting. However, it was my second pregnancy, I was planning on having a hospital birth and I went to the hospital daily for scans to keep an eye on the baby. When a baby is breech it is my understanding that sometimes labour will not come at all. I would be incredibly worried about your friend if she is refusing all checks and balances too. There is no harm to at least have the baby's heart rate checked and a scan to check for amniotic fluid. It's a very risky decision (which I suspect is not based on accurate knowledge/research) to blindly carry on without at least checks and supports. There are very good reasons that so many women used to die in childbirth and your friend is risking both her own life and that of her unborn child.

That's great news they are both out the other side @scottishlass43 many thanks for the update

The right course of action is what a mentally competent and fully informed woman thinks is the right course of action. Period.

I think this thread proves otherwise.

@Teaandcakeordeath83

I agree with you re language used by medical staff but I hve to say I think it has evolved that way from a standpoint of just wanting to deliver live babies. My experience from my first, totally unnecessary induction was the same. They see a risk, however minimal, and they want to remove it. Yes it makes for an unpleasant experience. But does it save babies and mothers? Yes. I suspect they have also had to adjust their language and mannerisms to deal with all the women who put themselves and their babies in danger. Must be tiresome. Like the subject of this thread - 44 weeks and footling and avoiding monitoring. Imagine being the doctors and midwives dealing with this shitshow. I get what you’re saying But birth is just so bloody risky. I don’t even really feel comfortable advocating for homebirth although mine was amazing; i do not know everyone's circumstances and would not want to be responsible for that!

@Glassofshloer

Why would doctors/midwives/healthcare professionals bother to actively lie/coerce you? It’s quite paranoid if you ask me. General neglect or a poor bedside manner I can understand, but some of these posts almost suggest there is a sinister plot afoot

It's not a sinister plot, it's a matter of priorities. Obstetrics is a highly litigious area of medicine and ultimately they want as many babies born safely as possible. Policies and procedures are based on mitigating the risks for those that have the worst outcomes. So if the 1/1000 tragic event can be avoided by treating the whole 1000 as if they are potentially that 1 they successfully avoid it. The unintended outcomes are seen as tolerable, to justify the benefit. The doctors want the best outcomes for as many women as possible, even if that means there is (for want of a better phrase) collateral damage. The problem with treating whole populations like this is that it doesn't take into consideration individual circumstances.

@Mamette so I’m going to speak from my own personal experience… I was lied to during my birth of both kids (more so on delivery suite with an IoL), not a conspiracy but because they have a conveyor belt sort of process in delivery suite and it was easier to come up with some BS rather than try and cater to my birth preferences. I’ll list the examples below to illustrate my point.

1. asked to use birth pool- told it was broken and had been for weeks, but another woman had given birth in the pool earlier in the day shift- so not true and a lie to make life easier
2. can’t have delayed cord clamping baby and skin to skin has to be weighed… baby had apgars of 9 so that was bollox
3. most recently on the MLU when I asked to see the infant feeding team as breastfeeding was painful, the team are based on the same corridor, i was told no, as they only see patients who have faltering growth. Luckily I had the number saved and text them to come, midwife got really snitty and they affirmed that any one can see them and the referral criteria the midwife said was not true.

Coercive language is routinely used in maternity care, you can see it on this thread with people commenting saying ‘I didn’t think they’d let you go over 42 weeks’- like there is 0 choice to be had in the matter. I was coerced Into an induction with an sga baby based on out of date guidelines and was told ‘we won’t let you get to 40 weeks’. Coercion is used to get women to follow clinical guidelines it’s as simple as that

They don't like small for gestational babies to go to 40 weeks due to a higher risk of stillbirth. It's a policy based on statistics, they do whatever is statistically more likely to keep mother and baby alive.

Risk of stillbirth after 37 weeks in pregnancies complicated by small-for-gestational-age fetuses
pubmed.ncbi.nlm.nih.gov/23523099/
Conclusion: There is a significantly increased risk of stillbirth in pregnancies complicated by SGA delivered after the 37th week. Given these findings, we advocate a policy of delivery of SGA pregnancies 37-38 weeks.

@Theregoesmyhomebirth but if you don’t know if you would be that 1 in 5000 or whatever, what circumstances make taking that risk acceptable?

@Glassofshloer I think it's often a more complex decision than just avoiding one negative outcome. Otherwise we'd all have elective c-sections at 38 weeks and physiological birth wouldn't happen. Except of course, that comes with its own risks. Like all interventions, or choosing not to have the interventions.

We all judge risk differently. It's why some people ride motorbikes and others don't.

@siestasiesta

They don't like small for gestational babies to go to 40 weeks due to a higher risk of stillbirth. It's a policy based on statistics, they do whatever is statistically more likely to keep mother and baby alive.

Risk of stillbirth after 37 weeks in pregnancies complicated by small-for-gestational-age fetuses
pubmed.ncbi.nlm.nih.gov/23523099/
Conclusion: There is a significantly increased risk of stillbirth in pregnancies complicated by SGA delivered after the 37th week. Given these findings, we advocate a policy of delivery of SGA pregnancies 37-38 weeks.

This is really interesting!

Both my babies were SGA and both were whipped out at 38 and 39 weeks respectively (via induction). "Better out than in" I was told.

Glad to hear your friend and her baby are ok

Glad to hear your friend and her baby are ok

It depends what the risk is, I would be very cautious with something like SGA due to the stillbirth risk. The background stillbirth risk in the article above was 251/10000 for SGA vs 56/10000 without. It's a small risk, but it's five times the risk and the outcome could be catastrophic. Maternity care needs to be better funded and women need to be listened to, I can still see why doctors err on the side of caution. Postnatal care needs a massive overhaul, I think this is a funding issue as most of the funding goes into prenatal and birth care as the main priority is to deliver babies safely. When there isn't enough staff, postnatal care is the first place to be cut.

Genuine question- do babies keep growing until they're born? My mum once told me after a certain point babies stopped growing. (She's always claimed she was pregnant with my DSis for more than 43 weeks before being induced.)

I'm glad it worked out for your friend. I imagine she had a horrible time before she got to the point of having the caesarean. I wish it was a case of our bodies always know what to do.

@siestasiesta

They don't like small for gestational babies to go to 40 weeks due to a higher risk of stillbirth. It's a policy based on statistics, they do whatever is statistically more likely to keep mother and baby alive.

Risk of stillbirth after 37 weeks in pregnancies complicated by small-for-gestational-age fetuses
pubmed.ncbi.nlm.nih.gov/23523099/
Conclusion: There is a significantly increased risk of stillbirth in pregnancies complicated by SGA delivered after the 37th week. Given these findings, we advocate a policy of delivery of SGA pregnancies 37-38 weeks.

This is out of date! The most up to date research informs the saving babies pathway which states that babies between 3rd and 10th centile with normal dopplers are likely to be constitutionally small ie no pathological reason and induction is offered at 39 weeks not before due to the fact babies aren’t as developed at 37/8 weeks as was once thought. This pathway came into place in March 2019. What you’re referring to is the old clinical guidelines. This is no longer policy:

@Namechangetimes100
I'm glad in 2019 my trust didn't follow the saving babies pathway as it wouldn't have my health girl who since 6 weeks old follows the 50th centile despite being born on the 3rd.
My IUGR baby had perfect Doppler scans and fluid levels, I never had reduced movements or anything but my placenta was failing and not feeding my baby

How do you know she was iugr then @Metallicalover? Did her growth slow down utero? Or did you get your placenta tested? If she consistently tracked around the 3rd centile and there were no other indications of something Pathological ie abnormal liquor volume, dopplers, amnio or growth slowing down then being on the 3rd centile on personalised growth charts isn’t inherently pathological.

^ not meant to be a challenging/ confrontational post, I’m genuinely asking how you got your fgr diagnosis :)