To request induction at 41 weeks?

[JukBoxe]

I am now 40+5 with first baby.
Have been under consultant led care but no problems, baby growing nicely at 50th centile, BP and sugars fine.
Had a week where I genuinely kept thinking I was starting latent phase of labour with stop start contractions- realised these were associated with expressing colostrum and haven’t had any since I dialled this down (we already have a freezer drawer full at this point! )
Attempted sweep on Monday when 40+2 and failed as cervix unfavourable- bishops score 5 at best.
On self examination today situation remains the same- cervix very posterior. I didn’t attempt my own sweep fyi- just was interested if it had changed. Midwife on Monday was quite pointed about asking if I had induction booked and was told one will be booked for me at my appointment today.
Have been reading SWEPIS study about stillbirth rates for induction at 41 vs 42 weeks and shit myself- am already technically at increased risk of still birth due to maternal obesity and autoimmune disease.
I have growth scan and obstetrician today. I’m thinking of asking to be induced at 41+1…local policy would be to go to 41+5 but I’m quite nervous about still birth risks and feel like if my cervix is still so shit after all the nipple stimulation, orgasms, walks etc I’ve done and all the BH I’ve had that it’s vanishingly unlikely that much is going to change in the intervening period.
On the other hand I think it’s first baby, do I just need to give them time to cook? One of the reasons it’s hard is because I won’t have any further checks between today and 41+5 to make sure baby is ok- and I won’t be able to go to drop in midwife, clinic or scan or anything as will be shut for Christmas for 4 days…
This means giving up on the alongside birth centre and water birth I had planned too but feel pretty pessimistic about the chances of that happening at this point anyway- when they agreed to it it was made clear I was on the high end of risk for them and they’d have a low threshold for transfer.
I also know that stressing about still birth is not going to help my oxytocin get flowing but prior to this I have done lots of nice relaxing things with husband and nothing..

I obviously will discuss with my obstetrician but was hoping for some lived experience, stories, reassurance or indeed not reassurance as may be the case!

Hi OP, I was in a similar situation with my DD. My first baby aged 39 and edging towards 40 I knew I was at higher risk of still birth and usually if you're 40 they recommend induction around 39 weeks to reduce risk. They said they'd let me go to 41+5 too and I was really flapping over this. At my 38 week appointment I brought up my anxiety and how I was really struggling, I found I was very anxious in this pregnancy due to previous losses and infertility. The consultant offered me induction but did kind of say that she wouldn't recommend just because I'd no medical reason for it but I just wanted baby out safe so was booked in for induction at 39 weeks. I too had a failed sweep at 38 weeks and I'd 38+5 as cervix was unfavourable, it was clamped shut my! My induction also failed as I still wasn't ready so my foley catheter never fell out like its meant to when your cervix dilates. I was very lucky that mine ended in an ELCS as was told I had a high chance of EMCS after failure of catheter and I requested an ELCS and was surprised when they gave me one and was booked in 2 days after failed induction at 39+4. DD is 5 weeks old now . The induction part wasn't particularly pleasant but I'd do it all again no problem. For me being so anxious i couldn't have gone to 41+5, I know the risks of still birth were still low in the grand scheme but my mental health would have been shot.
I suspect if you tell the obs your fears they'll offer you induction earlier. I was surprised how supportive they were when I requested induction and I'm assuming it's to cover their own backs as well if god forbid they refused and something happened. I think they do a one size fits all so sometimes you need to push for what you want but I felt very supported so I hope you do too

It doesn’t hurt to ask to be induced. Sometimes trusts get stuck when the policy says otherwise but hopefully they should take your anxieties into account and agree to induction. At 41 weeks baby is cooked and hopefully induction should just kick start things.

I was induced at 38+1 due to gestational diabetes and reduced movements. I could have been induced later but I took the early induction after a bought of reduced movements because I was just too anxious. I was prepared for a 5 day induction and interventions if it meant I could stop worrying about the state of my placenta and get her here sooner.

I had a really positive induction. I don’t think I would have benefited any more from being on the midwife led unit and having a water birth. The pessary was inserted at 4pm and nothing much happened overnight. At 5am it had nearly fallen out and I asked for it to be reinserted. At 10am I went for a 10 minute walk to Costa and contractions started on the way back. At 1pm contractions were so established and regular I asked for the pessary to be removed (should be in 24 hours). I was on the delivery unit by 5pm and 8cm dilated and baby was born just after 1030pm. I had paracetamol, codeine and gas and air for pain relief. I’m a FTM too so they’d told me to expect it to be a lot longer. I’d taken different hospital bags, one with induction things (slightly different clothes so more T-shirt’s than baggy tops and pyjamas rather than nighties) and DH didn’t even have chance to get the labour and baby things out of the car. So have an emergency baby supply in every bag of you are being induced.

An induction is considered for medical reasons. Your mental health is just as important as any other factor. You are choosing an induction for yours and your baby’s health, there’s nothing unreasonable about that.

Go with your instinct and they should follow. I was fairly low risk with my ds but he was measuring large. I requested they induce me when I was 7 days over, instead of 14 as I was scared of his size and slowing growth patterns. If you discuss your concerns then they won’t deny early induction.

You have valid reasons for wanting an early induction, if that’s what you feel is best then please discuss this.

I should also add that I had a failed sweep two days before, which wasn’t surprising as I was 37+6! When I asked for the pessary to be removed my cervix was still back so they couldn’t tell how much I was dilated. My waters broke shortly after and so they limited examinations after that but 4hrs after my cervix was still back I was 8cm on the delivery unit. So just because you’ve had a failed sweep doesn’t mean you won’t have a good induction.

My induction with first baby was booked for 41+5 (latest possible). My waters broke on 41+4 and they did an augmentation (like induction, same meds, but when you're already in labour) because they wanted her out fast. All went well for us. In the end it is up to your comfort level.

I was monitoring for kicks closely and any concerns I went in to maternity ward and they put me on the heartbeat monitor for a few hours to check. Would your maternity ward not still be open if you had any concerns with kick count?

I should add, I'm in Scotland and they apparently now recommend induction at 41 weeks...(changed since DD was born 2 years ago). Are you in England?

I would give anything to avoid an induction again. Honestly. Wait a couple of days and have a second sweep. Second sweeps can be very helpful. Inductions can be brutal.

@Saoirse82

Thank you and congratulations on your baby!
It’s good to hear that even though you had interventions and section that actually you feel you had a good experience overall!

@InTheNightWeWillWish

Thank you again that’s reassuring! I am glad to hear you managed without an epidural too as that’s one of the things I was worried about needing if I had an induction

@MizzFizz

If I had reduced movements I would absolutely be seen at maternity triage - it’s more if it was a normal week I’d be able to go to maternity drop in three times a week for sweeps/heart rate monitoring etc as per my preference but I won’t be able to access any of that from 24th - 28th inclusive. Also no routine scanning- sometimes they will do twice a week placenta scans but after today I won’t be able to have another one.

I am in England- NICE we’re going to change their guidelines to recommend induction at 41 weeks but then changed their mind when they published final update.

@Justheretoaskaquestion91

See I don’t have the option to have another sweep that’s the thing- they can attempt one today but I already can tell from my own self examination there’s not a chance as no different to Monday- the next time I would be able to be seen barring reduced movements would be at 41+5 when I would be induced anyway.

@JukBoxe

Just get the sweep today and see what happens.

Definitely ask to make it 41 weeks instead but if they refuse then just look out for movement and kicks and any changes go straight in to the maternity unit. Please please don’t check your cervix yourself at this stage u could easily introduce infection into your cervix.

Are u walking lots? Sideways walking is great for putting a little stretch on the cervix! Good luck

Surely maternity departments stay open over Christmas?
Baby's still arrive at this time of year.
Scans and midwife checks are still available too.

Try and relax.

Hot baths, good movie, retail therapy, spa,... Whatever works for you.

My first was 2 weeks over due, I was terrified and anxious as can be. They broke my waters at 42 weeks as baby showed signs of distress. She was due 30 Dec, but came 14 Jan. I had 3 failed sweeps!
They kept me at hospital for 3/4 days monitoring baby before they took action.

Ask midwife to book you in asap, it'll help you relax. I felt better once I was at hospital, not that they did anything for days. And the groans of other women and the machines bleeping were also just more terrifying.
I should have relaxed at home, I will in future. Maybe it's just experience and trusting things will be ok. It was hard at the time.

Good luck x

I've just had my baby last week at 40.5. I went into labor naturally but something was telling me I wouldn't make it past 41 and if I got to 41 I was going to insist on having him out one way or another.

Turns out he was way more overdue than anyone thought. I don't know how it could be calculated so incorrectly, even growth scans were out.

He was almost 10 pounds and the size of my dd when she was 1 month old but the big giveaway was that he had no more vernix left. He came out looking completely sunburned and has been shedding skin ever since. I just knew he was ready for a couple of weeks but couldn't get myself into labor.

So I would definitely listen to instinct.

But induction isn't a walk in the park either so good to consider it carefully. Despite my sons size, the induction with my dd was longer and more painful than childbirth without an induction.

Maybe it's a coincidence but a couple of days before I went into labor I started rubbing a uterus oil on my stomach and back, several times a day, boiled a massive batch of raspberry leaf tea and sipped it constantly, and I played just dance on the switch every evening (hard work but got me moving). Worth a try?

Firstly - very, very important - leave your cervix alone. You’re more likely to give yourself an infection than to self-diagnose the start of labour.

Have a chat with your midwife and try a second sweep.

Dating isn't an exact science, its only a few more days. I'd wait and go for natural over induction where the rates of medical intervention are much higher. Its first baby, they ofter are overdue. Some countries count 41/42 weeks as full term rather than 40.

Also stop your self examinations unless you are a midwife, they are not recommended at all.

If your Bishop's score is still unfavorable I'd be requesting an ELCS, not an induction. I had an induction with an unfavorable score (they didn't tell me this until I wanted answers afterwards) and ended with an EMCS.

You've thought it through and know what you feel is best. Absolutely ask. It's a sensible request

Have you read up on the likelihood of an induction being successful in relation to your bishops score? As above I’d be requesting a c section rather than induction.

Look into elective csection and seriously consider this as an option.