To decline induction/c section for baby measuring small?

[imalreadythere]

40+2 today. Baby measuring small but also engaged so maybe that's why?

Midwives offered induction or c section but I want to wait.

Aibu? The midwife wasn't that pleased I don't think.

My placenta was failing (assumed) and my LB was dropping down the centiles. He came early (37+5) but I've have had an induction or a CS in a heart beat if they had suggested it. The thought that my placenta was not giving him what he needed caused me no end of anxiety, I kept thinking he was starving in there and it was horrendous. I was delighted when I went into labour early.

I am not sure why you wouldn't follow the medical advice... presumably you are not under the impression you know more about this stuff than they do?

https://www.rcog.org.uk/for-the-public/browse-our-patient-information/having-a-small-baby/

There is some helpful information on this website.

And use the B.R.A.I.N acronym = Benefits, Risks, Alternatives, Intuition, Nothing.

What are the benefits? What are the risks? Are there any alternatives? What does your instinct/intuition tell you? What happens if you do nothing?

I would have this conversation as soon as possible.x

Personally I wouldn’t go against the medical advice.
Yes measurements and scans are not 100% accurate but they are better than nothing and plenty of times they do pick up problems.
I’ve no idea why anyone would want to take the riskier option just so they can say ‘no interventions’.
My baby would always be delivered by the safest method advised by the medical professionals looking after us who do it day in day out.

Personally I wouldn't risk it. Baby could be small due to placenta not working effectively.

Agree

The threshold for induction once term is very low, their priority is safe babies so they'd rather induce 10 people who would have been fine to wait rather than miss the 1 who wouldn't. It's completely fine to ask questions and make an informed decision rather than following their advice blindly, but I think it's important to have that conversation about risks of waiting, benefits, and what their specific concerns are, as well as any other options (like trying a sweep), whether they could examine you to see if cervix looks like it would be receptive to induction etc. I was induced at 37 weeks with my first as she was measuring small, and when checking if I could wait until 37 weeks (as this was picked up early) I had a special scan just to check the blood flow to the placenta, I think they called it a Doppler scan? Although they may have done this already when they measured your baby as small. They ascertained from that scan that while small and growth had stalled, she wasn't in any immediate risk and we could wait to reach term.

Fwiw I've had 2 inductions and after the initial induction needed no intervention with either so if you and the medical team decide that's best you won't necessarily have a medical heavy.

Personally at your stage of pregnancy I'd be comfortable with going with their advice but you have to be comfortable too.

There’s a risk you may end up being induced or having a section anyway, especially as you go overdue. Intervention isn’t bad in itself, intervention can save lives. I’d consider carefully but would follow the midwife’s advice.

I was induced at 39 weeks. I ended up on the drip but it was totally fine. No forceps needed.

At my NCT course the leader was very strongly against intervention and spoke with great admiration of people who went overdue and declined interventions.
I had an elective c-section so you can imagine her opinion of me but that was agreed with the advice of the professionals looking after me, not someone who I had paid for advice but who used it as an opportunity to push her own agenda to a bunch of first time parents (about 40% of the group needed EMCS, there were 1 or 2 forceps deliveries and no one got off without any interventions).

OP if you are basing your no intervention stance on information at an antenatal class I would suggest listen to the risks and benefits from the consultant.

My 3rd baby was measuring small... doctors advised induction. He was rushed out with ventouse and taken to nicu. The placenta was failing. This was at 38 weeks. I had both my babies before without pain relief and naturally delivered, as well as my 4th afterwards. I don't regret my 3rd birth it saved his life.

If OP chooses to go for induction (instead of c section), i’d recommend to first ask what the current situation is on the wards with staffing.

I was induced, didn’t progress, no staff to break my waters and this lead to EMCS. There is also a thread on here right now about women who had/are currently having the same situation due to no staff. Depends on the hospital though and OP might be fine.

I didn't get an induction and I should have op. Lasting damage to baby.
Saying that with my second baby I had resigned to an induction and had booked in when he was late had two sessions of acupuncture over a weekend and he was born in hours. Contrast to first. Worth a try?

41 weeks

Interventions are there to improve outcomes & save lives. If you're in the UK they don't recommend c-sections lightly, it's a resource hog & expensive.

I get the romantic idea of perfect & natural births, the Instagram births, but the reality is far different.

My second was overdue & and it was ONLY the intervention of the midwife (against the consultants wishes) that saved both our lives. This is their job, they see it all the time. It's all they do, day in & day out. I don't know better, you don't know better &, frankly, neither would the consultant. Trust your midwife is my wholehearted advice.

Good luck!

You can have daily monitoring instead. Induction will only be successful if baby is ready. The risk of still birth may increase but it’s a relative risk, absolute risk is still very small. You also need to weigh up the risk of getting the baby out early in a traumatic way. And you know, trauma to the woman.

I had an induction due to a small baby at only just 37 weeks. It was a balloon one, no medication, once they took the balloon out and broke my waters the baby was born naturally and without any further intervention in 4 hours. Just saying it doesn't have to be awful and end in c-section.
Baby was born only 5lb and placenta was failing unfortunately.

How would I know if the placenta is failing?

Poor baby! This is the thing isn’t it, working out the risks. Can you ask for a second opinion op?

Exactly the same here - no-one to break my waters and then I started haemorrhaging so it turned into EMCS.

Honestly, if someone medical told you that you could possibly die/get severe brain damage due to high blood pressure (for example) and that everyday that risk increased, would you choose not to have an intervention?

What is this obsession with not having interventions in childbirth when you would with any other potentially lifethreatening or painful condition?

DD was small and for that reason I had regular scans - from the start they told me if they had any concerns, they'd induce me. Scans actually did me a favour as they picked up another problem and told me for both reasons they wanted me to be induced, do a trial labour but one way or the other, they needed baby out within 48 hours. Induction was absolutely fine, some comfortable than the examinations I had in labour.

DD was only 44.5cm at birth, but luckily she was fine. Is it really worth risking any complications for baby or yourself?

My baby was borderline IUGR (9th centile) and I had an ELCS at 39 weeks.

I'd had weekly monitoring, and everything looked fine, but my consultant had a hunch something wasn't right and she was correct. Turned out it was marginal cord insertion and baby wasn't getting enough nutrients. She was born 6lbs 1oz and 10th centile, so the measurements were pretty much exactly right.

I was planning an ELCS anyway (vaginal birth doesn't appeal to me) so I was fine for her to be born so we knew she'd be safe.

I understand you don't want interventions, but think very carefully about how you'd feel if something were wrong with your baby and intervention could have saved them.

It's entirely your choice and it's terrifying but personally I wouldn't go against a health care professionals advice just for the sake of 'as little intervention as possible'. As others have said it could be there's a problem with your placenta which could be increasing the risks and potentially have lasting impact on your baby. No way would I risk that. In fact my consultant has already said to me that if I get to 40 weeks and there's no movement then they recommend an induction. I don't want to be induced but I trust the doctor with years of medical training and experience over my own judgement.

Forgot to say, if you're induced you'll know there's a bed for you and also you'll be monitored at every stage.

@arecklessmanor At my NCT course the leader was very strongly against intervention and spoke with great admiration of people who went overdue and declined interventions.

Intervention has become a dirty word for some reason despite it being done for the baby's safety.