To not want induction in these circumstances

[Toinduceornot]

I’ve been offered an induction at 39 weeks with these circumstances and wondering what you would do and if IABU to decline?

Low risk first pregnancy no complications.

34 weeks - referred for growth scan by midwife, bump measured small but this coincided with baby changing to head down

Growth scan showed no problems baby on 50th centile.

35 + 4 - saw a new midwife as usual one was on holiday. She didn’t realise it hadn’t been two weeks since my growth scan and bump was 1cm smaller than the tolerance level so referred me for another.

At the scan sonographer could only get 1 measurement of the femur, which was measuring smaller than the first growth scan? Doctor and midwife said to disregard this scan as it was clearly inaccurate although they did plot the measurements on my chart.

They asked for me to come back for a scan now, at 38 + 4. Today I saw the same sonographer who again struggled to get a measurement but has deduced baby is on the 10th centile for femur length. Estimated weight is 6lbs.

Midwife and doctor want me to have an induction within the next 72 hours. They haven’t done any monitoring and they didn’t check the placenta or cord flow at the scan today, midwife wasn’t sure why.

I’m really skeptical about the measurements given the errors previously and feel really pressured into the induction. AIBU to refuse and what else can I do eg can I ask for a second opinion? I’ve had no sign of labour so far but haven’t been examined at all.

OP I wouldn't pay any attention to the scan.
I've known countless women who were told they were having small babies, yet the babies came out at 8, 9 or 10lb!

Is the fact he's measuring small a worry though? For context I was born 2 weeks late and weighed 4lb 11.

Based on your follow up private scan I'd agree and go for the induction. At the hospital you should see a Dr before you start your induction. I did but it wasn't preplanned... maybe have a list of questions, talk about your options. When you go in. You could always change your mind up until the point you start induction.

Hi OP. Randomly thought of you as I’m up in the middle of the night. Any news?

I would find out how favorable your cervix is & if it isn't, ask for a c section. You can be in & out in 24 hours but an induction could last 3 days & still end up in a c section.

This is really weird. Where I work (midwife) we don't even take femur length into consideration when assessing for growth restriction. It's really to do with abdominal circumference and fetal weight. There is nothing about femur length in the RCOG guidelines on growth restriction.

An induction for femur length alone, if that is what is happening here, is absolutely batshit. There is no way I would do this! I know it's easy to feel railroaded but I would be asking a lot more questions before I'd agree to anything, OP. What guideline are they basing this on?

I came in for a pre-induction appointment yesterday and spoke with a consultant who was helpful and agreed I could have an elective C-section but that they still wanted to get baby out as he’s dropped below the 10th centile. She said they could estimate weight based on femur and abdomen measurements? They haven’t been able to get a head measurement for weeks as he’s so low.

I agreed to let a midwife examine me to see if I was dilated and I was, 3cm! The examination actually broken waters so I’m in hospital now waiting to see if labour starts. Having a few tightening but not much else.

Can you go for a wander?

I found that a good brisk walk did wonders for getting contractions going, once I was at that tipping point.

Op, can you update please? I hope all is well

Under no curcumstances get an induction. Horrendous and desoite trying over and over they never worked for me

My bump was measuring small with DS. I had a growth scan & was told his size was fine & it must just be a compact bump. I started to notice (very subtle) reduced movements & luckily I was listened to & induced at 39 weeks. Baby was much smaller than the scan had suggested & not doing very well. I hope all is going well for you.

Well that is exciting! Breast/nipple stimulation can get contractions going. Good luck!

Ohhh exciting. Go for a walk, the giggling helps move things along.

That's awful for you, but doesn't mean that nobody else should ever have an induction.

I was induced twice, with DS and DD and had 2 absolutely perfect births, not even a stitch needed.

Best of luck today OP. Hope everything goes nice and smoothly for you and the little one.

Good luck, OP!
I hope it isn't too much longer.

OMG who would deliberately want major abdominal surgery?

I realised I never updated this thread 😅 baby was born my C-section as my labour didn’t really get started after my waters broke.

A CTG showed his heart rate dipping when I was mildly contracting, so I got rushed from the induction bay to delivery ward. The doctor wanted to insert an epidural in case we needed to go to theatre quickly, then get me started on the drip. I declined the oxytocin drip as by this point I hadn’t eaten for 24 hours (was on monitoring every time they served a meal!) and hadn’t slept much in the whole week due to worrying so much! DS was born by c-section that evening. He was very small, under the second centile at 5lb, and had to have increased obs due to low blood sugar but he’s putting on weight fast. This was 8 weeks ago and he’s about 9lb now! No other concerns with him and I’ve recovered well. Next pregnancy will likely be high risk due to his size but I wouldn’t hesitate for another c-section.

Thank you so much for the update @Toinduceornot and congratulations on your absolutely adorable sounding DS.

I think that you did the right thing in refusing the drip. Sometimes they just need to be out and quickly

If it makes you feel any better OP, statistically 39 weeks is the safest time to deliver a baby.

40+ weeks the risks of stillbirth are higher, and under 39 weeks the risks of SIDs is higher. 39 weeks is actually the ideal in terms of risk - so I wouldn't worry about it being a week early.

Risk of stillbirth is higher at 40 weeks than 39, for example

Also I had an induction at 39 weeks - I begged them for it as my pregnancy made me so ill.

Induction was fine - I only had the pessary, no drip - labour was fine, had an epidural and tore a little but not too bad. Overall a good first labour imo, I've heard of much worse. I'd always planned an epidural as well, so that wasn't as a result of the induction.

Apologies OP didn't realise this was an old thread! Glad to hear you and baby are doing well :)

Congratulations @Toinduceornot

I had all this with my 2nd baby. Major concerns over her size, short femur etc. It really worried me but I was already booked in for an ELCS at 39 weeks. She weighed 7lb 4oz at birth so not small in the slightest.

Also just realised this is an old thread. Congratulations on your little boy 🥰

@Toinduceornot

Congratulations!! Glad all is going well. Thanks for updating us :)