Is it lunacy to be induced to fit in with holiday plans?

[allhailtheaubergine]

Logically I don't think it is, but something about it makes me feel as though I am being evil and wicked and selfish.

This is my 3rd pregnancy.

1st baby went 3 weeks overdue (yes, 43 weeks) and I was then induced which took 2 days so she was born at 43+2. She was fine, if a little overcooked. Placenta healthy as anything.

2nd baby I went to 41 weeks and then the general consensus was that as I'd probably end up being induced anyway there was no time like the present, so he was born at 41 +1. It was a fairly arbitrary date.

So, 3rd pregnancy - chances are I will be induced again. All being well we are planning on making a trip 6 weeks after my due date. I have found myself wondering about getting induced on my due date so as to have 6 weeks to recover and go on holiday with a 6 week old rather than a 4 week old.

I fully realise that we may not go on holiday at all, and our plans depend on all being well, but assuming there are no complications would it be wrong to be induced at 40 weeks for my convenience? It would wouldn't it. But why exactly?

Holiday dates are non negotiable. Holiday is more important than just a family holiday - it is a special occasion trip with friends that will never be duplicated.

Anyone?

Yes I think it is mad to want to be induced early when it might not work as your body might not acutally be ready until 42 weeks or more, why risk having an unnecessary caesarean section. Plus unless you are private you will have a job convincing someone to do a clinically unnecessary inducution of labour. Plus I personally think that going on holiday with a four week old would be much the same as going with a six week old, but then maybe time has dulled the memories!

Is 40 weeks early then? My understanding was that after 42 weeks the risks in continuing with the pregnancy massively increase. But after 40 weeks it's fine to be born any time. V happy to be corrected if I have that wrong.

With ds 2 no one was telling me to wait until 42 weeks. They were very relaxed and happily induced me at 40+6 (I think). This was 3 years ago on the NHS.

Yes, I am having this one privately so I do get a say in what happens, though obviously will listen to all medical advice.

Other factors: Even at 43 weeks my body puts up a tremendous fight and the induction is not easy. In fact the 41 week induction was less of a struggle.

Also, I do not have easy pregnancies (sickness, SPD, back problems etc) so even if there was no holiday I may well decide not to go to 42 weeks. The last few weeks are the hardest, from memory.

Oh, also, both previous babies have been huge and healthy. I know this doesn't guarantee anything with this one.

The silly thing is if it weren't for the holiday I'd probably aim for 41 weeks and get induced then. It's just the holiday that makes me examine my motives and feel terribly guilty about making a decision that is convenient.

I don't think it's wrong to ask for an induction for any reason actually.
If you are OK with the small possibility of a cesarian ( which is hardly the end of the world), why should it be a problem? Why should you feel guilty?

I am a firm advocate of women having full autonomy over their bodies. As long as you are fully informed, you have a right to make any decision about your body and your child. It makes me sick to think that women need to ask for "permission" from hospitals to make decisions about something that affects their lives profoundly.

I didn't know that you couldn't ask for an induction unless you are going private.
So the real matter is this- they can choose to use anything on a labouring woman without asking her ( happens all the time, read the papers ), but women have no right to ask for a procedure they are fully aware of?
Well that makes sense. sarcasm

I am unclear about the issue of induction increasing the chance of c-section. Are you saying that induction at 40 weeks has a higher risk of c-section than induction at 42 weeks? Or simply that induction of any sort increases to risk of c-section?

I am working on the assumption that I am almost certainly going to have to have an induction, be it at 40 weeks or 43 weeks. I can't know for sure, but in both my two previous births my body has shown no inclination to labour spontaneously which is a reasonable indication, I understand.

Also, I don't want to mislead - I am having the baby privately because I now live outside UK. I have no idea how going private in the UK alters your choices when compared with NHS in UK.

(Given the choice I think I would choose to holiday 4 weeks post vaginal birth rather than 6 weeks post c-section)!

The longer you wait, the more likely you are to go into labour naturally without being induced. With your 41 week induction, perhaps if you'd waited you might have gone into labour at 42 weeks (obviously there's no way of knowing!). As there are some risks to induction and it's often not very pleasant, what about waiting until 42 weeks in the hope that your body will go into labour itself. You could have sweeps before then to try to get things started. Perhaps the second induction was easier than the first because your body was nearer to doing it naturally anyway, and also because you'd already given birth before.

Another issue is how sure of your dates are you - are you 100% sure that you'll be 40 weeks, as if there's any possibility of being a week out then you might be inducing a 39 weeker that would prefer to be inside for a bit longer.

Yes, that makes sense. Although when I say my second induction was easier, it still took 2 X prostaglandin + manually breaking my waters + seratocin drip. It wasn't quite 2 days of labouring mostly on a monitor though - it was about 4 hours shorter and didn't result in episiotomy and forceps, though pushing caused me to tear far more horribly than the episiotomy.

Dates - I know precisely the day of my last period.

Hmm. I suppose the worst combination would be to go to 42 weeks and end up with a c-section. Perhaps the thing to do is split the difference and get induced at 41 or thereabouts.

Bump. :)

Might seem like a random question but how long are your cycles normally ? The reason I ask as if you have longer cycles then the chances are that you concieved later so this could mean that your babies are just born later as they are ready later, if you get my gist? I would talk it over with your consultant and weigh up all the sides before you make a decision. There are potential risks either way but only you and your consultant can know your particular circumstances and make an informed decision. Good luck .

Its up to you what you want to do really and a baby at 40 weeks is just as ready to come into the world as at 42 weeks.

Its more the chance of a failed induction leading to c/section that would be the deciding factor in my opinion. Any induction will increase your chance of a c/s and the earlier and less ready your body is to go into labour by itself, the higher the chance of failure. Saying that, with 2 successful vaginal births already, your chance of a failed induction and c/section is very small. (you may need a c/s for many other reasons, but failed IOL is not a great risk factor imo).

If its what you want then talk to your mw or OB - of course you can ask for an induction even in the NHS. Whether they agree is between you and your hcp, but going privately it should be no problem.

Current NICE guidelines state that induction at 41 weeks isn't associated with higher rate of c/s.

Lol - ShagmundFreud is a brilliant name. Are you a name changer?

This is all useful and interesting, and thank you for replying. I shall of course discuss the whole thing at length with my consultant, but I always find meetings of these sort to be more useful if I am armed with a little information to start with. Especially given the language issues.

Perhaps aim for induction at 41 weeks?

I am very very nervous about the idea of a c-section. Fear of the unknown. The idea of coming home and looking after 2 small children and a baby after having major abdominal surgery frightens the bejeesus out of me.

If I do have a section is the holiday completely off the cards?

shag - with respect, I think that you would need to be a bit naive to believe that. I know there have been studies recently - this is one - which do suggest no difference, but with the increased use of epidurals, reduced mobility and the increased risk of a cascade of intervention that an induction brings, I really cant accept the findings. I have seen so many failed IOLs in my years on labour wards. Maybe they would have ended as c/s anyway but who knows.

However, I would say that for most women who have had successful vaginal births previously, the increased risk is very low. IMO it is definitely higher in primips. In Allhails case, at 40 weeks, I dont think it would be a problem.

Just my thoughts.....

Allhail I did it last time on due date and will be requesting same again

yep i think its a bit mad and it may not work.

like you i went very overdue, 3 wks with my 3rd.

with no 1 i was induced at a week over and it took days and nearly ended in an ec as it wasnt working.

no 2 i waited till over 2wks and was induced, all fine took 7hrs.

no 3 i REALLY wanted a home birth and waited as long asi could, but in the end went in to be induced, it worked fine 3hrs.

no 4 again went more than 2wks overdue and then fed up and so got induced, it took ONE hr!

no 5 i had a much harder preg, was sick, my kids were sick (one almost hospitalised, another one had kawasaki disease and was hospitalised, this was towards the end of my preg) so i went in at 9 days over asi had had enough, was tired, had been ill myself and just wanted it over, but i ended up on the syntocin drip as it just wasnt happening, once it got going it only took just under 3hrs, but i am pretty sure had i waited another few days i wouldnt have needed the syntocin drip, which made it hugely painful!

i would really wait as long as you can, if you go two weeks over, then your baby will still be 4 wks old which is fine for going on holiday and you are likely to have a better birth than if you try and force your body to labour when it isnt ready.

just my thoughts anyway xx

btw your hospital may NOT want to induce you on your due date or within one week of it, i had to PUSH to get induced at term plus 9 as they wanted me to wait till plus 14, but i had been ill and felt the baby wasnt moving as much and a scan revealed slightly low fluid levels so they agreed, had that not been the case then they would have wanted me to wait till term +14.

I was induced with DS1 at 40+11 and had an EMCS. Recovery was awful, I could barely contemplate visiting somewhere an hour away 6 weeks post birth.

Had an ELCS with DS2, much better recovery. As long as I had been able to get help with domestic stuff and organising then a holiday would have been a definite possibility at 6 weeks post birth.

The problem with a section post induction is that you are knackered and then they slice you open. It is not a good combination!

I would discuss with the consultant, aim for 41 weeks but be prepared to wait another week if things are looking v.unfavourable.

mint - re: induction and c/s, yes, to me it's completely counter-intuitive as well.

I've thought long and hard about this and wondered at times if the results of the studies used for the Cochrane review, were confounded by the higher rates of c/s among women who don't have one to one care in labour (many more of these in control arm I suspect).

Have you seen this study of birth outcomes for healthy primips? here

According to this study over 70% of HEALTHY primips having an induction PLUS epidural end up with an instrumental or operative birth. Shocking really.

shagmund i think for a first delivery you may be right but second third etc ...?

Notan, you're right. Different issue for second/third baby. Sorry OP!

I was induced for dc3 and dc4 by choice, because I didn't want a panicky quick labour in the middle of the night (dc2 came very fast). All went v smoothly. Consultant was v happy to do on due date. He said if you've had a couple of babies before it's a completely different matter from a first-time labour.

thanks for that coffeeaddict - I am in the exact same predicament - i also demand epidural these days and the due date induction allows for that - no nasty shock of anaesthetist not available malarkey

good to hear others feel the same as me!

Quite! With DC4 I had the epidural sited BEFORE they started the drip :) Much safer in my opinion as I really was able to keep nice and still!

Wow coffeeaddict me too!!! With dc6 - I'd never heard of anyone else doing it like that. I'd do the same again!

Personally I'd go for an elect c-section rather than an induction. Less pain, same end result - doesn't bugger up your trip and you'll end up with an 8 week old because they'll probably do it at 38 weeks!