40 week appointment tomorrow, induction questions

[pixie04]

Any suggestions on how to approach this?

I'm having my 40 week appointment tomorrow, I'm expecting to be offered or to be able to request a sweep, which is fine but I'm also expecting to be offered an induction date. I'm thinking of refusing at this stage. My worries are:

I'm small, 4ft 10", if I don't go into labour without medical intervention ie gels and further methods then I think I may be too small to pass him.

I'm planning a homebirth, so in the hope that he hasn't grown bigger than I can pass then I'd like to be able to have him at home all being well and I don't know if arranging an induction at this point could make a difference to that.

Lastly I'm scared that by accepting an induction I could be setting myself up for a lot of intervention to no avail and potentially an EMCS. I would prefer to hold out while all is fine but if things change re asses then.

Do I bother discussing all this with MW tomorrow, or do I just say no thanks can we review next week? These thoughts are in my head but I'm not really overdue yet am I so don't want to start worrying and being monitored ect when right now there is no need.

Women often don't grow babies that are bigger than they are able to give birth to - some small women give birth to large babies and have no problems, some big women have small babies and have lots of trouble in the process. At 40 weeks, babies are generally as big as they are going to get. Some start to lose a bit of weight after 40 weeks.

Also, measurements AND growths scans are both fairly inaccurate sometimes, they give an idea of how big a baby can be but can also be out by a lb or two.

You're absolutely right about not being overdue yet as normal pregnancy goes up to (and in some women) beyond 42 weeks. I think the average date for women to give birth spontaneously to their first baby is actually 40+9 or 40+10.

I would discuss your concerns with your midwife - however mine didn't offer an induction date until I reached 41 weeks, and I said I wouldn't go in any earlier than 42 weeks. If you want to hold on and see what happens naturally, and that's what makes you happy then do it. If you're relaxed then you're MUCH more likely to go into labour naturally anyway.

Induction wasn't discussed at my 40 week appointment other than to say 'we can have a chat about that if you're here next week'.

Hope your sweep works. I swear mine did. I was 40+1 at the appointment, was in labour the next evening and she arrived 13 hours after that. Fingers crossed for you.

My midwife doesn't talk about induction until the 41 week appointment. For what it's worth, I've had 3 babies, one at 40+11, one at 40+6 and one at 40+2 so you've still got plenty of time.

Thanks for your replies. I am hoping that induction isn't mentioned tomorrow or that she accepts or offers a "lets wait and see next week" before we go into it.

My sister went to 43 weeks, no labour, was booked in for induction at 42 weeks and they decided to do ELCS at 43 weeks instead after growth scans showed the baby was too big. She's in France though and they have a different medical system and different approach to birth from what I understand.

I do tend to agree with you though flisspaps, I don't believe that a growth scan can determine A. how much a woman's pelvis may open during labour as I believe it does and B. how much the baby's head can move during the birth, because I'm sure that's why baby's have the soft spot so there is some give. Think I got told that on the NCT course.

Also whilst my dates have been pretty much the same all the way through maybe he's a 42 weeks baby :)

Just another to say that neither sweep nor induction were discussed at my 40 week appt with DD2 (didn't actually even have a 40 week appt with DD1, just a 39 week one and then I was in labour before the 41 week appt -born at 40+8. It was a holiday period).

At my 41 week appointment I was offered a sweep that day and induction at 40+14. I booked that in, but obviously could have changed my mind. DD2 was born at home at 40+9.

I have my 40 week appointment tomorrow as well. Think I'll request a sweep for week 41. Something is happening in my belly for a few days, so I rather wait.

But induction is something I reallly don't want too.

Had the appointment, sorry I name changed, I'm Pixie04.

App went well, had a sweep apparently things are already starting, cervix coming down and am 1cm open. She said that's significant as this is my first. Sweep didn't hurt at all, not even uncomfortable really not sure what that says for me.

She did want to call the hospital to book me in for induction for 12 days time. I asked to leave it till next week and she said no problem. She did want me to discuss why and I just explained that I don't want to plan any intervention yet and would prefer to hang on until next week before worrying about it as baby may have arrived by then. She really didn't mind. She said we can look again if I'm still pregnant after sweep next week. She said they can hold out until 40 +14 and after then I'd need to see consultant and daily monitoring but they are happy with that as long as baby is ok. She also said depending on the monitoring and what consultant says, homebirth isn't ruled out after 40 + 14.

I think it went well

pixie have you had a show yet? I had my second sweep yesterday but nothing has happened, although MW said i was at exactly the same point as you re dilation.
Wish i didn't have the option of induction tomorrow cos it's starting to seem tempting even though it's not what i really want!

That's great news. Good to hear about a supportive home birth team. It sounds like there is a good chance you will get there well before +14 anyway!

[Of course, people will remind you that homebirth is always your choice regardless what the consultant says or how far overdue you are, but I can understand that having a midwife who is uncomfortable caring for you would not be a great start to a labour].

I did a 2 mile walk, and had some period pains but not had a show yet. I think I may have lost my plug earlier on in the pregnancy. I did have a very slight show a few days ago but I'm not sure there is much there. We will see I guess.

MW strongly recommended having sex today, apparently most effective after a sweep. She even drew us a lovely diagram about where the sperm needs to get to to be most effective and why certain positions were best. I thought it was brilliant, she is a fab MW. Now all I have to do is seduce DP as he "can't take the pressure" selfish person!

The induction thing is so difficult. I want to refuse because I strongly believe that if I don't go into labour naturally then it won't happen but if I go to 40 +14 then I may be more willing to try. I don't envy you Grohlsgirl what are you thinking of doing? X

Ack, pour him a big glass of wine, you'll soon get him in the mood!

Don't worry about the show - haven't had one with either of mine and a 2.5 year old and a 6 month old will verify they definitely managed to come out in the end.

secondelf that's good to know re show, it's become a bit of a fixation here (god how bored am i?!)

Am going to stick it out til i'm officially overdue, as tempting as a "convenient delivery" may be ( consultants idea, not mine!) it is absolutely not what i want unless medically necessary. Just means an uncertain christmas, and potentially another week of those lovely well meaning texts from people! But if the homebirth plan eventually happens then it will be soooo worth it!

SecondElfLucky funny you should say that, I bought a bottle of wine whilst out for a walk . I am really pleased with the level of support from my local MW's they've been brilliant.

Grohlsgirl you hold out if that's what feels right. At the moment I'm planning on holding out as long as it's safe. Convenient delivery prior to xmas the Dr may say but that's assuming that your dates are spot on and that your body and baby are ready. I may switch my phone off soon if I were you though. I may start loosing friends if I don't switch mine off soon

Interesting that the MW has encouraged sex...NICE guidelines say its not to be recommended to get labour going. SecondElfLucky is right though, there's no cut-off point time wise at which support for a homebirth can be withdrawn - and I certainly wouldn't agree to induction for convenience of time, I think that's more convenient to the NHS than mother and baby!

Yeah it was definitely all about "getting this baby delivered before christmas"! She wasn't pushy though, and i can ring tomorrow to cancel. I said i'd only go tomorrow if i had another horrendous HG night of vomming, but so far no puke for almost a week so both myself and OH feel like its worth hanging on for homebirth.

As far as texts go, i've stopped replying! And OH has printed off a large sign which he has pinned to his desk saying NO NEWS!

These babies will come when they're ready, (please be soon, please!!)

Grohlsgirl If you do have a sick-free night, I hope that tomorrow you do have the courage to call in and cancel if that's what you still want.

I think sometimes these appointments are made with the thought that women will turn up because the appointment has been made and it's too much hassle for everyone else to not go ahead. Besides, you could go in tomorrow, not get started until 22 and then be in labour for 48 hours which takes you up to Christmas Eve, and if you were to have complications you'd still be in for Christmas anyway - hardly convenient!

flisspaps totally agree, and fortunately my community mw is of the same opinion so v supportive of me avoiding early induction.

I suppose i should actually count my blessings, some people have had really rubbish care provision and are struggling to get appropriate antenatal appointments, at least here i've got the luxury of choice, however confusing it has made things!

Flisspaps she more than recommended it, she pretty much showed us how it needs to be done, via diagram on notes . I think there's probably a lot MW's recommend that don't follow guidelines that they just find works. Don't get me wrong having sex this heavily pregnant is not fantastic but at the same time it's nice to spend some time with DP as a couple without thinking too much about birth and baby ect, so didn't do any harm.

Been up since 4am with period cramping, so maybe sweep, walk and sex has had an effect....

Grohlsgirl I hope you had a good nights sleep with no vomming, best of luck for today whether you cancel or go in. X

Ooh that sounds encouraging xmas, hope things are starting for you!

Had a crap night with sickness, and to top it off i've woken up with really bad toothache . Had a good cry on OH's shoulder when he got in from work at 1am, agreed not to make a decision when feeling tired and poorly so still got to decide what i'm doing. Part of me wants to be strong and stick it out, the other part of me thinks how much more can i take after a really rubbish pregnancy? My mental and physical energy are running pretty low now.

Sorry, that was all a bit me me me, gonna go and get some paracetamol to see if i can get rid of the toothache...

Grohlsgirl sorry you had a shitty night and don't be silly about mememe posts I think all of mine are . I hope the paracetamol helps and you get some sleep before making a decision. There's no right or wrong at this stage, if you really don't want an induction then fingers crossed for you that you feel able to hold out. If it's getting too much don't feel bad about going for the induction, the most important thing is that your baby arrives with both you and baby healthy and safe. Without a crystal ball it's gotta be a hard decision, best of luck ((((hugs to you))))

Oooo I've just sent DP off to work but have had a show the last two times I went to the loo and cramping still happening so fingers crossed things are starting. I couldn't tell DP and keep him off work yet, this could still be days if it does continue.

Well i've decided to stick it out and have cancelled appointment. Am hoping that karma rewards me by bringing on natural labour today sometime with the homebirth i've been hoping for...

Keep active xmas sounds like this could be the start for you, wishing you lots of positive labour vibes

Good luck. I'm pleased that you were feeling strong enough to hold out for what you wanted for a bit longer. Thinking contracty thoughts for you!

well still had achy pains, period pains all day, not turned into anything, had some more of a show so if anything is happening it's happening slowly.

Grohlsgirl hope you've had a restful day and are feeling better, good for you for cancelling, really hoping things kick off for you

Thanks everyone, i'm glad i didn't go for it in the end. Still no labour symptoma here although it does feel like baby has moved position, getting kicks in different places and pressure has increased.

Spent most of today going to various shops to try and get a TENS machine. A bit late i know but i needed a mission to keep me distracted! Went to 3 different Boots and several other pharmacy type places like lloyds, could not get one anywhere! lots of TENS machines available but none suitable for pregnancy! Maybe i was really naive but i thought they would be pretty easy to come by. Oh well, looks like i'll be relying on gas n air and the waterpool.

Also amused ourselves by thinking up christmas themed names should she decide to show up in the next few days, my current favourite is "Our Nativity" (to be said in the broadest northern accent you can muster!)...