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Childbirth

Share experiences and get support around labour, birth and recovery.

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Original poster

Expectant management 'not offered'?

14 replies

Elasticsong · 31/12/2012 16:56

Hello all
I'm 40 + 5 now, 2nd pregnancy and have opted for a homebirth following a dreadful time in hospital last time round.

It has been chaotic with the community MWs (though most have been lovely).
The MW who has seen me all along has just retired and I met my new one just yesterday. She offered me a VE and a sweep which I accepted. I was gutted because she was extremely negative about absolutely everything and, to top it all, she said my cervix was showing no signs whatsoever of being ready.

So, the whole induction stress has begun. Last time, I went 2 weeks over and the baby was born without induction (a close shave). When I asked the MW about expectant management, she said that the hospital 'doesn't offer that' and that I 'would be going against medical advice' and would 'have to have an appointment with a senior midwife should I choose to go beyond 14 days'.

Can this be that a hospital 'doesn't offer' expectant management? Should I have expected the pressure to come from the community MW?

Any advice gratefully received...

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StarOfLightMcKings3 · 31/12/2012 16:59

Ah don't worry. See the senior midwife. Tell them you do not wish to discuss induction or alternatives until day 14 and you are happy to arrange an appointment with her for that day to discuss next steps and to have a scan if she wishes. Then go home and have a bath.

Original poster

Elasticsong · 31/12/2012 17:08

Ha! Thank you for that advice. Made me laugh. Just could do without the hassle and stress of such all round negativity at this stage.

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5madthings · 31/12/2012 17:11

They cant not offer. Yes you csn have an app with a consultant and they may well try and persuade you to be induced but if you refuse, as is yor right they have to offer expectant management.

StarOfLightMcKings3 · 31/12/2012 17:18

For sure. But you can also refuse to be put in a position where you are having surges of adrenaline sat outside a consultants office. You do not need to convince them. You do not need their agreement, nor permission.

The mw might prefer that you do as she needs it to be clear that she was following protocol and that she won't be blamed for your not going along with it. However, this is easily dealt with in a note/letter. 'Dear MW, this is what I am doing until further notice.'

It is reasonable and polite to reassure that you're not just bloody-minded and have researched your stance, but it is your right to have no reason at all, and that is the position you can start from.

blondietinsellyminx · 31/12/2012 17:32

You say you had a terrible time in hospital with your first - have the MW staff indicated in any way that the reason they're not keen on expectant management is because of previous complications?

Is it worth going to see the senior midwife for a debrief about your first birth (if you haven't already had one)? Might help both sides - for them to understand your previous hospital experience wasn't a good one and that's why you want to avoid induction/intervention and for you to hear any specific concerns about your/your baby's health this time around (and if these amount to spurious "policy" reasons then you can go straight home for that bath! )

I can well understand that you want to avoid induction and the usual cascade of interventions - i assume you're well into the "nothing but curry and pineapple to eat washed down with raspberry leaf tea" stage by now?! I really sympathise, my DD was born at 40+6 and I remember that fed up overdue feeling.

Fingers crossed for you that baby decides New Years Eve would be the right time to meet mummy! Guaranteed a good party each year

Original poster

Elasticsong · 31/12/2012 17:37

Thank you both for your replies - very helpful. I have the midwife coming for another visit tomorrow and, along with my husband, have agreed that we're going to take the 'until I'm 14 days over, we don't want to hear another word about it, thank you very much'.

I am not silly or reckless and if there were any reason for concern other than dates alone, then yes, I would reassess but for now...

Like the letter idea too.

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nickelbabylyinginamanger · 31/12/2012 17:44

don't listen to "not offered".

they can't force you to be induced and they can't force you to do anything you don't want.

nice guidelines say you can opt for expectant management after 40+14 at least twice weekly.

the other option is telling them you're refusing induction and that if they won't do expectant management then you will call them for a midwife when you go into labour.
you will most likely have to nagged by the supervisor of midwives and probably a registrar.

they won't want to risk you homebirthing on your own

Original poster

Elasticsong · 31/12/2012 17:45

Thanks also to you Blondie and yes, curry and pineapple are my friends!

Last time round was terrible not due to induction or complications in labour, but due to a series of mismanagements both during and post birth. Errors were made left, right and centre and care was in extremely short supply. A debrief was never offered and it's only recently I have even found out about their existence. The mw I saw yesterday was um, uncomfortable when I started talking about my last experience - annoyingly, though 5 years have passed, I welled up and my voice became choked, dammit! It's a different hospital this time round too.

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Original poster

Elasticsong · 31/12/2012 17:51

Blimey, you have to be so forthright, don't you? I did say there was going to be no more Mrs Nice Guy this time round and it looks as if that's going to have to be put into practice.

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blondietinsellyminx · 31/12/2012 17:58

Ah - so naturally you're feeling scared to go into hospital for care, when the "care" you experienced in the first hospital was not what it should have been. I'm sorry you went though such a horrid experience.

You could play them at their own game - agree to meet with senior midwife/registrar to discuss next steps but only on the proviso that such a meeting would include a review of the notes from your first birth. Take your DH along too so he hears it all as well - he may have questions too! He can support you if you feel teary again and registrars can be less pushy when the partner is with the woman, in my experience

nickelbabylyinginamanger · 31/12/2012 18:31

yeah you really do.

you tell them what you have decided and you tell them what you will agree or not agree to.

your body your decision.

nickelbabylyinginamanger · 31/12/2012 18:32

i had a homebirth too and was 40+16 when dd arrived.

Original poster

Elasticsong · 31/12/2012 19:37

My dh will definitely be coming along with me and, oh yes, does he have questions.

40 + 16 sounds a lot over but, as I kept saying to myself last time, term is 37 - 42 weeks. Well done for sticking to your guns, nickel. I plan to do the same.

Thanks again all for the support. Sometimes it just helps having someone else's input.

Bring it on!

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MrsHBaby3 · 31/12/2012 19:55

sounds like shes just trying a power game to convince you to do what she wants, a bit like 'go see the headmaster'! you want a good midwife who will listen to you. good luck, youll be fine :)

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