Handling pressure to be induced on due date

[Liveinthepresent]

Hospital policy is to induce on due date as I am 40+.

I am very keen to avoid the pressure of induction looming over me before I am even overdue as this marred the end of my last pregnancy too ( due to waters breaking and no contractions).

Have a meeting next week to discuss the plans - and am keen to arm myself with enough facts to know what my options are and how long it is reasonable to stall this intervention for.

I know I can push for monitoring instead - but last time I was put under huge pressure to stay in and be induced - and I just want to agree as much as possible next week rather than having constant negotiations.

I do understand there is a reason for the policy but would be especially interested if anyone has any access to actual stats relating to an increased risk of going overdue at my age. Is this policy standard at all hospitals?

I'm not advocating making any decisions that genuinely put my baby at risk - I just want to unerstan it beyond my midwife telling me they many give me a few days but not much longer...

Thanks in advance if anyone has any information or experience of this.

[Shellywelly1973]

Starlight - your brilliant! Im going to use your very calm & collected way of dealing with hcp's!

Just wondering how you got on this morning?

[Snowsquonk]

I love the way hospitals have "policies" on things like induction!

What we need to remember is that a policy is something which can be enforced - so the policy actually relates to the hospital staff and not the patients - because they cannot do anything without our consent.

So a policy for induction of labour if you are over 40 means that the staff have to suggest or recommend this. But you, as the patient, can take it or leave it. Because they cannot MAKE you do anything - what are they going to do, come round and frog march you to hospital?

It's actually a guideline for patients and guidelines are just that !

[Liveinthepresent]

Thanks starlight and snowsquonk more ammunition here!
shelley I am confused and confusing - my appt is next weds - not Thursday - so am going to do some notes / prep and rehearse my lines with DH over the weekend!
Found some interesting info about risks of induction in Ina Mays Guide to Childbirth which I may also use.

[EldritchCleavage]

That's key-you are having to balance competing risks here, not pick a no-risk avenue over a risky one (which was how it was presented to me). I had a very ratty consultation with one patronising doctor that got me very worked up at the time. In retrospect I should not have engaged as much, just used Starlight's approach.

And it was verrry interesting how the pressure from the ante-natal clinic folk (unanimous, sustained) was met with quiet derision from everyone on the labour word-midwives, registrar, consultant. Bear that in mind-at least at Queen Charlotte's, there didn't seem to be anything like a consensus about this among the HCP.

[Karoleann]

This is a good and recently published article, in a peer -reviewed journal. I couple of the articles mentioned are just one person's opinion.

//www.biomedcentral.com/1474-2393/13/12

Good luck hope all goes well. Incidenally I was induced with my second and third pregnancy at 40 weeks as I had a placental problem with my first child. It was all very straight forward with no intervention)

[Karoleann]

Sorry one digit out

//www.biomedcentral.com/1471-2393/13/12

[Irishfairy]

Contact www.birthrights.org.uk/
And www.aims.org.uk/
Both are really excellent organisations that will help you in whatever way they can and will have the statistics and other info you were asking about. Good luck!

[Irishfairy]

Sorry on phone and don't know how to do the links so you can click on them!

[Liveinthepresent]

Thanks for all the advice and links to data everyone.
Had my appt this morning - was a totally different experience to what I had prepared so carefully for!
Met senior registrar who was lovely - she started off by telling me it was my choice - and did I know why it was recommended - even referring me to the relevant study.
Made it clear there is no medical consensus .
Then asked me how I wanted to play it.
So outcome agreed is if no baby at 40+4 I am booked for a scan ( to check placental blood flow) then a meeting with the consultant to agree what's next - sweeps offered if I want them - no pressure re .induction.
I am so relieved and frankly so encouraged to meet such a refreshing health professional who treated my like a grown up!

So sounds like I am all on track to head to the MLU when it all starts - excited now!
Good luck tomorrow purple - please report back.
I printed off the birthrights PDF from Irishfairy in case I needed to point out my rights - you might find it useful too.

[glorious]

Fantastic live, if only everyone had that kind of experience

[Purplemonster]

Really pleased for you Live. I'll let you know how I get on, fingers crossed its as positive an experience as yours!

[Purplemonster]

Well my consultant wasn't willing to be flexible at all unfortunately, I know my situation is slightly different as it's due to a medical condition rather than age but she basically said no to everything I suggested. So I've ended up asking to be referred to another hospital which is further away from where I live but where I should hopefully be able to have some of my requests met. There's still absolutely no shifting them on induction though so I'm afraid that seems inevitable but hopefully I might be able to get at least the water birth I wanted. Just got to wait to be contacted by the new hospital to arrange to go and see them and enter into more arguements negotiations with a new consultant there. They better get their skates on though, I'm nearly 38 weeks and some care trusts have a policy of inducing at 38 weeks for the condition I've got!

[StarlightMcKenzie]

'There's still absolutely no shifting them on induction'

What they gonna do, arrest you and pin you to the wall whilst they put a drip in?

If you are convinced of their arguments then fair enough, but it is still YOUR choice, not theirs.

[StarlightMcKenzie]

Did you ask the consultant for their concerns on each of your points?

Could you request them in writing?

[Liveinthepresent]

Purple really sorry to hear that. Have you got clear information on why they are recommending it for your condition at least?
As Starlight says you can still decline - as long as you have all the information to make an informed decision.

Hope the new hospital are accommodating - and quick - I found the worst thing is dealing with all this stress in the last few weeks when we should be relaxing!

[Purplemonster]

Thanks Live - I'm kind of ok with it all now that I can hopefully at least have the water birth I wanted I just couldn't deal with the total inflexibility!

Feel like I can deal with being induced if I can have the pool - it was the idea of being strapped up to monitors and stuck in a bed that was freaking me out the most. The monitors in the water doesn't seem so intrusive and restrictive somehow. Waiting to hear from new hospital and go and have a look around but feeling quite positive about it all.

Hope you're doing ok, not long to go now!

[Liveinthepresent]

Glad you are feeling ok about the situation -and that the waterbirth is achievable.
I am feeling so much more relaxed about the birth now - and instead seem to have reverted to fretting about coping with two and newborn sleep deprivation !
Not happy unless I am worrying about something it seems.

[sleepyhead]

There's no official guidance on induction at term aged 40+ as you probably know. The Royal College of Obs & Gyn are looking into it at the moment and I think there's a trial underway.

The summary of the current evidence is here.

I was the opposite to you as I requested induction at term (I'm 40) because I'd read the evidence as part of my work (non-clinical) and although the risks are probably tiny I knew I'd fret about it. I was on a midwife led, low risk pathway though and they'd have been happy to go to term +10 before talking about induction.

Anyway, I went into labour 2 days before my due date, 4 hours start to finish and it was great! I hope you get the birth you want - I found birth and the aftermath at 40 much easier than at 34!

[Purplemonster]

How are you getting on Live? I saw my new consultant at the new hospital today and it was a MUCH more positive experience. They were far more ready to listen to what I wanted and were keen to do everything they can to encourage things along naturally (loads of sweeps) rather than blindly inducing because its 'policy' when my body isn't ready and risk induction failing so all in all feel much happier with my situation now.

Hope you're getting on ok, any signs of baby getting a move on?

[Liveinthepresent]

Purple that's such good news - hope you can relax and enjoy the end of your pregnancy now.
I have no signs but am trying to get into relax and mentally prepare mode - just not thinking about what if he/ she doesn't arrive punctually - it's easier to do that now I don't have a deadline date looming.

Good luck - do report back!

[Purplemonster]

Sweep number 2 today and things had improved since last time (which was only tue), next sweep Monday so fingers crossed things get going next week! Any movement Live or is your baby firmly staying put?

[Liveinthepresent]

purple sounds promising!

I gave birth to a baby boy last night! Unplanned home birth - a bit scary when I realised how quick it was progressing but am feeling very serene now that he is here safe and sound - with no medical stresses.

Hope you have a similarly positive outcome ( without the 999 call!)

[Purplemonster]

Wow! CONGRATULATIONS! hope it wasn't too traumatic, sounds a bit stressful. Fabulous news though, you've made my day

[Liveinthepresent]

Thanks purple it wasn't traumatic - just a bit of a shock - am now in newborn snuggly heaven.

The irony that I didn't even make it to my due date after all that is very pleasing!

Good luck and please let me know when you have more news.

[Purplemonster]

Ha yes, all that worrying about induction unnecessarily, what a fabulous bit of luck!

Aww enjoy your newborn snuggles, I'm not due until 2nd July so you might have to wait a week and a bit for my news but hopefully not, I can't wait to have a newborn to cuddle myself! Look after yourself x