being pressured to go for early induction due to age - anyone else?

[curlyLJ]

I am high risk due to 'advance maternal age' in this pregnancy - I'm 40.
Saw my consultant a couple of months ago when she explained the risks / their policy to me re age. I told her about my fears of induction/intervention (after last time) and she said that as long as I was aware of the risks, it was my choice and that I could have daily monitoring from 39-41w instead if I prefer.

Have thought about this a lot and unless there is a real reason ie something showing as being wrong with me or the baby, I don't want to be induced unnecessarily. My midwife thinks it's over the top too and she quite rightly said that there are risks with all pregnancies/births.

I am exactly 37w today and have just been to see my consultant - only she wasn't there and I saw her registrar and he just wouldn't listen to anything I had to say. He was insistent on trying to book me in for an induction at 39w and gave me such a look when I said thanks, but no thanks.

I really want to deliver in the birthing unit, in the pool if possible, but he said I can't if I'm induced...

In the end we agreed that I would see the cons again at 39w instead, maybe having a sweep if favourable, and then go from there (am getting DH to come with me for that one so he can help me stand up to them as I tend to back down around medical professionals which is what happened last time).

Am really hoping I go spontaneously in the meantime though as baby is already engaged and I have had a show.

Has anyone else had this? It just seems daft when if I had gotten pg 6 months earlier, I wouldn't even be considered high risk!

curly I wasn't pressured into an early induction at all, but I had read the RCOG paper about the increased risk of full-term still birth in women aged 40 and above and due to placental issues with my first child and some uterine blood flow hiccups early on, I discussed it with my consultant and decided to book for an induction in week 40 (it went well, in fact was a great birth story and I have a lovely 10 month old now (I was 41 when I had him).

But remember it is entirely your decision NOT your consultants, stand firm if you want to wait for natural labour, my consultant didn't pressurise me at all, in fact I raised it with him, so it was very much my decision not his. Consultants can only give you options and describe what they think is the best option, they cannot compel you to be induced, you will always get to decide, please do take your DH with you and stand firm against the bullying.

You might want to read the RCOG paper as that way you can give him the 'yeah yeah, I know where you're coming from but I still want to have a natural labour' :-) Good luck and don't let him bully you!

Oh, the paper is at: www.rcog.org.uk/files/rcog-corp/1.2.13%20SIP34%20IOL.pdf with a summary at: www.rcog.org.uk/news/rcog-release-induction-labour-older-mothers-may-reduce-risk-stillbirth-say-experts

I was the same as badidea and requested induction at term as I'd read the RCOG paper through work. I just knew that I'd stress about the stillbirth rate if I went overdue.

As it happened, I went into spontaneous labour at 39+5 and had a great birth.

My consultant was happy to go along with elective induction,but equally would have been happy for me to go to 40+10. You're not considered higher risk due to maternal age in my area until age 41.

Thanks both. That's just it, it depends on what area you are in.

Strangely, since my booking in appt, the midwife said they no longer have to put women at high risk if the only factor is age This was me - I answered 'no' to all those other questions which is why it seems a bit over the top.

The first cons I saw was so nice about it and said it was my decision and that I could go in for scans/monitoring on the CTG instead. I told her I had read the paper and was well aware of the risks.

I am happy to be induced if I get to say 40+5 or 6, so I don't go past 41 weeks, but at least that gives my body a fighting chance to go naturally.

I am hopeful things are moving along and that I might go early anyway as I have had loads more plug loss and lots of niggly pains low down this evening.

Fingers crossed for you. I didn't even have a niggle before labour started. I went to bed assuming that I would be going in for the induction the following evening and ds2 was born about 5 hours later

Ditto fingers crossed that you go into labour well before you need to think about induction.

Different areas might have different policies, but the patient still gets the final say - you just might have to be bolshy about it.

When I was taken to the labour suite for my induction, the outgoing consultant (nightshift) had the chat with me about what was going to happen and what I wanted. I told her my list of things I want and didn't want, she said it all sounds great and went to update the incoming consultant.

When she came back she said the the day consultant didn't want me to wait for 2 hours after my waters being broken before putting me on the drip (I'd asked for this). I felt crestfallen, but then she said, "but it doesn't matter what he thinks, he's just a doctor, it's your decision" and I felt so empowered :-D

Think of that whenever you feel you're being bullied - they're just doctors - you're in charge :-)

Sounds like baby might have other ideas & is getting ready to come. I had a show with 2 of mine & went into labour the next day. Good luck & keep us posted xx

Similar here - only risk was age, but that dropped me into "high risk" category. I had a pretty much textbook boring pregnancy, all tests, scans, etc fine all the way through.

Consultant was initially keen (earlier in pregnancy) to persuade me to go for induction on my due date, but what we agreed in the end was to try a sweep first, see if that kicked things off over the weekend, and to come in for daily monitoring & play it by ear. I wasn't keen on going too far beyond due date but also didn't want to go straight for induction so a sweep & waiting a couple of days suited me fine. Worked too, went into labour in a few hours.

Good luck!

Thanks for that badidea - that's exactly why I am determined this time not to let them make me do things that I don't want! I had exactly the same thing with them wanting me to go on the drip after 2 hours of waters being broken last time, only I gave in when i should have stood my ground. It meant I was then bed-bound due to constant monitoring which then led to me having an epidural (I'd vowed not to have one and regret it to this day), episiotomy, ventouse delivery and a blood transfusion

Kaza that sounds promising then - am also having quite a few BH tonight. As long as baby waits until DH is home tomorrow evening (he's working away) I will be happy for it all to kick off. I am ready to get my body back now!

slightly hopefully if comes to it, a sweep might bring things on for me too.

curly I know what you mean, my first birth was induced (had severe pre-eclampsia) and i was all over the place and bullied and they made me bedbound and ended up giving birth with my legs in stirrups (which was the last thing I wanted).

So, this time when I opted for induction I made it clear I was NOT going to be bedbound that whatever wires they were putting on had to allow me to stand and move around and that's what happened. They also didn't put on a ctg until 5 hours of labour had passed and just used intermittent monitoring this time (at my request). My birth this time was just fantastic, didn't have any drugs and both me and my DH really enjoyed it (odd I know). And I think the main reason was because I actually felt in control, that things were happening the way I wanted them too rather than being rushed along by others telling me they knew best.

Definitely stand your ground and remember how crap you felt the last time when it was all spinning away from you, that should enable you to stand up to them and tell them how you want it to be.

Really hoping it all goes well for you!

That makes me feel better badidea - I just can't stand the thought of being bed bound again - I am sure it made it more painful - and yes the stirrups, oh God the stirrups, it was just awful. It should have been one of the best moments of my life, but I always end up welling up if I think about it or talk about it too much.

I didn't realise there were options for being mobile and not being constantly monitored with induction - will definitely push for that if I do end up being induced.

The midwife said that if they are just going to start me on the pessary, that there should be no reason why this can't be done in the birthing unit, and only transfer over if need be (on same site) but he was adamant that if I am induced, I will be 'high risk' and therefore on the labour ward.

DH is under strict instructions this time to intervene for me if I start caving in to anything I have said I don't want. He sat back last time and said he felt like a spare part - the medical professionals only ever speak to the woman don't they - and I just went along with it as I felt that they were right and I had to do as they said. So, this time he has a job to do and it will be written into my birth plan!

I think it's partly about you deciding what level of 'risk' you're happy with. I declined the automatically-booked induction appointment at 40+12. Got a fair bit of raised eyebrows from the hospital midwife at my post-dates scan. But I was going for a home birth and really didn't want to give birth in the hospital and definitely didn't want to be induced. I did a lot of research on going 'overdue', etc, and decided for myself when I'd be willing to be induced and opted for monitoring from 42 weeks onwards and that I'd go in for induction by 40+17. Of course, if anything had indicated an issue with baby or placenta prior to that I would have consented to induction earlier.

As it was, I went into labour naturally at 40+13 (about three hours after the time of that declined induction appointment) and baby was born at home, safe and sound.

Fingers crossed that you get the birth you're hoping for.

Jeez! It just goes to show how different areas work. I had DC2 with help from the assisted conception clinic. I was constantly scanned until 23weeks and then released from their care to the midwife at the MLU in my town and never saw a consultant again. They didn't consider me high risk at all and I was 41 when I had him.

I was 43 when I had DC3 (unexpectedly as I was told I wouldn't be able to have children naturally) and I didn't see one consultant and just saw the midwife at the MLU. Think I saw her about 5 times and was not considered high risk at all.

All three of my children were natural births with no assistance at all.

I'm going through the same thing.
I'm 37 weeks with first child at 40yrs and the consultant swooped in and asserted an induction at 39 weeks. I asked her for the supporting data and she went all muttery and backed off pretty fast. Like others here, I did a web search and found that the guidelines vary massively by hospital / trust.
I've offered to go in and be regularly monitored / scanned post 40 weeks but have siad no to early induction. I am really keen for a natural delivery /water option and just don't want all the brouhaha that (might) come with an induction. That said, if monitoring does highlight a problem then obvs, I'll switch to Plan B and do whatever needs to be done to get him here safely.
So I'm holding out at the moment, with the support of NCT and midwives. but I will deffo read the report mentioned earlier in the thread..shame the doctors couldn't reference it themselves..
Good luck

Hi Noodle - it's so annoying isn't it, that they assume we'll just blindly go along with whatever they say or what the policy is?!
That's exactly my point, that unless a problem is indicated via monitoring, then there's no solid reason to consider early induction...but of course I wouldn't hesitate if anything showed up on a scan/CTG.

I am going to do exactly as you have said, but I am expecting another stand off with the consultant next week at my 39w appointment. Doing all I can to get this baby out before then!!

It does seem ridiculous as 40 is not exactly old. Apparently the data on 'older mothers' comes from the 1920's and although I don't have the evidence to hand I admit to substantiate that claim. Do look up the NICE guidelines. I managed to delay induction by a few days when I was 40 and I'm so glad as I was well on my way and therefore gave birth in 11 hours with only 1 intervention. Now I'm 42 I'm sure I'll be under the same pressure. Good luck!