Has anyone refused induction??

[Bangonthedoor]

So I'm 40+1 with #2 and yes although I know I've still got several days before they talk about arranging an induction, I kind of want to be a bit more prepared this time.

DD was born at 42+1 following induction. Those of you who have been induced know how crap it can be and long! It took 4 days from beginning of induction to DD being born.

Basically I'm just looking for facts/experiences/advice on refusing an induction? I feel because this will probably be my last baby I want to have the best chance possible to labour naturally and to know what it's like to spontaneously go into labour. Not only that, I can't be waiting around in the hospital for days waiting for baby when DD is in childcare!

Of course I know I've still got every chance it can happen naturally, I just remember this feeling all to well.....

Protocol is based on known risk that is learned from the experience of thousands of women. Procedures based on protocol are not randomly done. In the case of childbirth, a doctor makes an educated guess none of them are God and they can't predict the future with any exactitude but there is nothing wrong with this as an approach. They are going on their knowledge of thousands of other outcomes in very similar circumstances. I think it's a pity to see them as some sort of enemy or to hold their scientific approach in suspicion.

I've had 3 kids, overdue with all of them.
First time I did as I was told, had the horrible sweeps etc and went in as instructed at 40+10, had a pessary, went into labour straightaway had lovely straightforward birth, no monitor/drip/examinations just went with the flow.
DC2 was exactly the same process.
DC3 was a good few years later and I was more confident. This was the only pregnancy where they changed my dates at scan though as baby was big. My dates were exact, I knew my dates and my previous babies were 9lbs 7 and 10lbs 11- DH is a giant, so normal for us.
When they talked of induction I put them off. Went in at 40+10, gave a few pessaries a go but absolutely nothing happened. Was 40+12 by now, and discharged myself.
They wanted to break my waters, start a drip the works! When my body wasn't ready.
I went home. Spent a lovely lazy day waters popped that PM and baby born pretty soon after!
I was 100% confident in my decision. Baby was happy as was I.
Do what is right for you and stick to your guns.

it's a pity to see them as some sort of enemy or to hold their scientific approach in suspicion.

I agree utterly. The experience of those thousands of other women and babies is vital in pointing out the situations where there is risk so that a safer response can be made. The scientific approach looks for evidence and in this wealth of knowledge plenty can be found. There is also evidence in the individual situation and evidence should be gathered there too.

Thanks everyone, this is all really helpful. I'm having a sweep on Tuesday at 40+4 if nothing by then. But as we all know, if your cervix isn't ready then they're pretty pointless! However, at least I'll have a better idea of what my cervix is looking like.

I wouldnt refuse an induction on medical advice . Induction isnt that bad and even if it was it wouldnt be as bad as something happening to your baby . My 1st (12 yrs ago) was 3 days early I had been having stomach pain and extra fluid doppler didnt show anything anyway as it happens half the placenta had packed in and if I hadnt of given birth then it would have been a hurrendous outcome .
Needless to say I always air on the side of caution now .
My 2nd hind waters went and was induced as had GBS they started me off in the morning i had him in the evening .

Someone I know had a 39 week stillbirth.
She chose to be induced at 37 weeks her next fT pregnancy.
that was her erring on side of caution.

Baby badly got GBS. Preterm labour & breaking waters more than a few hours before birth are risk factors for GBS disease, we all know the EDD has a +/- 3+ day error margin so was she really 37 weeks? (Baby pulled thru fine, btw).

So her erring on side of caution may have led to a host of other problems.

Induction can be overwhelming, can easily fail, can lead to a cascade of undesirable interventions. I wish we didn't have such difficult decisions.

The majority of women who are induced would give birth naturally and without any problems with the baby. Our mania for induction is causing countless unnecessarily complicated births. Women are presented with the stillbirth risks in an isolated way, out of context, and with no mention of the risks of induction to counterbalance. I have a friend who almost died because an adverse reaction to pitocin, and another whose baby almost died from the same cause.

If I'd accepted induction at my trust, at a point that is within the normal gestation period, I would have ended up with a c-section. I have been told this by midwives and a consultant. And my second birth would have been very different as a result of that.

Protocols are a lowest common denominator based on minimising risk across a population: this is not made clear to women. What should be an informed choice becomes 'you have to do this because that's what happens to women in this hospital'. Protocols vary from hospital to hospital - why would this be if they're all based on the same compelling medical evidence? Why are these vital inductions deferred for up to a week because of lack of beds without any medical concerns at all? Why are women told they must be induced days before their hospital's protocol date to avoid a weekend? Why are women put under stress at a time when being relaxed and calm is actually more likely to allow them to go into natural labour? Why are inductions based around estimated due dates which are themselves based on crude measurements?

Yes, protocols are applied based on mass risk. That does individual women few favours.

Bang - just bear in mind that a cervix can change very fast. With my second my cervix was closed and posterior at a failed sweep. I had a baby 36 hours later

RE protocol being based on evidence/experience - how does that factor with the fact that in France pregnancies are counted as being 41 weeks long? Does all that brie keep them in their for longer, or is it just possible that sometimes protocol is based on precedence and cultural norms, which shouldn't be followed slavishly where individual monitoring and support can be used much more fruitfully...

*in there - indignant point undermined by poor spelling...

You have every right to refuse induction, its your body and your baby.
What IOL doesnt take into account is that every woman is different and every cycle is different so while 40 weeks is the average gestation that a baby will be born at - there is a large percentage of people who wont fall into that criteria.
Ive seen a baby born at 43+1 - covered in vernix weighing 7lb - not 3 weeks overdue methinks!
The MWs may ask you to pop in for a CTG every second day until you go into labour just to ensure that baby seems ok but dont ever let anyone pressure you into anything.
Have a look at NICE guidelines or AIMS for further info and Good Luck for when your bundle arrives. x

I said no to induction. Midwife seemed panic stricken even though I wasn't even overdue when she tried to book it in. I was sent to see the consultant to make my case and agreed with her that they would let me go into labour on my own but, if it had still not happened 18 days after my due date, I'd consent to induction. Baby arrived on day 16 after due date so I avoided it.

Due date today for me and no signs at all grrr. Feeling frustrated and worried about possible induction, although I know not to worry too
Much right now as got along way to go . Would just be my luck though.

Planning on refusing induction too unless medical problem with baby. For those who did refuse it and got them to agree to over 42 weeks, what reason did you give?

You don't have to give any reason. It's your choice, they can't force you. I would read up on the risks of post term stillbirth vs the risks of intervention though, both to inform yourself and reassure the medical professionals that you're making an informed choice.

I'm 40 this time around (will be 41), and had a consultant's appt. where he explained very clearly to me the greater risk of going post term in the over 40s (a stillbirth rate of 1 in 440 vs 1 in 1000 for all women), and has left the decision up to me, which I'm thankful for. He didn't mention any of the drawbacks of induction though . I probably will go for induction at 40 weeks though- I waited until 40+ 13 last time until I caved in and went for induction, so this time might give in gracefully....That's interesting that they want to induce you at 39 weeks sebsmummy- the consultant did say there might be new guidelines coming in to recommend that for the over 40s.

I wonder, if you've been induced, how many people got away with just the pessary, and how many had to go for the full works with the syntocinon drip, and then the epidural blah blah......I had to last time, but the pessary got my contractions going, just not strongly enough to satisfy the Powers That Be . It strikes me that if you just have the pessary, you could move around and have a pretty much normal birth?

I had two pessAries and then an epidural. I panicked with the pain and didn't cope well. Had gas and air and then epidural. Was monitored so ended up lying on the bed which although I wanted to get up from found I couldn't once contractions one on top of the other. Hence why want to avoid it this time.

My first Dc was late and I refused induction. For my next two pregnancies I lied about my last period date to give myself a bit more time

Doesn't help if they move you based on the scan...

I found this useful - but I didn't have to argue in the end as due date was around Xmas. The consultant was on holiday so it was left up to me what I did!

www.aims.org.uk/pubs3.htm#inducingLabour

The reason I gave was that I saw no need for it unless there was a need for it. So, had they said it was necessary for x,y,z reason then i absolutely would have done it. I went armed with stats and research, like stubborn says, on the likelihood of stillbirth once past due date. Doctor recommended i went for a trace - is that what it's called? - to make sure foetal heart rate was ok, which I did. It is a balance between being assertive so that you have the birth you want and being sensible.

I didn't say I was refusing. I said I was 'delaying' (i.e. not ruling it out entirely, just didn't want it now). My reason was that, as I mentioned in an earlier post, the scan had my dates around 6 days out.

He came out at +13 and covered in vernix!

By the way, I've just had a rootle around the AIMS website- aims.org.uk, thanks phineyj and others for mentioning it, because I'd never heard of it before . It has a completely different breakdown of the stillbirth stats. Bloody hell. This is something I've found with looking into the research regarding pretty much every issue I've had to do with fertility or pregnancy- the more you look into the figures, the less certain it seems that anybody knows anything for sure.....

Our local hospital will let you go to 14days over, the one in the next town only allows 7 days.

I was quite prepared to wait until 14 days over with monitoring if necessary.

Worked out happily thank goodness. DC1 was 13 days over and 7lb 10, DC2 was 11 days over and 7lb 8. Both spontaneous labours and my dates were exact. They would have been tiny if induced on due date.

OP I hope the sweep went well!

If you're still not in labour and want more induction delay / refusal stories:

I couldn't have a sweep as I was spotting and in pre-labour from 40+5.

My midwife wanted me to go in to the day assessment unit at 40+8 just to check on things (planned home birth) at which point they told me I "had to" book in for an induction at 40+12, in order to make sure the baby was born before 40+14.

I told them I was planning to go for expectant management (low risk pregnancy) unless there were indications that things weren't ok. Which freaked them out and the head of midwives had to be asked if this was ok (which I found amusing as I wasn't asking for permission). So we made a 40+12 appointment to see the consultant.

The upshot of all of that was DD was born at 40+11 completely covered in vernix and with a healthy placenta. She was just taking her time - her head was very squished on one side and my midwife thinks the 6 days of pre-labour were due to her having her head tilted to the side so she wasn't putting proper pressure on my cervix.

So I'm not sure induction would have helped, I was certainly contracting off and on pretty hard for those 6 days so I don't think it was lack of pressure!

After all that, when DH rang the hospital to cancel my appointment they didn't even have it booked in

I refused induction with DD1. She was my third child and at that point I had figured out that I just take a bit longer than the average 40weeks to produce a baby. She was born 17 days after her date.
DD2 was eleven days overdue and DD3 eight days.
After the first week I had regular checks at the ante natal assessment centre in the maternity hospital. Those were special scans to determine the placenta was still functioning properly.
There was a bit of arguing involved but much better for everyone than induction at ten days.

Thanks everyone for further input. 40+4 today and woke up this morning to a bloody show. Midwife still did a sweep anyway and said I'm 2cm dilated with a soft cervix although it's quite far back still. She was able to strip quite a bit away.

All afternoon I've had period pain and heaps of bloody mucus which she said is normal following a sweep.

She's booked me in for induction on 19th if nothing before then, she doesn't seem to think I'll get to that which is why she didn't entertain my concerns at this stage. She just said if it comes to it next week we can re access and talk about it. But I'm so hoping something happens in the next couple of days.