Refusing an induction - Have I done the right thing?

[bebespain]

I'm 40 wks today and will be having baby in Spain. The Spanish doctors have put my dates 2 weeks on because baby is 'big', they want to induce me tomorrow.
I really feel I should be left a bit longer so refused to be induced when I went to hospital today. Now I'm really worried that I've done the wrong thing. I don't want to endanger baby but feel I should give him chance to come by himself - any opinions?????

It takes courage to refuse the doctors in your situation. They can be very persuasive.

You can ask for daily monitoring if you are worried, that's what I did, I'm in Belgium where they have a high rate of induction. They wanted to induce me on the day I went into labour.

Stand your ground. When the uk docs wanted to induce me at due date plus 7, wed phoned a friend who also happened to be a Obs and Gyn consultant; she said the percentage risks do rise BUT they are still VERY VERY low up until 42 weeks. I was railroaded into one eventually at due date plus 10 and I had a difficult labour and my contractions never got fully established; they had trouble putting in the pessary as my cervix was still tilted back....obviously my body wasn't at all ready and I am sure this is why the contractions were never strong or regular.

So are they wanting to induce you on the basis that they think you are 42 weeks rather than 40 weeks? Determining a baby's gestation by its size is only accurate if it is done by ultrasound before 12 weeks. If it is done by ultrasound later than this or just because the baby seems to be larger than average, then it is quite likely to be wrong becaue by definition, babies aren't always average!

How was your due date worked out originally? Did you have an ultrasound before 12 weeks? Do you know when you ovulated? I think it might help to figure out whether you really are 40 weeks now or further on to make an informed choice as to whether to accept induction.

If you are 40 weeks, then really, with no other indications that there are problems, it is a bit mad IMHO to recommend induction. If your body is some way off going into labour then it is likely to you will need a fair bit of help to go into labour and the chances that this will fail and end up in c-section are relatively high.

In terms of risk to the baby the rates are roughly as follows - at 37 weeks 1 in 3000 (ie 0.03%) babies will be stillborn. At 42 weeks the rate is 3 in 3000 (ie 0.1%) and at 43 weeks (0.2%)

Hope this helps

The questions is: how are you and baby doing? If you are both doing well, than there isn't really a reason to induce you.

I don't know if you've done the right thing, but you've done exactly what I would have done. The consultant here would have put my dates a whole month on (!) because DS was a big baby if I hadn't been absolutely sure of my dates and stood up for myself. In the end he arrived bang on time by my calculations .

When was your first DC born (am I remembering right that you have another one?)?

If you are confident that you are really 40 weeks and the only reason they have moved your dates is the size of your baby then I would not be thinking about induction for a while yet.

Hi
As I said in your other thread, I chose not to be induced and went into labour spontaneously at 42+6. As soon as I made the decision I felt exactly like you - was I doing the right thing for my baby? I decided that I was because although the consultants are quick to give you the risks of not being induced (the ones that daisymoo quoted are what my consultant told me), they are not so quick to quote the risks associated with induction. And there are risks there too.

Having said all that, when my baby arrived he was 100% healthy with an Apgar score of 10 after 1 minute. But he was a bit big for my size 6, 5'2" frame at 8lb 12oz and I took a real battering. I am still feeling the effects 13 weeks later.

I wouldn't change a thing though, because I am convinced that if I had been induced I would have ended up with a c-section and we both would have been distressed.

Have faith in yourself and remember that you can change your mind at any time. I bet you go into labour naturally long before 42 weeks anyway, like the vast majority of women do.

Phew! Sorry for the long post. Best of luck..

Nine

Thanks ladies for all your replies they have been ever so helpful! (Special thanks to DaisyMoo for the statistics!)
I am certain of my dates, no doubts whatsoever and this gave me the confidence to refuse - I feel absolutely fine, B.P fine etc and baby is fine too. I just needed some reassurance that I'm doing the right thing if that's ever possible when it comes to having a baby.
It really hacks me off the way they are sooo obsessed by baby size here and use that as a valid reason to induce which I am convinced would only cause avoidable probs, emergency C-Sec etc. In addition I am treated as some know it all, over the top foreigner for not going along with their wishes...
Thank God for Mumsnet!

A obstetrician I know says he only induces large babies early if mum is diabetic/gestational diabetic. But if its just a large baby for no abnormal reason (and everything else is fine), then he will carry on with normal care.

Have they given you an idea of how "big" they think baby is? But remember sizeing estimates from a scan is fairly inaccurate. I was told my baby was an 8lb size at a 39week scan. A week later she was born weighing 6lbs7oz.

bebespain - how are you today?

mw i had last time had spent a lot of time in germany, she said they only class babies as big there if they are over 12lb! which makes my 9 - 10 lbers look a bit tiddly

Well done you for going with what you wanted. I agree with all that has been said in the posts below. As long as you and the baby are fine then there really is no need for induction... it can make it a much more difficult process.

At a 36 week scan I was told DD was on the 99th centile- massive. When she was born she was almost exactly on the 50th centile. They cannot accurately predict size, though they'd love you to believe that they can. It's something like 60% accuracy which is pretty poor considering the basis of many an induction and c-section is the big baby issue. If I were you I'd wait until at least 42 weeks, THEN consider induction.

Hi Belgo

Thanks for asking. I feel much better today, much calmer and really feel I've done the right thing - all thanks to all your kind replies!
Had a few twinges last night so hoping things will take their natural course - fingers and everything crossed...

not sure on this one. i had my first baby (a stillbirth) at 43 weeks and was subsequently induced with my other 4 babies. ds1 was a long and difficult birth, but other 3 were quick and simple despite all 3 of them bbeing born back to back, youngest was mega quick labour 1 hour 28 mins from start to finish. i think it all depends on whether your body is ready for the baby to come- my ds1 was not ready but other three apparently were. longest of the 3 was 4 hours 37 mins, so its not always a bad idea to be induced

I agree xmasmummy that so much depends on whether your body is ready or not. I have this feeling mine's just NOT ready but don't suppose I'll know that for sure 'til it happens
(induction) that is, or not as I sooo hope will be the case.
Clearly in your case it was the right thing to do and I'm glad it was positive experience.

Hi - have read this post because it came up as a hot topic on the Mumsnet email news round up. Don't come on here much normally. But this is really interesting. My friend in NZ had a natural labour and birth at 43 1/2 weeks - but had to hire an independent midwife as the state refused to treat her as she wouldn't go to hospital. Long and tiring labour but Mum and baby perfectly fine after a home birth.

On the subject of big babies - I am not convinced they know as much as they like you to think. They had me in for scans with my first as they said she was small and not growing. She was absolutely fine and was a full term 6lb 12oz. Had exactly same scenario with second under different care team - but had courage to refuse scans!

When I had my second I lied (sorry - was creative) about my last AF date so that I wouldn't be pressured into an induction. Just by a week or so, but it helped me relax as by then had heard so many induction horror stories I knew I didn't want one!

Bebespain - i was induced with my 1st dc - didnt really realise i could have refused and went along with it - it wasnt the best labour - epidural, forceps etc but she was born healthy at over 9lbs so i was just glad all was well. When it came to my 2nd dc i was in tears at the though of being induced but went late again and they put so much pressure on me to be induced that i agreed - and the birth couldnt have been easier and he was narly 11lbs. i dont think that it is always the inducing that affects the labour - there are complications with natural labours too!

Ps. i was induce with my 3rd dc too! think i'm missing something that makes me go into spont labour - it was a normal birth too!

I refused first induction at 41 weeks as didnt "feel" ready plus the midwife couldnt even reach my cervix, a week later however I felt reduced movements and asked to be induced on the consultants advice after a scan. Did end in emergency c-sec but both dd and I were fine as a result, I think you will know when it is the rght time, but don't let them bully you with statistics, if they are seriously concerned you should be induced they will give you the reasons.

Why are there meant to be complications with being induced..? esp stillbirths.?

Worries me slightly as Im 33 weeks and huge (only 4ft 11in) and Im now fed up. My mw saw me on tue and although this week I am "measuring" right she is concerned that I do appear to be big and that like dd this baby will be big (dd was 9lb 4).

I am due back in 3 weeks time when I will be 36 weeks and she will check me then and may send me for a scan to check baby's size. If baby is appearing big she says they will offer an induction at around 38 weeks.

I have heard bad things about inductions that do worry me a hell of a lot BUT then I feel that I couldn't go full term as I feel like my body is going to give up .

Sorry to hijack but can anyone offer any light..??????

if you are 40 wks there is claerly no harm being induced now. danger lies with going 'over'

i really don't want to be any kind of scaremonger while you're in this vulnerable state - so I will keep teh detaails brief - but a friend of mine refused induction and consequently had a VERY difficult birth and an emergency CS

sorry, spelling bad on this one.

Bugs my consultant told me that with an induction there is a 33% chance of an instrumental birth and a very high chance (I forget the figure now) of failed induction = c-section. There are risks with these procedures too, so I don't think it is all that simple. Your friend might just have easily have ended up with the emergency c-section if she had been induced.

you know when its time to go.

Well done for saying No! I was 40wks+11 days and I wish I had given it a little longer, I am sure it wouldve happened naturally with a few days extra.
never mind I didnt need forceps/venteuse, I pushed and was lucky...but MW said I did what 99% of primates could not have done(!)

best of luck with it, senora!

The due date I was given for my pregnancy was definitely wrong. I was always certain that my baby would arrive around 10 days later that predicted. At 41+2 I had a membrane sweep (yuk!) in the hopes I could avoid induction and an induction was planned for 41+5. I unwillingly went along with the plan and was admitted on the evening of 41+4 to discover my contractions had started.

However, the labour progressed very slowly and because technically I had been admitted for inducation, the obstericians were keen to get things moving. This resulted in my waters being broken (v painful) and a syntocin drip being set up. This ended up with me requiring an epidural which I hadn't wanted and ultimately an emergency c-section.

If I do it again, I would definitely refuse induction. I'm convinced I would have been able to have my dd with far less intervention if I'd been left at home, doing it all in my own time. I was confident that the due date was wrong, my baby and I were both healthy and with hindsight I feel that my body wasn't ready to give birth just then. Even now (5 months on) I feel guilty that I didn't stand up for myself and try harder to have the birth experience I wanted. Good luck to you, I wish I'd had the courage to stick to my guns.

Basically there is increased risk to your baby's health if you go too far post term increased and definite risk of still birth.
I do however I have a problem with inducing babies because they appear to be big on ultrasound scan because they are notoriously inaccurate.
yes consider it if you're going to be too far past dates. My friends who have chosen to be induced or told to be induced have had variable labours. One was quick and intense the others had stop start very tiring labours one ended with forceps she like had been told she had a big baby and was very tired and requested induction. If a baby's big wouldnt it be better to make an assessment of whether you can have a normal delivery or need a section.

Hi bebespain, I just wanted to say I went to 40+15 weeks before being induced and that was only because I was worried about complications after 42 weeks. I didn't much like induction and would have put it off further if I could, but the foetal monitoring was a bit iffy so I thought I should be induced when they suggested. He was born not breathing but I couldn't say whether this was related to being so far overdue and he is fine now!