Hospital not letting me choose how I want to give birth

[Monkeypuzzle32]

Just that really.
I am in my 40's 1st baby via IVF.
From my very first midwife appointment they were saying to me "you'll be induced at 38 weeks" . As time has gone on and I've spoken to to other women about labour, I questioned why they wanted to induce me and why at 38 weeks-the only answer I've been given is "you're in your 40's and its an IVF pregnancy" , because they are classing me as high risk due to this (I've had a healthy pregnancy so far), they say I can only use the delivery suite rather than the birthing centre. I really want a water birth for many reasons, I also do not want to be induced full stop, nor do I want a sweep, it all sounds very invasive and hurried up-it is definitely hospital protocol to do this but I want to be given some choices!
Should anything go wrong, or either myself or the baby are ever at a real risk then obviously things will change, I get that but although I've challenged this, I am worried I will be pretty much forced into lying on a hospital bed with midwives pressuring me to have a sweep or induction.
I dont want it to be like this.

Just beware and read up on birth over the age of 40 - don’t put your baby at risk

In theory you can't be forced into anything you don't want but this is the NHS, they don't give two hoots about medical ethics. I would strongly advise you to take a very firm position of no induction (inductions are not great if you don't need them) and no sweep unless and until you say so. They won't listen to you unless they fear a law suit.

Don't get too fixated that they are just being cautious because of your age. I was 27 when my water birth request was declined due to high blood pressure, I was disappointed but now completely understand that my desired birth experience was overruled by a midwife who needed me on dry land for constant monitoring.

Actually that medically supervised birth was a far more enjoyable birth than the birth of my son who due to the speed arrived drug free and midwife free, I had the entirely intervention free freebirth experience that some women aspire to!!!

IVF, first child, over 40?
My view: ask for a planned c-section.

I had my first at 40, was induced at 40 weeks. In hospital for 5 days all tolled and ended up on the drip. I started off wanting hypnobirthung water birth, I ended up on the drip, catheterised and with a needle in my back. I did actually have a pool and got in it before the epidural. I hated it, it made me feel hot and claustrophobic, and this I think led to the pain spiralling out of control, gas and air made me feel totally out of control, morphine did nothing for the pain, then the lovely epidural lady came. within minutes was pain free and back in control. Got a few hours kip and then pushed DD out myself. I was even together enough to tell a forceps wielding consultant to fuck off.

You could read this as a nightmare birth, it really wasn't for me. I got a healthy baby, was home within hours of the birth with my nether regions fairly intact. For me the sense of being in control turned out to be what I needed most, and the epidural gave that to me. I did not know this before hand and I am really glad I was not too invested in a more 'natural' birth, otherwise what was one of the best days of my life would have been tinged with disappointment.

As long as you and baby are well, your birth experience only has the significance you give it. It is one day in a lifetime.

Dont let them induce you, it's horrifically painful. If i had to be induced again I'd insist on an epidural or they can sod off. Done it once never again.

In your opinion.

Inductions get this bad rep because honestly we're all different and we all have different birth experiences and pain thresholds.

I was induced for GD and it was - childbirth is not meant to be fun, is it? I followed the advice of my consultant and went for induction, I was on a hormone drip and delivered with gas and air. It was fucking painful but I delivered a healthy baby boy and that is all that matters.

Educate yourself on why they want to induce you early and make your own decision based on that. I would 110% have another induction if I was advised to.

I would be careful about an induction if you want as little intervention as possible. Ask questions about how long they will allow you to respond to the drug before classifying it as a ‘failed induction’ and rushing you to theatre.

I had IVF, induction (with a very supportive midwife and doula) and consultant (but like pp, I changed consultants late in the day).

A few thoughts. You say you want a water birth because it is 'natural'? It really isn't, it is a very modern practice indeed. There are no proven benefits to your baby for a water birth and certain specific risks.

On risk generally, the thing about pregnancy and birth is that the state of scientific knowledge is imperfect. We know that there are more poor outcomes when mothers are over 40. We know there are more poor outcomes with post-due date pregnancies. We know there may be more poor outcomes for placentas for IVF babies. But we also know that plenty of women and plenty of babies in these categories will be just fine. We cannot predict which women and which babies will definitely have problems. But because the consequences of you being the unlucky one are so awful, greater intervention is recommended if you are over 40 or whatever.

There is a whole culture of pressure around supposedly 'natural' practices for birth and it is often dismissive of medical advice. Yes, nobody can tell you that you specifically will have a good or bad outcome. They can tell you that mothers and babies with your profile and circumstances have a higher chance of XYZ and recommend that steps 123 be taken in order to manage that risk.

Human biology isn't perfect. I would strongly advise that you listen carefully to your medical team, and less to the 'birth culture' bloggers and writers.

Congratulations and best of luck.

The protocol for ivf babies for mums over 40 is to induce to reduce the likelihood of stillbirth due to problems with the placenta. This is based on evidence. A living baby is surely better than the chance of a birth the way you've pictured? They can't force you to follow the protocol and they should help you understand the risks involed and see if there is a compromise, eg wait a little longer and have more monitoring.

Just follow their advice.

It’s to help ensure you give birth to a live, healthy baby. Not to piss you off or inconvenience you.

Sorry. I meant our birth centre would let you in without a question.
If I were you, I would go onto the rcog website and read the scientific papers on pregnancy over 40 and the one about pregnancy after ivf. It has all the stats on and will help you make a decision, with a full knowledge of the risks.
38 weeks is very early to induce under those circumstances (assuming you have no other risk factors such as antibodies, pre eclampsia, lupus, history of stillbirth etc etc).
You need to talk to the head of midwifery.

Links here:
www.rcog.org.uk/globalassets/documents/guidelines/scientific-impact-papers/sip_34.pdf

www.rcog.org.uk/en/guidelines-research-services/guidelines/sip8/

Nan I have none of those issues, I've been tested twice for GD which was negative, I'm not overweight, don't smoke, no stillbirths, baby is a normal size etc
I think what I want most of all is a sense of control-not being told I will do something just because it fits in with hospital protocol-they've openly said they wont let me use the birth centre to keep their good outcomes i.e only allowing 'low risk' births only.

I had no preconceptions before getting pregnant but I do feel strongly that I want them to discuss it with me and that I do NOT want to be lying down on a brightly lit hospital bed yet no one is really taking it seriously at the hospital. I guess it really doesn't help that they barely tell you anything anyway-38 weeks is very early IMO, I am happy to access along the way as I know there are some risks to going over my EDD.
If you are in a delivery suite, where is there to move to other than the bed?
I suppose I could try another hospital but is it too late as I'm 34 weeks now?
I have got a session booked in with a private birth adviser who will go over everything with me, but as I say I'm worried about getting there and being told I have no access to anything other than a brightly lit hospital bed!

I am going to speak to the midwife consultant at the hospital.

Ask for a tour of the birthing suites. That will give you an idea of what is available in your hospital. Last time I was in the consultant led unit. My room had a birthing pool, various bits of equipment that you could sit on, bounce on, hang off, wireless monitoring etc. BUT whether midwife or consultant led there is no guarantee what room or facilities you will get, it is the luck of the draw.

You can move around if you are induced, even on the drip. It is a bit of a faff but very doable. Only if you elect to have an epidural would you be bed bound.

Don't take your eyes off the prize, you as in tact as possible taking home a healthy baby as fast as you are ready after the birth. The birth is just the wrapping imo.

@Monkeypuzzle32 if it helps I’m high risk for other reasons & am not allowed on the MLU & have argued it and this is my 2nd birth.

My first was on the DS & there’s plenty of places to be apart from the bed. Have you had a tour of your DS?

no, no tour-I have asked about it though and want to do that, lack of information is part of my fears I recognise that, but my goodness, Its like pulling teeth getting any information!
I am reading the articles now-I've read them but I interpret them as there is a higher risk but 38 weeks is too early still and comes with its own issues.

I am due my 35 week scan and appointments next week so I'll take a list of questions to ask the midwife consultant and ask for a tour at some point-the consultants/registrars I've seen so far seem to know less than the midwives!

Be wary of midwifes who will ‘accidentally’ break your waters while doing internal exams.

Make sure that’s discussed in advance. Get it in writing. Eyeball your MW on delivery day and make it quite clear that you’ve heard of such things happening and you’re quite sure that she would never do such a thing would she now?

You do not need to consent to induction at 38w. Again. In writing. No, I do not consent to x. What are my options?

You would be unwise to not consent if significantly overdue or if any kind of monitoring picks up issues like placental insufficiency, but you know that anyway.

Talk to your birth advisor and practise your ‘I do not consent to x’ lines.

38 weeks is full-term, not early. My DS2 was an ELCS at 38 weeks - 9lb 6oz and bigger than DS1.

Also - birthing suites are as brightly or as dimly lit as you want them to be. There are also many options between ball, bed and chair. I was induced for no 1 (not painful at all, BTW, but mainly because it still didn’t put me into real labour as he couldn’t descend) and the pool was still offered as an option.

I think you have black and white ideas about what your options are. Once in labour, the idea of getting into water may make you want to run screaming. The more you set up your expectations about birth, the more likely you are to struggle in the aftermath if your birth doesn’t meet those expectations. At the end of the day, you have zero control over what happens in a completely ‘natural’ unassisted labour - your body will do what it needs to do. With the option you’ve been given, you actually have more control, not less.

Also, as an HCP myself, I second PPs saying listen to the advice of your medical team. If you’ve seen four (!) consultants, then follow their advice for a healthy, live delivery. No competent HCP gives advice for their own benefit or to avoid cocking up their stats. It’s based on real research (not Google-whacking) and bags of experience, some of which is probably pretty grim, and what they want you to avoid.

Best of luck, whatever happens.

Term is from 38 weeks, it was a lot sooner than that my placenta started failing more like 31 weeks. I would at least look at daily monitoring if you are dead set against the induction. Not a risk I'd be willing to take tbh.

What makes you think it's a 'brightly lit hospital bed'? You need a tour I think, you're assuming an awful lot of stuff.

"they've openly said they wont let me use the birth centre to keep their good outcomes i.e only allowing 'low risk' births only."

And what does that tell you? Whether it is driven by protecting statistics, or the far more likely situation that your doctors care deeply about the health of you and your baby, either way they don't advise certain things because they are more likely for you than for someone else to lead to a bad outcome. In those circumstances, I would care very little for lighting. (What if you labour on a bright sunny day?)

I feel you want control I would ask for ELCS. I hated induction, it was flipping painful and I ended up with shedloads of interventions all but CS for DS1

DS2 was ELCS at 39 weeks and just shy of 9lb. 38 weeks is not early.

Please listen to your consultant(s). They really don't recommend things just to piss you off.

BRAIN

Always ask.

Benefits - what are the benefits. What's the evidence base.

Risks - what are the risks and how does this relate to MY situation. Again evidence base.

Alternatives- what are the alternatives. Seek second opinion.

Intuition. What is my intuition telling me. What might be clouding that.

Nothing. What if we do nothing.

You need to go on a tour.

The whole ‘ brightly lit bed ‘ thing sounds like a scene from the telly. Especially with people yelling ‘push,push’. I think you have a very fixed idea of how it’s going to be OP and it could take you by surprise.

Take advice OP. But be open. It’s a very hard thing to control. Remember it’s tiny part of the life you will share with your child.

I had all of mine in daylight. No lights.

Hope it goes well.

"they wont let me use the birth centre to keep their good outcomes i.e only allowing 'low risk' births only"

You do realise this is a good thing, don't you? Because it!/ not about stats. They want good outcomes. It really is as simple as that.

When there are factors which increase the risk, they want to mitigate that risk.

There are (non-MLU) delivery suites with pools - is there one at the hospital at which you are currently booked? Things such as birthing balls, ambulatory labour and mother choosing position are all totally routine too.

I think you are having some difficulty in fully realising that, no matter how good the indicators, you are in a higher risk group.