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.

OP, if you've spoken to four consultants then you have discussed it - you not getting the answer that you want to hear doesn't mean the discussions don't count!

Are you doing any classes, they would normally tell you about the tour.

I always say that labour is the start of a lifetime of compromises You sound very rigid about your birth plan. How will you feel if it doesn't go according to your plans?

Honestly they are advising it for a reason.

IVF pregnancies are statistically more likely to end in stillbirth. So are pregnancies for over 40s.

This is hugely likely to be your only child so do what is required to get the baby out as safely as possible. I was in your situation at 31 and had an elective c section. Don't make this. Bout you and having a birth 'experience'. You don't have the luxury of being able to choose.

Having a healthy baby is not "the only thing that matters". Being railroaded into the kind of birth you don't want can lead to a lifetime of mental health issues.

To be blunt @ferrier a still birth or an emergency c section because your baby is in distress can also lead to long term mental issues.

'Keep their good outcomes'means delivering live babies.
I had my first when i was 34. No problems when pregnabt. Deemed low risk. No gestational diabetes. My son died at 37 weeks 3 daya. We went in with no movements and were told he had died. I delivered two days later.

We had no warning that this might happen. It was a textbook perfect pregnancy. My son still died. They found no reason. Ypu might be perfectly healthy and normal and your baby dies at 39 weeks for no reason. You'll wish you had been induced at 38 werks.

The risk of stillbirth goes up with the age of the mother. Over 40 is high risk.
The risk of stillbirth for first time mums with no other problem factors is 1 in 200. That risk will increase for the over 40s.
15 babies a day are stillborn. You don't want your baby to be one of them.

I was induced with my first son and then induced at 37+3 with my second, who thankfully was born alive. I delivered my first with no pain relief and my second with an ineffective epidural. I found induction easy and straightforward and would do it again in a heartbeat.

If you are adamant you won't be induced at 37 weeks please get daily ctg monitoring from 37 weeks.

I haven’t been allowed to use the MLU ever - I was 22, 25 & 36 when my babies were born. You generally speaking can’t have the benefit of consultant care in pregnancy (which you will have with your circumstances) and labour in a MLU. You are consultant care until you are discharged after delivery. You need to be delivering where there is a consultant available if need be (this is how it was explained to me).

I was induced all three times, at 37, 40 & 38 weeks. None of my labours were the horrific nightmare that some people would have you believe ALL inductions are. I also have three healthy children - had I refused induction this very realistically may not be the case.

IME, induction is not offered without very good reason. I know far more people who have been refused induction before 42 weeks, than I know people who have had an induction before 40 weeks recommended.

Your labour is seen as “high risk”. I know it’s not a popular opinion on MN, but I would always take the advice of my highly trained consultant & medical team over my own wish for more “control” and “choices”. Delivering a healthy baby is what will matter to you most at the time, I’m sure.

I had my first child when I was 40 (not IVF though). I think what got to me was health professionals saying 'You won't be allowed to go over 40 weeks', like I had no choice in the matter. I really wish they would update their practices and say 'We recommend that you don't go over 40 weeks for these reasons' and give facts! No-one seemed able to tell me how much the risks increase, I looked it up myself and it was less than a 1% increase in the risk of stillbirth. I had absolutely no problems with my pregnancy despite being old, I went for monitoring every 3 days once I passed 40 weeks. When it got to 40+10 they put a lot of pressure on me to be induced, I agreed just to get it over with. Ended up having a c-section after 5 days of failed induction. Personally I would not have another induction, I would go straight for an elective c-section.

You seem very fixated on how labour will be in a consultant led area.

Bright lights
Stuck on your back
Etc etc

It’s really not like that.

I was on consultant led and was able to use a birthing ball and change positions as much as I wanted. They just wanted me hooked up to the monitor so they could continually check on the baby. How else would they know about any problems? The room had sofa and big cushions/mattress on the floor to use if I wanted as well. The room was lit normally, no big glaring lights.

If you use the pool in a MLU they can’t monitor you and the baby effectively. If anything goes wrong as-well, you will be better being cared for by consultants equip to deal with it. It’s as simple as that.

Obviously it’s totally upto you how you wish to proceed with this, but they only have yours and the baby’s best interests at heart.

I don’t understand why some people get so wound up over how the labour is planned. The most important thing is that the mother and baby get through it safely, not whether you get to float around in some water.

To be perfectly honest the 'bright lights, push, push,' thing pretty accurately describes one of my induced labours. However I've mostly forgotten it now.

The main things I would say are try to make an informed decision i.e insist on the answers to your questions about why they want to induce you at 38 weeks.

Don't get hung up on the birth process. It is right to be assertive about what you cannot accept e.g not being flat on your back, turn the lights off etc but ultimately there are no prizes for the best birth - the best birth is the one you and the baby come out of healthy. It hurts like a fucker anyway (sorry).

If you end up being induced it works best if you accept that's what's happening so try to get yourself in a mental state in which you're ready for the baby itself and accepting of the birth you're having.

Good luck.

OP like you I wanted an active, low-intervention birth if possible. I wasn't fantastically attached to the whole natural birth philosophy, but I dreaded the kind of hospital experience that would take away all my choices and leave me feeling like an animal at the vet's. And I was buggered if I was going with the default interventions unless someone could actually explain the balance of risks to me.

Ideally I wanted the MLU, and chose my hospital on that basis. But of course it didn't go like that - my waters went prematurely and an induction became the recommended option. MLU was no longer available to me, it had to be the delivery suite. Induction went ahead, and the syntocinon drip created very painful contractions so after a couple of hours I opted for the epidural, hence I did end up flat on my back attached to a monitor. Not at all what I'd hoped for.

But it was fine. I didn't feel railroaded in the event, I still saw mostly midwives, plus an anaesthetist for my epidural. I was so grateful for the pain relief by then I would have married that man if he asked. He probably looked totally average but in my memory he's Ryan Gosling in scrubs. The midwife turned the lights down at the end so I got to push in a dark, intense atmosphere.

It was very much a hospital birth. But it's still me that did it. Nobody else birthed my daughter, I'm the one that pushed her out (and got away without needing stitches, so hooray for that). And part of what I did was to change my birth plan according to circumstance. Medics can seem high handed and protocol driven, but they aren't out to get you. Most of us end up in the middle ground between very 'natural' and very medicalised birth. Ask questions and exercise what choice you can. It won't be infinite but there are options.

Personally the only thing I'd change is to decline sweeps. I found them painful, intrusive and bloody pointless. If they want to induce me for DD2 next year, I'll politely suggest we crack on with the drip and bypass the rummaging around in my nethers.

There is really no reason you shouldn't be able to use the birth centre if you labour spontaneously. Yes the stillbirth rates are slightly higher for your age group and IVF but induction at 38 weeks is ridiculously early. Our birth centre generally doesn't accept women over 40 BUT a motivated otherwise "low risk" woman would likely be OKed to use it. We sometimes have VBACs etc there now.

There is quite a bit of misleading information on this thread. As mentioned by pp, you really need a chat with the head of midwifery or your hospital's Professional Midwifery Advocate (used to be supervisor of midwives).

I think there's too much focus on having a "birth experience". The end goal should be a healthy baby.

I was going to go with a delivery suite, but I ended up being induced as DS was two weeks late, and I didn't want to take the risk of waiting. Yes, it was painful, but what would have been more painful would have been losing my son.

Medical professionals have trained for years. I would always seriously consider, and possibly take, their advice over anyone else (including Mumsnet).

The end goal should be a healthy baby

Those who say this and dismiss a mother's other feelings really need to do some reading on how birth and the experience can shape how women feel about motherhood.

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.

Absolute bullshit, I’ve had ‘natural’ and induced births and neither were more or less painful. It’s crap like this that scares FTM.

OP, in your situation personally I would accept being induced. If it’s absolutely not what you want then refuse but maybe request regular monitoring of baby and the placenta to make sure all is okay.

I was induced with dd1 - painless and easy, healthy baby and happy me. About as medical as you could imagine without a caesarean.

I would echo PPs - focus on going with the flow and doing whatever needs to happen. Any “control” you may think you should be entitled to exercise is illusory as both is after all a natural process. Trust your medical team. They are not the enemy - they are trying to keep you healthy and deliver you of a healthy baby. Basically...

“I would always take the advice of my highly trained consultant & medical team over my own wish for more “control” and “choices”.“

Quite.

*birth

Over 40 and IVF... I would definitely use the delivery suite. There is absolutely no reason why you can't have a natural water birth there, unless they have no pool rooms? The hospital I had DD in had 4 "home from home" rooms with pools, aromatherapy, music, dim lighting, loads of space to move around. Honestly there was more space to move around than there would have been at home. But you will also be in the safest place should something go wrong.

Not sure where you are OP but my local birth centre is a 30 min drive from a proper hospital, with a higher risk pregnancy it's not something I would risk.

The end goal should be a healthy baby*

Those who say this and dismiss a mother's other feelings really need to do some reading on how birth and the experience can shape how women feel about motherhood.*

A healthy, live mother and baby is more important to me than having an ‘ideal’ birth experience.

Advice given is based on the fact that the OP is considered pretty high risk for 2 reasons.

It’s up to each individual woman what they choose to do with such information but I know I would feel a hell of a lot worse about motherhood if me or my baby were harmed or worse after I chose to go against what I was advised.

www.positivebirthmovement.org/pbm-blog/a-healthy-baby-is-not-all-that-matters

Hi op, I’ve had quite a few birth experiences with 2 labours, induced,
C section, forceps, I could go on.... :)
It doesn’t matter, all that matters is baby arrives here safely. If that’s what the docs advise I go with there advice, the babies birth is a tiny part of there whole life and it’s what’s best for them is the important factor.
Good luck with your soon to be new arrival

Their not there!!!!

I really don’t want to sound harsh when I say this, but after going through the IVF process, which I know is far from easy, wouldn’t it be wise to just accept the advice from trained professionals to ensure that your precious baby makes it safely into the world?

I wanted a water birth. First one the pool was out of use. Second one they hadn't turned on the taps 'because it will be hours yet, oh look a head', third one due to be home birth -induced in hospital because of v low fluid. I do though have three lovely children and am just happy that they are all well. In your position I would even consider the sun roof option. The birth is only the start of parenting, just concentrate on getting the baby out healthy and don't worry too much about the rest.

I wanted a water birth too Should. DD was a big baby and had other plans. She came out of the sunroof. At the time I was upset I hadn’t managed a natural birth. She’s nearly 6 months old now and is currently asleep next to me doing the quietest of baby snores. I couldn’t care less how she came out now. She’s gorgeous and she’s healthy. Listen to the professionals OP.

OP, this is very interesting. It's from the RCOG.

Also, my first child was an IVF pregnancy and, because of a blood condition, I'm not a candidate for a birthing centre. I gave birth, with no significant interventions (support from midwives but no instruments) with just gas and air, on a labour ward. No-one shouted push push (if anything they shouted at me to stop doing that!), and there were no bright lights. In fact it was very low lighting when DD1 was born and DD2 was born in the day time.