Being induced - my "rights"

[MaverickSnoopy]

My "rights" is probably not the best choice of word but I can't think of another.

With my last pregnancy I was booked to be induced on day 14 overdue (2nd pregnancy and 2nd overdue baby). I went in at on 10am day 14 and was monitored for a couple of hours, then moved to a private room to wait for a slot. As the day progressed it became clear they were struggling to fit me in. I had my blood pressure tested mid afternoon and told they may not fit me in that day - no further observations were done. I was nearly taken down at about 8:30pm but then a spontaneous labour came in. In the end I was induced on day 15 overdue at 3pm in the afternoon (they literally just had to break my waters and labour was fast). They knew I was unhappy about going so far over but there was nothing they could do. Labour was difficult and babies heart rate dropped so low that a team of doctors and midwives rushed in ready to intervene and brought with them an incubation unit. I have never been so terrified. I was told after that baby had been in too long. It was touch and go but in the end she was ok.

I'm 39+6 and with a history of going overdue and living in an area with a major midwive shortage (so much so that many birthing centres have recently closed and home births all cancelled - hospital is also very very full) that I am feeling quite anxious. I have a MW apt tomorrow and plan to discuss this with them (I have mentioned bits in passing but am feeling more anxious now). I am so worried about a repeat of last time and desperately don't want to be induced so late. Equally I do appreciate that the midwives are between a rock and a hard place at the moment and there is only so much they can do. Of course I could go spontaneously....

What are my "rights" though? A midwife said to me not long ago that I shouldn't have been left so late. Is that the case and how can I make sure it doesn't happen again, or do I just have to suck it up?

NICE guidelines recommend Induction between 41 and 42 weeks, so you can request to be booked in earlier than 42 week s. This may depend on local policies - midwife will have to follow these. My current trust will book post dates induction from Term plus 12 days routinely, my last one from Term plus 10 days. But a consultant can over rule these so you could ask for consultant appointment to discuss earlier induction. But would probably be seen as a low priority on the ward - if no other risk factors. So Ms X is booked for induction for post dates at Term plus 12, Ms Y at 39 weeks for diabetes, Ms Z at 40 weeks for reduced movements and Mrs W for post dates at 41 weeks. In my unit order of proceeding if it were busy and we had to pick and choose would be Z, Y, X and W.

Sorry, hope that made sense!

But, if we can't proceed with induction at any point then we do have a policy for regular monitoring of baby and maternal observations, so you could also ask how they plan to manage this in the event of delays? You can also ask to speak to senior midwife in charge (who will be the one running Labour ward) for reassurance you're on their radar, although if it's a busy day that could take a while to happen.

Also can request sweeps (jury out on effectiveness but may help?)

Thanks. Ironically I don't particularly "want" to be induced, I just don't want to be left past 42 weeks like last time and I certainly don't want to be put in a side room and forgotten about again (ie not enough monitoring).

I have a sweep booked in tomorrow (had 3 in my last pregnancy and didn't work at all) and will discuss with the midwife. Now I know I will specifically ask about the policy in our area and you've given me some excellent pointers for if it happens again.

Frankly my experience last time was terrifying and it's left me very anxious and I was traumatised after the birth for a long time. It's only now that my due date is imminent that I'm really starting to panic.

We've been told that if there are no problems with you and the baby you can and possibly should refuse an induction and opt for what is called 'expectant management', where it's a wait and see approach, with close monitoring.

It'll involve you talking in depth with them about risks and making an informed decision, and going in every day for exams/scans etc, but you by no means have to have an induction if everything appears to be fine, you're just a bit later on dates.

I don't want to go past 42 weeks though that's the thing and I can't go in daily because I have pgp and sciatica so can't get the bus because it's 3 busses and takes 2 hours and I can't manage it and I'd have to do it with my toddler which would mean folding the buggy which I can't physically do at the moment.

However I spoke to the midwife today and she is going to book me in for 40+13 in the hope that if I am delayed I would be induced at 42 weeks exactly, rather than over 42 weeks like before. I'm hoping that it doesn't come to that though.