stressing out about prospect of induction

[aikigypsy]

I know I'm getting ahead of myself (only at 32 weeks) but with my family history of long pregnancies I doubt I'll go into labour until a while after my due date. The hospital I'm going to aparently insists on induction at about 41 weeks, which I am afraid will be a bit premature in my case. I know I can just not show up for a scheduled induction, but I actually would like some monitoring if the pregnancy runs long.

I'm in the US, so I know that dealing with the system will be a little different. Am I completely out of my mind to be stressing out about unnecessary induction?

The experts will be along soon but I think generally going up to 42 weeks without extra monitoring would be seen as acceptably safe in the UK especially given family history.

Alternatively give yourself the mindset that you will be induced on x date in which it will be a very pleasant surprise if baby arrives under it's own devices?

Yeah, I'm thinking that I would probably want to be induced if I went over 42 weeks, which would probably mean 42+2, since conception (I'm very sure of dates) happened on the weekend. I just worry that I would have to go to another hospital. Good to know that extra monitoring wouldn't be required there before 42 weeks.

Maybe I'm dealing with some sort of semi-sub-conscious birth trauma. My mother was induced with me, and I really feel like she wasn't sure of dates and I wasn't quite ready (just a gut feeling, and not based on any major health issues).

No, you're not out of your mind at all! I refused induction at 42wks (scan edd) and had my VBAC the next day.

Unfortunately the fabulous site 10 Month Mamas is no longer available as the webmistress had to give up because of family reasons.... I managed to grab a hold of a link that Gloria Lemay found in archives and put it on my website so that it was not 'lost' forever.

You can also find Gloria here and I suggest you ask there also for tips as the American and Canadian systems are different from the UK.

I'd advise asking for Expectant Management once you get to or near to 42wks and wait it out, but that's my personal choice.

41 weeks is ridiculous, it isn't even overdue anyway! over 42 weeks is 'overdue' and even then some people do just stay pregnant for longer - I had DS at 41+6 6 months ago (turned up for my induction appointment in labour) and when the midwives examined the placenta after the birth, they said it was in perfect condition - so I probably was just designed to be pregnant for nigh on 10 months.
I was very sure of my dates too and an early scan confirmed them.

I would get a GP or whoever to check your blood pressure maybe once you've gone over 40 weeks, but unless any other issues come up before then I can't see any reason for worry

still at 41 weeks for induction, madness

Thanks for the links, Klaw.

I've been poking around a bit on the internet and finally fell through the rabbit hole to the professional journal for the ACOG, and the articles which recommend induction at 41 weeks. I can see their point, but it's not good science on a case-by-case basis, more of an epidemiological study. The one controlled study of induction vs expectant management (a 2006 article, so I could only get the abstract) showed no statistically significant differnece in outcomes between induction and expectant management.

Here, they start expectant management at 40 weeks! Isn't that insane?

I have had 4 inductions

first at 41 weeks (they thought I was 42 weeks but I know when I conceived, no early scan available where I lived)

42&2 (me desperate not to be induced) one lot of gel

40 (at my insistence - long story)

42 (mutual decision happy to be induced then) 2 lots of gel

Let's just the 2nd & 4th births were relatively quick - 10ish hours from the first lot of gel, the other 2 inductions went on for days and I had to have controlled ARM both times so I would really ask to wait until 42 weeks as it is more likely to be a shorter labour. HTH

Don't be sure that your baby will be late though; I was convinced dd would be late as I was 12 days late and my mum was induced, my sister was late as were her children, dd came a week early to my complete surprise, I was convinced I'd have at least another fortnight, I only had just over a week on maternity leave when she arrived!

Here are some of the articles:

Complications of Term Pregnancies Beyond 37 Weeks of Gestation

another interesting article Some of the statistics make my head swim, but I can make sense of most of them.

and then the most recent one

I will go in armed with these and my knowledge of my family history, and they really should treat me as a sensible human being.

x-posted. I'm not totally opposed to induction at 42 weeks or so -- glad to hear that it can work out OK.

Also to encourage you that I didn't end up with assisted deliveries despite having epidurals with the first 3 labours, also the last 3 were whoppers and it was all fine, just exhausting when it goes on for days especially as I hate hospitals!!!! Only had one stitch ever and they weren't too rapid or anything - the 2nd stage was very very short for the last 3 but I still took hours to get fully dilated IYSWIM

Your last link Aikigypsy has the conclusion: No differences were found between the induced and monitored groups regarding neonatal morbidity or mode of delivery, and the outcomes were generally good.

So WHY induce then? if there is not a valid medical reason to induce then Expectant Management should be the norm!

I know that some women are able to say that they had a 'good' induction experience but they are the exception to the rule in my experience. MOST of the women who have told me of their experience of induction have found it a horrible experience to varying degrees. This I compare to the experiences of women who tell me about their non-interfered with births. I know it's all anecdotal but....

sorry, I realise I've used a lot of 'experiences'

Also look at some of these links:

Overdue:
www.homebirth.org.uk/overdue.htm

Just say NO to induction:
www.birthrites.org/inductionRisks.html
www.kentmidwiferypractice.co.uk/20 06/induction.htm
www.radmid.demon.co.uk/induction.htm
www.mother-care.ca/bishop.htm

To scan or not to scan:
www.homebirth.org.uk/big.htm#2

DOn't be so opposed to induction that you avoid any kind of monitoring: complications can set in (I was induced at 40+5 due to soaring blood pressure - it hit 210 over 150 at the end). And whatever happens, as long as you end up with a healthy baby and a healthy you, it doesn';t matter how you got there.

I'm all for monitoring. The only thing is I'm worried that they're going to be so induction-happy that they won't give me a straight read on the scans etc., and just make up some excuse to induce.

Yes, I was very pleased to find that last article, about expectant management being just as good from a medical perspective (and better from my perspective!)

i had an induction, it was intense but FINE. i'm with madamez on this one, tbh, and i too had the soaring blood pressure.

I'm also in the US aikigypsy, and my induction for my first went very well. Any doctor worth seeing is going to tell by the state of your cervix whether or not it's a good idea to induce.

Talk to your doctor about what you are feeling and thinking and figure out why your hospital does that, is it policy or is it that your hospital see a lot of high risk situations. Your hospital may say one thing, but your doctor makes the final decision.

If you are really worried and your doctors aren't supportive of waiting as long as you and the baby are ok, you do have the right to change doctors or hospitals depending on close one is at anytime.

yes I was induced first time round too at 40+5 due to high BP, and it was absolutely fine. BUT I wouldn't have been happy to be induced just because they reckoned 41 weeks was overdue

Switching doctors/hospitals wouldn't be practical because I live on an island (decided to come home-home for the birth as I was going to have to move anyway) so getting off to the next nearest hospital can only be done when the ferries are running, which is between 6am and about 8pm... a pretty frequent schedule, and probably giving plenty of time to get there, but not reliable, and no use at all if we get a big storm.

The nurse-midwife here is great, unfortunately they have shunted me over to the OB/consultant for the past few visits and he's... not very bright, and not particularly respectful of patients having opinions, either. Oh well, hopefully I'll be able to avoid him from here on in.