Overdue and hating doctors....

[grey12]

rant warning!

Just came back from the hospital feeling completely disappointed and let down....

It's my 3rd pregnancy and all have gone beyond the due date. I have talked in a different post how I have been bullied/lied/.....wtv into numerous sweeps and induction. And my experience with the first induction was terrible.

That was in a different country, very trigger happy for medical procedures. From what I read, the UK seemed much more forward thinking. But I have just been through the same bullsh**......

My previous experiences have left me with anxiety issues towards the end of the pregnancy. Last night it felt like the baby's movements were less strong (baby changed position?!). I decided to wake up DH and go to the hospital for monitoring. I was expecting reassurance, baby is fine, this is your anxiety talking, go home! Oh no!..... That's not what happened! Doctor said I was a risk pregnancy because of going 5 days beyond the due date, and any other concern, however minor or imagined, immediately pushes for an induction (disclaimer: I am very healthy, no other problems whatsoever). It's like my health is being determined by some 18th century guy who said pregnancy is "10 moon cycles plus a few days"!!!! (Honestly! Look it up) What kind of mambo jambo is this??!!!! Not only do I have previous experience with overdue pregnancies, I also have family history. And doctors are completely dismissing everything.

I sat in that room and a part of me wished I hadn't gone into the hospital!!! And that is BAD! It goes completely against what I believe and what I studied at university even!! (I'm a biomedical engineer with focus in patient monitoring)

So it seems that I'm being induced on monday..... with drugs?!!! (Never heard of a tape?! Doctor refused to say anymore) Wtf?!!! When did I fall down Alice's rabbit hole?! And how do I get out??!!!

Im sorry I have no experience in this but just wanted to offer my support. Someone will be along to help shortly xx

Five days over is nothing. A mother usually has to wait to be a fortnight overdue before induction.

As your baby is OK, just wait another five days before allowing anything to be done. Hopefully you will go into labour spontaneously.

@Qwom thank you :)

@jessstan1 I really want to do that but also I really respect the medical profession and going completely against their knowledge and experience is not something I do lightly I fought as much as I felt comfortable to... Junior doctor was nice but senior doctor was really adamant and I would be having the baby today by her opinion!!! When I said I didn't feel comfortable with it she asked ME to give a cut off day what am I even supposed to answer?!

Oh OP you should not be subjected to this. The policy of my health trust is not to induce until 12 days overdue - that's based on medical evidence, so you could use that if you felt comfortable with it? But you don't need to be induced at all, it HAS to be with your full consent, I'm so sorry you're being pressured like this.

In my experience / understanding it's doctors who are more trigger happy to hand out the drugs to speed things up, midwives will tend err on the side of letting nature take its course.

Just refuse. They can't force you. Ask for a second opinion from a senior midwife.

If you said you had reduced movements and overdue they will worry as could be a sign of something starting to go wrong but might not be picked up on the monitoring you had in hospital which is a snapshot. They are trying to care for you and your baby but they can’t make the decision for you!

Also there is good evidence to support offering inductions from this large scale examination of records www.qmul.ac.uk/media/news/2019/smd/new-stillbirth-risk-figures-help-womens-decisions-on-timing-delivery.html

If you’ve reported reduced or changed movement at this stage then they will want to keep a close eye on you and the baby

With my first I had one episode of reduced movement at 40+6 which i mentioned to my consultant as I saw her that day. I was taken in that night and given the pessary induction at midnight he was born later in the early morning.

You have to consent to the induction but unless there is a good reason it is offered before two weeks overdue so they must feel there is one.
What is it about inductions that you are opposed to?

• it isn’t generally offered

@shesgonebatshitagain with my first I really wasn't ready for labour. It took 2 pessaries, 2 days of contractions, epidural, episiotomy, ventouse being pulled hard and 2 nurses pushing with their forearms with all their might on my tummy for DD1 to come out. The doctors weren't very professional either in a couple of occasions....

If I am well (even if with anxiety) and the baby is well then what is the issue with waiting for things to go their own way?

@grey12 that sounds tough I can totally see why you might dread them pushing another baby before they are ready to jump.
What gestation were you with that birth?

I’ve had three inductions two before term as well as my first
They all went well but I know that not always the case.
Is it the gel they are offering this time?

How have your baby’s movements been today?

Ready to jump so to speak that should read.

And sorry I clearly meant in my first post you do NOT have to consent
Sorry

@grey12 oh this is so annoying! I'm 40+5, no signs of labour so far. I was born week 41. I was at the clinic for reduced movements at week 39. So far midwives are happy for me to wait till I'm week 42. However I was offered induction by the doctor at my 20w appointment because I have an IVF pregnancy with known due date. They wanted to induce me week 39.. doesn't make sense to me. I've read so much research since then and decided to decline all inductions as much as possible. Risk of stillbirth is 1/1000 goes up to 3/1000 after week 42, that is still very low risk overall. My main reason for declining induction is to avoid instrumental delivery as it can be damaging for both baby and mum.

My advice would be to have a good think over the weekend. You can either ask for monitoring and decline induction. I believe they should monitor baby's heart and placenta on ultrasound and Doppler every 2 days. If no medical reason to induce, wait for things to happen naturally. Or if you decide to get the induction on Monday, make peace with this idea, there are some hypnobirthing techniques that can be used along with the induction to hopefully stay calm and get your natural oxytocin coming. Make up your mind and stick to it. If you can't decide ask for another appointment with doc and midwife let them hear your reasoning and see what they say. Maybe try sweeps first? Good luck!

I've been through similar coercion at NHS, they don't know I'm giving birth privately within the same hospital. My consultant just referred me for monitoring for gestational diabetes. They put on a right show saying I NEED THE SWEEPS, and an induction at 40 weeks. I said I'm going to 41 weeks or past, they don't care about individual patients - just the overall stats for the hospital to bring down the stillbirth rate.
So you can decline any procedure, induction, whatever. If they somehow book stuff, you just don't turn up. You are completely in charge of your labour! And you choose what you want them to do or not. I have seen the tactics in action, and please do not feel intimidated. Stick to your birth plan. NHS has very specific targets in mind, and sadly natural labour without intervention doesn't seem on top of their agenda!

Read the book "Induction Matters", it's quite short and is based on evidence, which the maternity policy sadly isn't always... I was not told about the risks of induction, which are significant: baby in distress, shoulder dystosia, painful labour, emergency c section rate shoots up.

You can respect medical profession without being forced to gice labour to suit them, surely? Their recommendation has nothing to do with your personal situation, my consultant thinks all women should deliver at 39 weeks... so what? And that's one of the famous ones. They just have an out of date perception of labour and often see the worst case scenarios in everyone.

@Coronet08

I've been through similar coercion at NHS, they don't know I'm giving birth privately within the same hospital. My consultant just referred me for monitoring for gestational diabetes. They put on a right show saying I NEED THE SWEEPS, and an induction at 40 weeks. I said I'm going to 41 weeks or past, they don't care about individual patients - just the overall stats for the hospital to bring down the stillbirth rate. So you can decline any procedure, induction, whatever. If they somehow book stuff, you just don't turn up. You are completely in charge of your labour! And you choose what you want them to do or not. I have seen the tactics in action, and please do not feel intimidated. Stick to your birth plan. NHS has very specific targets in mind, and sadly natural labour without intervention doesn't seem on top of their agenda!

Whilst I “get” most of what you are writing here the OP did report a change in movement. It would be wrong to ignore this and so often we read about women reporting this sort of thing Feeling fobbed off and worried. Telling someone to stick to their birth plan is pointless as I found out. You can’t stick to a birth plan for the hell of it.

And as for booking stuff but not turning up, well that is really not right especially with the pressures on antenatal services

@shesgonebatshitagain sorry, did you read my post? I'm very well aware that NHS ignore women's choices are routinely book induction without consent. I believe one was booked for me earlier this week, and I never consented. One should cancel and not turn up, if that's the case! Also plenty if examples of doctors lying that induction cannot be cancelled...
Absolutely the change of movements should be investigated. Which is what OP did. Then she got her assurance, and should have been let go, as there is policy to induce due to reduced movements. Most women I know had these episodes, all investigated and were fine, but they were luckily not "kept in" or coerced into staying and having an induction.
And Absolutely women should stick to their preferred birth setting and method, unless there is danger to health.
Most of the time intervention in labour is not to save lives though, but improve the statistics or to suit the doctors (being risk averse). Induction does not improve health outcomes, according to research.

[quote Coronet08]@shesgonebatshitagain sorry, did you read my post? I'm very well aware that NHS ignore women's choices are routinely book induction without consent. I believe one was booked for me earlier this week, and I never consented. One should cancel and not turn up, if that's the case! Also plenty if examples of doctors lying that induction cannot be cancelled...
Absolutely the change of movements should be investigated. Which is what OP did. Then she got her assurance, and should have been let go, as there is policy to induce due to reduced movements. Most women I know had these episodes, all investigated and were fine, but they were luckily not "kept in" or coerced into staying and having an induction.
And Absolutely women should stick to their preferred birth setting and method, unless there is danger to health.
Most of the time intervention in labour is not to save lives though, but improve the statistics or to suit the doctors (being risk averse). Induction does not improve health outcomes, according to research.[/quote]
I don’t know a single woman who has had an induction booked against her wishes and coerced into one. Any of them who had an induction were offered and recommended one for valid clinical reasons related to mother or baby or both. I have had reduced movement with all my babies and every time it was concerning enough to warrant either immediate induction or overnight stays, scans and continuous monitoring.

Also when a woman reports more than three episodes of reduced movement which are investigated then in the two hospital trusts where I had my three children it’s policy to recommend induction particularly 37 weeks plus. That seems very sensible to me.

Nobody is saying women can’t have a birth plan and want to stick to it. Feeling empowered and supported to make informed choices is a large part of the psychology of labour, but ultimately the safe delivery of a live baby and a well mother is the priority. If aspects of a woman’s birth plan are irreconcilable with her circumstances then she needs this explained in a respectful manner in terms of risk and outcome. Things can turn in the tip of a pin and in the blink of an eye during childbirth snd plans should always be made with this in mind.

I don’t know enough about statistics surrounding outcomes for inductions so would need to look before I had an opinion, but I had three inductions and no pain relief with any of them. I was never challenged on this. I was encouraged to labour actively and gave birth with no instrumental assistance.

I think though you perhaps you need to qualify your statement “ most interventions in labour are not done to save lives but improve outcomes” . It seems important to me to distinguish the offering and promotion of inductions in this case from both necessary, urgent interventions and choices a labouring mother requests - but which is not recommended - such as epidurals which increased chances of assisted delivery and statistics

I am more than happy to continue monitoring. Thing is the senior doctor wasn't even into it!!! She complained that I hadn't had an ultrasound past the 20 weeks (not a risk pregnancy) and she didn't even hint of the possibility of getting one now I said before my previous pregnancies were in a different country. I had ultrasound at around this stage to check size of baby (VERY inaccurate... she wasn't 5kg, she was 3.2!!!) and volume of amniotic fluid.

After my experience with the pessary, I'm not interested in using the same drug again. And the senior doctor completely ommited that the "tape" is the exact same thing in a different presentation! I'm starting to get really annoying at her! Looks like I'll have to get to the hospital on monday and fight this out! Hence anxiety..... I have to keep fighting and fighting against doctors

I understand where they come from getting worried about possible problems. However I do really believe now I was just being anxious and the baby didn't have reduced movements, proven by the monitoring and examinations. I was very honest with the doctors and still they didn't listen at all!

Once you’ve said reduced movements though they act/advise based on that. Just because you’ve now changed your mind on whether it really was reduced or not they won’t change their advice.

There’s a lot of fairly new evidence about how an earlier than standard induction reduces still birth rates. Combined with the fact you have a documented episode of reduced fetal movement then I’m not surprised they recommended induction.

It’s all very well saying you’re happy to have monitoring but realistically you can only rely on monitoring to give a picture of the health of the baby at that moment. Yes, sometimes you might be lucky and pick up on a problem before it’s too late. But equally I’ve known women having monitoring twice a day. First one was fine. Eight hours later when went to monitor again no heartbeat. That was for a routine post date induction.

Meant to add that it is of course your choice but the doctors have an obligation to make sure it’s an informed choice. You can of course decline their recommendations.

Isn’t the tape with gel that is absorbed directly and can’t be pulled out unlike a pessary?

An episode of reduced movement can be just that:an episode
Or it can be indicative of other issues which may or may not be picked up sporadic on monitoring hence why they might be keen not to wait for another similar thing to happen.

Obviously it’s your choice at the end of the day. Every labour is different and this induction if you agree to it might be a totally different experience. I understand your anxiety around it though.

Also just to add being induced is not necessarily an indicator of poor maternal health. With my daughter one of her episodes of not reduced but massively increased movement were because she’d gone transverse at 38 weeks (i’d been scanned at 36 she was a frank breech ) And she also had the cord around her neck. I was monitored found the clock and scanned again the next morning but was told that night to en prepared for a c section the next day if she hadn’t moved as there were concerns around feral hypoxia

She was fine thankfully but that all came out of my thinking she was a bit livelier than usual

You are past your due date and have reduced foetal movements? Of course you're going to offered induction. I'd have said " how quickly can it happen? ". Placental abruption is a real risk as well as loss of heartbeat. My DD had a PA, but she was already in hospital. She was rushed to theatre and one baby was resuscitated for 17 minutes. Luckily they are both fine. I know you've had bad experiences previously, but surely a live baby is the most important thing?