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Childbirth

Share experiences and get support around labour, birth and recovery.

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Original poster

Has anyone else been thrown this line as a reason for induction?

51 replies

OldieButGoldie · 06/03/2008 20:19

Was at hospital today for monitoring, currently 40+10, and myself and baby are both absolutely fine. When cervix was checked it had softened a little from last check 6 days ago but was still unfavourable for a sweep.

I asked to wait to 42 weeks (Monday) and see how things were. However I was told that it could take several days of prostin gel to kick start my labour (as I am in my 40s, first child and unfavourable cervix) and by that stage I would be well past my dates and.....the "baby's reserves would be depleted" by this stage making him less able to cope with labour and likely to become distressed, resulting in a CS. She advised me the best way for me to avoid a section was to be admitted for induction tonight. I refused, it sounded like gobble-di-gook to me, and I needed time to think (and ask mnet ),

Any opinions on this one?

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bethoo · 06/03/2008 20:26

i think i heard that it can be quite dangerous if you let the baby go quite overdue.. could be right about the reserves.

Daisymoo · 06/03/2008 20:34

Well, it's a possibility that induction would be less well tolerated by the baby in a few days, but unless she's got a crystal ball she has no way of knowing.

You might like to look at this in particular, these bits: "There was no evidence of a statistically significant difference in the risk of caesarean section for women induced at 41 and 42 completed weeks respectively."

And also "A policy of labour induction after 41 completed weeks or later compared to awaiting spontaneous labour either indefinitely or at least one week is associated with fewer perinatal deaths. However, the absolute risk is extremely small."

HTH

dizzydixies · 06/03/2008 20:36

you need to find lulumama - she gives great advice - will see if I can find her for you

JodieG1 · 06/03/2008 20:38

Some babies take longer than others to be ready. I've known some women to go 43 weeks and have a non induced labour and everything was fine. They did go in for daily checks though and the baby wasn't in distress at any of those. It's up to you really. 42 weeks isn't a magic number when baby suddenly needs to come out, it could be a day or two more.

franklin · 06/03/2008 20:39

Have you tried all the 'natural' ways to induce labour?

entropy · 06/03/2008 20:40

they scared me into an induction with pretty much the same line. Only they added that the placenta could fail and I might not realise my baby was in distress as she didn't move around much. (too comfy) I was 31, and 42+1 wks pg when I was induced.

for what its worth I regret being bullied into it but I didn't need a C section. The birth was very quick though (46 mins from dilation to baby) but I tore very badly as you just can't stretch that quick! and there was no time for my epidural I'm not sure waiting would have made any difference though. she just didn't want to come out!

Lulumama · 06/03/2008 20:56

thank you dizzy. daisy has posted excellent stuff there!

if your cervix has softened in 6 days,then could have changed completely by monday.

it might take one dose of prostin, it might take 2, you might jsut need your waters breaking !

scaring oyu is not a good way to get you to make an informed decision.

a normal full term pregnancy cacn go to 42 weeks, or even 43. expectant management, i.e scans and CTG can help pick up on any issues. a placenta does not automatically stop working on the dot of 41 or 42 weeks.

if she tried to induce you tonight,with an unfavourable cervix, and a low bishops score, then there is every chance it could take days to get you going and you have more chance of a c.s

so she is contradicting herself thre.

PutThatInYourPipeandSmokeIt · 06/03/2008 20:59

Yes I had this and the head midwife stressed that if we were all in France, they wouldn't be thinking of doing anything until after 42 weeks anyway you're not 'overdue' until then. It's an infuriating situation because once they have told you that your baby has an increased risk of being still born if you wait, you can't get it out of your head. I would suggest you have a chat with the head midwife and see where you end up....mine said absolutely no induction until a min of 42 weeks....

edam · 06/03/2008 20:59

the baby's reserves of what, exactly? Irn Bru? Lucozade?

BroccoliSpears · 06/03/2008 21:01

In France, 40+10 is considered to be your due date.

(I went to 43+1 and then consented to an induction - but I have no medical knowledge of the ins and outs so don't have much of use to add.)

BroccoliSpears · 06/03/2008 21:02

X post with ptiyp.
Slow typing tonight.

mears · 06/03/2008 21:08

The view is (not substantiated by evidene) is that the placenta starts to die off by 42 weeks and therefore the baby is then at risk in labour.

This thought is actually out of the ark to be hoinest and with modern dating scans etc, pregnancies may well have a norm of 42-43 weeks.

I tend to think that mother nature is not completely stupid and that babies will come when they are ready.

We really should not be propagating this unhelpful propaganda about post mature pregnancies. We end up trying to induce labour when the body is not ready which results in C/S.

There is technology around now that can monitor fetal wellbeing. I think it is best to wait and keep an eye on how the baby is coping.

SalVolatile · 06/03/2008 21:09

Oldiebutgoldie - I just feel I should add this although I know it isn't the same for everyone - five weeks ago a girl I know lost her beautiful baby boy at 41 weeks+6 days. He was perfect. the placenta failed in the final 24 hours. If I had gone 40 weeks (I'm mum to 4) I would not go to 42 weeks. Just personal opinion and as I say. sorry if iformation is inappropriate but I felt I had to say it: I know my friend would.

SalVolatile · 06/03/2008 21:12

mears, I have the greatest respect for your expertise and I am sure that what you say is factually correct. But the fact remains that the girl I am talking about was checked at 40 weeks and at 41 weeks. Her placenta did fail, and I don't suppose she will be comforted by feeling that what happened to her was out of the ark tbh.

BroccoliSpears · 06/03/2008 21:12

I was told my a midwife that the problem is that when the placenta does decline, it does so very quickly.

PortAndLemon · 06/03/2008 21:16

If your cervix isn't even favourable enough to do a sweep it seems very unlikely that having an induction at this point is your best chance of avoiding a c-section .

Are they keeping an eye on blood flow properly now?

Lulumama · 06/03/2008 21:17

sal, what happened to your friend is awful, absolutely awful. some placentas fail at 38weeks,some at 40.some at 43. thank goodness it is rare, but that does not detract from what happened to your friend

no-one is saying there is no risk of failure, but it is a low risk

mears · 06/03/2008 21:21

SalVolatile - I am really sorry for your friend but in my experience we rarely find out why a mother has a stillbirth. Just last week I looked after a lady who was 38 weeks whose baby had died.

In most cases there is no reason found. Women lose babies at all ranges of pregnancy - to assume placenta failure or suggest it without proof is very diostressing.

I remember a consultant doing a lecture who said that we do not know whether babies who were stillborn at term - if they had been delivered earlier they may well have succoumbed to cotdeath. It may well be due to some other aspect rather than placental failure.

I have cared for many women who have lost babies and our pathologist goes to great lengths to stress that we do not say things about assuming a cause for the loss until after pathological examination. Someone may well have said it was placental failure with no actual evidence for that. It is ofetn an assumption and said so that the woman can hold onto a reason.

PotPourri · 06/03/2008 21:26

I was induced first time at 42 weeks. It then took 4 days from start to finish for DD to come out. I was in the 'queue' for a CS, but finally after pethidine (to get me through the 6 hour wait ahead) the baby decided to come - think I had finally relaxed.

However, I have to say I insisted on getting induced at 8 days over next time - due to knowing 2 people who had still birth at 10 days over around the time I had DD1. That time it took 24 hours start to finish - I still had to get the full shebang, but a natural birth, no tearing or anything that time.

Am not sure what I will do this time (due next month). Honestly think it will cause me so much anxiety to wait past 10 days that it would be more dangerous to wait for nature to take its course. Also, I was starting to feel quite ill as I got overdue - swollen hands etc and feeling generally sick/nauseaous

It is commonly said that induction is more painful though - so if you feel you want to wait - do so.

Sorry, not much help really - as it's quite inconclusive.

SalVolatile · 06/03/2008 21:28

mears - I don't ever suggest things without proof - the hospital arranged a full autopsy and placental exam: cause of death was given as placental failure. No reason to believe that further pregnancies would be adversly affected.

bundle · 06/03/2008 21:29

i seem to remember having a doppler late on in pg to check on placenta - how much weight is given to that? #

personally, i didnt' want to go over 42 weeks both times.

mears · 06/03/2008 21:34

I am really sorry for your friends loss. You copuld equally have placental failure at 38 weeks.

The point I was trying to make (badly) is that not all placentas will fail after 41 weeks which is the information that is ages old but not evidence based.

What type of montoring did your friend have in that last week? Was she scanned and a fetal biophysical profile done which can tell whether the baby was OK to be left or not?

Raher than blanket induction dates, we need individual pregnancies monitoerd.

I have seen babies delivered at 35 weeks because it has been demontrated that the placenta is no longer working by doppler scan.

I don't mean to argue with you but there is so much more to assessing a healthy pregnancy athn just going by the date.

SalVolatile · 06/03/2008 21:44

Hi Mears, I'm not arguing with you at all - your professional experience is a much wider perspective, and one I respect. I'd be dead without my third midwife's skill! I think you haver hit the nail on the head, though, as far as I know she had no monitoring in that final fortnight other than her weekly clinic checks, even though her dh ( a biologist as it happens) queried why she was being left without futher checks being undertaken.Perhaps the OP could ask for a Doppler check? I accept your point that placental failure is not s simple consequence of placental age, though, and I guess that it's very hard to accept that your body has somehow 'failed' in that way, but it is also difficult for my friend to get over the feeling she has that she waited too long.

PotPourri · 06/03/2008 21:53

The 2 still births I knew did not have reasons given.

A friend of mine gave birth this week 6 weeks early and the baby is really well. Only 4.5lbs, but both are healthy. Just goes to show that your body generally does know what it is doing - if you can just bear to trust it.

Good point about SIDS if the baby had been induced. It's all a mystery really.

To OP - do what feels right for you. If you want to wait, you should go with what feels right for you.

Original poster

OldieButGoldie · 06/03/2008 22:19

Thanks so much for all your replies. I didn't manage to keep up as I was on the phone to my friend having a huge RANT at the time....amazing how much better I feel for it too

Just wanted to say, Daisymoo, how on earth did you manage to come up with such spot on info so quickly? Thanks for that.

BS, that was my main worry, that the decline of the placenta may be rapid - I posted about that last night.

P&L,I asked about having the blood flow checked by scan today, the sonographer said that she didn't even need to, she could tell by the amount of amniotic fluid and health of the baby, activity etc, that all was ok.

Everyone else, thanks for your replies. I will take some time to mull it all over and reach a decision that feels right to me

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