Induction for small baby - really don't want it

[WombatStewForTea]

I'm almost 34 weeks. Was having regular growth scans anyway and consultant led for other health conditions. Currently under foetal med as this baby keeps dropping down centiles on growth scan (was 10th, then above 3rd now below 3rd) and preeclampsia test is back as a higher risk so I'm in twice a week for blood pressure and CTGs but all is fine.

Midwife last week mentioned that with small babies they tend to want to induce around 37 weeks. I've always been really adamant that I don't want to be induced. I can't find any actual evidence to back it up but I believe the risk of birth injury and needing interventions are much higher. Also just anecdotally it seems to either take days or be super quick and intense.

I've always said I'd rather have a section than an induction but overheard my consultant talking to another lady in a similar position and saying neonatal don't like sections on small babies before 39 weeks as they don't get the good old squeezing of the lungs.

I'm seeing my consultant for the first time tomorrow since growth scans have started to go south so I know we'll be discussing birth plans.
I'm going to ask for how many inductions ended up as emergency c sections anyway but is there's anything else I should ask to arm myself?

@WombatStewForTea if you've been flagged as high risk for pre-eclampsia, you need to be very vigilant. Might I suggest buying a blood pressure monitor to use between trips to the clinic, and make sure you're aware of the signs to look out for.

Not all trusts recommend this now. I am having twice weekly BP monitoring at the Maternity Assessment Unit and have been specifically told not to use home monitors as they are not properly calibrated for pregnant women and in my case were giving wildly inaccurate readings.

@WombatStewForTea please talk to your midwife before doing any home monitoring. Some hospitals will lend you a properly calibrated machine if you want to go down this route.

The BP machines that are used in the maternity hospitals are no different from the ones used in normal hospitals, which are not calibrated specifically to pregnant women. I can't see why they would need to be calibrated to pregnancy either? A high BP reading is high whether you're pregnant or not. The parameters for a high BP doesn't change just because of pregnancy.

Ok, well that's not what the 4 different midwives I've spoken to in the two weeks have told me whilst dealing with my high BP! But ill be sure to ask them at my next appointment tomorrow...

Sorry if I've provided misinformation- I just passed on what's recommended in my trust. @WombatStewForTea-do ask at your next appointment. As I said, pre eclampsia can come on very quickly.

They absolutely are different. The following quote is from nhs england

1.2 Pregnancy and blood pressureThe accuracy of blood pressure devices that are validated and calibrated for the general population is not assured, which makes them unsuitable for use in pregnant women. The physiological changes in pregnancy (increased heart rate, stroke volume and reduced total peripheral resistance) are accounted for in devices that are validated and calibrated specifically for use in pregnancy. The British and Irish Hypertension Society provides a published list of devices independently reviewed and approved for home and office monitoring during pregnancy.

I sort of liked the induction I had, it was done as an emergency pessary because dd kept messing with her cord and they couldn't find her heartbeat constantly, so I was keen to do whatever they felt was best. When I went into full labour it took about 45minutes and I had no real injuries, just a few stitches. I know everyone's different, but just wanted to share a positive experience.

Hi I was in a similar situation baby’s growth had tailed off the line it was going along from week 33 and week 36. The medical term were concerned about my placenta failing towards the last few weeks of pregnancy and offered my induction at week 37. I had to have two pessaries and a sweep and my labour was less than one hour. I think you should insist on regular monitoring and ask the team looking after you the pros and cons for having an induction and not. I know growth scans aren’t always accurate but my baby’s weight was going up as much as it should have done in the weeks between scans so it was felt it was better to bring baby out early to help grow better outside. Good luck with whatever is decided and hope
you have a safe and healthy delivery

I've had 4 Inductions op and never had issues at all. Never even torn or needed stitches. Just very normal births. You will be okay.

If you would prefer a c section, you have the right to request one. If your consultant won't agree you can ask to be transferred to one that will.

I did my own research and after reading up, i decided that induction was not something i wanted due to the risk of complications, birth injuries and increased risk of forceps.

I was told the same thing about not doing c sections on premature babies. I had a complicated pregnancy and I ended up with a hugely traumatic emcs (resulting in ptsd). id done my research and knew the set of risks i was most comfortable with was a c section but they talked me out of it when i went into labour early, telling me that if i wanted to do the best for my baby i would deliver vaginally and if i didn't i could be harming my baby because of not giving them the opportunity to have fluid squeezed out of the lungs. I don't believe i was given enough information to be able to give informed consent. Any attempt by me to discuss risks were waved away.

I wish i had stuck to my guns and insisted on the elective section. I very, very nearly lost my premature baby because of their insistance on a vaginal birth. If id had the ELCS, i wouldn't have ptsd.

The consultant even wrote on my notes after i said i wanted a section "mother wants to try for vaginal birth".

Fuckers.

But really, it doesn't matter how many of us had a good birth after an induction or didn't - what matters is what YOU want. Premature births are very different to full term inductions with an uncomplicated pregnancy. Follow your instincts.

Just back to update. Seen both consultant and my foetal med consultant this week. Both more than happy with c section and didn't even suggest induction was more advantageous. So I'm booked in for 38 weeks! Another growth scan in between so hopefully growth won't drop and he comes sooner

I'm so so pleased for you that they've taken you seriously and arranged the plan you need. Well done for advocating for yourself 👏

Great news OP and best wishes for everything.
Just a word of warning when looking at stats and data, you are right that inductions may cause worse outcomes for baby and mother but this is in otherwise healthy and normal pregnancies. Your low papp-a and growth dropping centiles rapidly means that you wouldn't come under that category so take the data with caution. It's about weighing up the risk in a fully informed way and not being misled by data headlines. The book 'expecting better' does a good job of explaining pregnancy and birth research and statistics.