Hospital wants to induce at 40 weeks - should I ask for ECS instead?

[niccibabe]

At my last appt, doctor said she was booking me in for an induction at 40weeks. I said I wanted to think about it as I want baby to come out when its ready.

I've seen lots of scary stuff about induction on MN and elsewhere online.

Would it be safer for the baby / easier for me to have an elective c-section? Obviously there would be additional recovery time for ECS...

While I could refuse the induction and just wait for the baby to come, hospital says there is additional risk because my blood pressure is high (systolic only, diastolic is fine).

Seems very heavy handed of your doctor. NICE guidelines say induction should be 'offered' (not forced on someone) only after 40 weeks plus 14 days, so you should have 2 more weeks to go into labour by yourself.

It certainly wouldn't be easier for you to have an elective caesarean. Recovery is so much longer.

There are lots of ways you can encourage your labour to start naturally.

Why 40 weeks? There must be a clinical reason for such an early induction - and that would influence your other options.

Congratulations!

Doctor was saying that my blood pressure being high is an additional risk, even though its only the systolic measurement that is high. She said that the placenta matures after the due date and that means the placenta is less efficient, so coupled with the higher blood pressure they would normally schedule for induction at term. She did say that they cannot force me to have the induction, but that I would have to understand and accept the additonal risks to me and the baby.

I've had experience of the hospital being heavy handed already here but this was a different doctor

All you can do is arm yourself with as much research as possible about the possible risks of continuing beyond term with your blood pressure levels, and then make the decision based on that. There are no certainties in childbirth so it's always a guessing game to some extent, but at least if you do the research you can make a more informed guess!

Induction of first time mothers carries a risk of emergency c-s of about 50% in some hospitals, so bear this in mind. The inductiion process is often unpleasant (I had a bad one), but sometimes it works quickly and leads to an easy vaginal birth, so you never know.

Niccibabe - on your other thread you said you had started tablets for your blood pressure. Have they taken an effect yet?

Has your blood pressure always been high? Is this new? Have you got protein in your urine? Have you got swelling of your hands and face?

Sometimes other things can get in the way of a pregnancy before the baby is ready to be here - I was induced because of antibodies out with my control.

If you do need induced, I would try that before CS. Women with high blood pressure often labour well.

If your tablets are helping, and everything else is OK, I don't see why you need to be induced bang on 40 weeks. However that is a discussion you need with those looking after you.

You can make the choice though - you cannot be forced to do anything.

It is true that essential hypertension [sounds like that is your condition maybe?] can have affects on the pregnancy and the placental function. Any raise in BP will put the tiny vessels in the placenta under stres - thereby affecting their performance. Particulary towards the end of preg when performance drops of, and particulary in labour.

Doesn't have to, but it can.

I believe scanning the placenta and the umbilical dopplers could provide information as to how the placenta is functioning - thereby helping you and the team come to a personalised plan. Might be worth a mention.

Also the liqour volume is a good indication of placental function.

If it is essential hypertension then there will be no protein in your wee and all the pre eclampsia type stuff, as these are 2 seperate conditions.

Hi,

Thanks for all the interesting suggestions - I will ask if placental scan would be appropriate.

Had a scan on Tuesday - liquor volume good, good flow through cord. Baby has hydrophrenisis on right kidney - was told that not usually something to worry about - and no need to take baby out early because of hydrophrenisis. Hospital suggests prophylactic antibiotics for baby once born, with ultrasound scan of baby a couple of weeks after the birth.

My BP doesn't seem to have come down much, but I have only been on tablets for 2 days - since Friday.

I don't have the protein in urine or facial swelling etc, so I don't seem to have pre-eclampsia. Midwife said my blood results were "entirely reassuring." I do have some oedema in feet, but was told that doesn't indicate anything by itself.

All sounds good niccibabe. If monitoring remains good, I don't see why you can't wait.