Outpatient induction, feeble-ness in face of consultant, and other worries

[herbaceous]

Hello ladies. Just wondered if you could calm me down, as I'm having a multiple worry moment...

I'm 40+5, with my first baby, and am getting antsy about when he might put in an appearance. Had a MW appointment yesterday, which the consultant took instead. She tried to do a sweep, but my cervix is high, posterior and pretty much closed. She's very matter-of-fact, which is good from the point of view that if she says something's OK, she means it, but bad as it means I always come away having lots of questions...

I was expecting some kind of tests to see how the baby was doing, but she just said 'if he's moving, he's probably alright'. Is this right? Is it only after 42 weeks that they should start checking up on him?

She also did a face when she measured the bump. She didn't say anything at the time, but when I got home I looked at the notes, and she's put 36cm, which is 2cm smaller than a fortnight ago!

But the biggy is that I came away booked in for an induction at 40+10, which starts off with an insertion of prostin gel as an outpatient, mid-afternoon. I then get sent home. If labour doesn't start in the interim, I go in again first thing the next day for more prostin, drips, etc. Obviously, I'm hoping labour starts naturally before next week (but am not hopeful, considering baby is still very high, right under my ribs, and the state of my cervix), but it would seem outpatient induction is the worst of all worlds: the hideous unpredictability of going into labour at home (when to phone for a taxi, up all night fretting, worrying about having the baby on the way to the hospital) plus being medically managed.

Does anyone have any experience of it all? Is it just a way of keeping ante-natal beds free, or are there actually any benefits to the mother?

Your bump may well be smaller because baby has dropped down.

Please remember that you do not HAVE to be induced if you don't want to. If you are, though, and you are not really ready it may take quite a long time and a few goes which is one of the reasons they send you home. You will not be too happy when you have spent a few days in hospital hanging around waiting for it to work, so make the most of the time at home if you do it that way!

Babies do not usually come on their due date. A normal pregnancy is 38-42 weeks so please do not worry. They will start checking you as you near 42 weeks if you decide not to induce

Your cervix is not ready NOW, but that doesn't mean that things can't change quickly. Baby will come when he's ready!

second turtle23. Also chemical induction is about introducing oxytocin to the body. There are lots of ways to raise the levels in our body naturally- it is what is washing around our system when we feel all loved up and happy. SO do what makes you happy! Could also see an acupuncturist or google for acupressure sites you can do yourself.

Thanks ladies. I had a big old session of acupuncture yesterday, and she gave me some acupressure points that I'll be pressing most of today... I'll also finish off my pineapple, and stick an evening primrose capsule up my area...

I'm a bit of a worry wort about this pregnancy. It comes after five miscarriages, so my mind has always found it difficult to imagine it will all turn out OK, meaning I read doom and gloom into every thing that doesn't go precisely according to the book, or indeed the NCT class!

After how long do they send you home post-pessary? Not meaning to be alarmist, but some women are hypersensitive (me for one!) to the prostaglandin gel and it can trigger off a very fast labour. It sounds like a very odd policy by your hospital. Crikey, I thought I was 2cm and in for the long haul when I started pushing... noone thought I was in labour!

I read that you have to eat the core of the pineapple as well... because it's nasty blended up as a smoothie or milkshake is supposed to be best.

Good luck

Well indeed Hawkmoth, this is what worries me. What if I get home and things kick off immediately? I don't live that close to the hospital, and going backwards and forwards would be much more stressful than just staying in. I often hear the old flannel of 'you'd be far more relaxed at home than waiting around in hospital' when MWs talk about labour, but I'd much rather be being looked after than frantically pacing the rooms at home, fretting about taxis turning up, etc.

From a spot of googling, I think 'outpatient induction' is in its experimental stages, and has as much to do with saving money and freeing up ante-natal beds as it does with the mother's welfare. Cynical, I know...

And I've been eating the core of the pineapple! That's dedication...

I had this with my dd - don't worry about being sent home straightaway and going into labour immediately - they wait for an hour or so after inserting the gel to make sure that you're not hypersensitive to it, so you'll be in the hospital if that happens.
FWIW, although everyone is different - I had first lot of gel at about 9.30 pm, home by 11.30 pm, and then had minor contractions which were perfectly manageable, from 2 am until we went back into the hospital the next morning for the next lot of gel.
I hope that helps to reassure you a bit - I was also worried about going into really quick labour overnight but looking back it was much better for me to be at home for that night before it all really started happening..

But as others have said, you don't have to be induced if you don't want to. Don't let anyone force anything on you that you don't want

Good luck

I can see that they would save money on the poor women that end up having three days of pessaries stuck in hospital. That must be pretty grim.

I would be minded to stick it out until 42 weeks at least but go in for regular checks if they ask.

It's the semblance of choice you get that annoys me. It's all 'well it's up to you', but they never give you enough information to make an informed decision, so you end up doing what they want anyway. Which is probably the right thing, but I end up feeling all powerless.

Another example is my blood pressure reading yesterday. All through pg it's been low - about 120/80 or below. Consultant was too grand to actually take my BP, so minion did it, and it was 143/91. She was concerned, and went off to ask consultant while I sat in the waiting room. Cons eventually emerged and just waved me away, saying I could go home. Now, reading up on it, it would seem that 140/90 is a sign of pre-eclampsia. In which case, maybe induction would be a good thing!