Overdue (or not) discussion with Consultant

[bluesatinsash]

My LMP was 20 March 2009 and using the ovulation sticks I got a +ve on Friday 3rd April. DH and me were off all that week and babydanced every day from Monday 30th March until Sunday 5th April (twice a day, ah, those were the days...).

Anyway, my calculated EDD is 25th December but 12-week scan and subsequent scans have always dated me one full week ahead, this Friday 18th December.

A few weeks ago I though the above was all a moot point as baby had irregular heart rate and there was talk of sectioning me at 32-weeks. Thankfully after five weeks of weekly scans, heart rate settled down and they are letting me go to term and even beyond. DS was delivered by c-section after 36-hour labour and failure to progress (he had never fully engaged).

So the consultant is happy to let me go 10-12 days post term which will take me to 28th ish Dec but according to my dates that is me only 3 days overdue. Can I refuse to be induced? They will only induce by breaking my waters not by articficual means due to previous scar and heart rate concerns..

I'm meeting my consultant on Wed. and would welcome any advice.

Thanks

Yes, you can refuse and induction - you should be offered expectant management at that point. You have a legal right to decline any medical intervention.

That said, there are usually good reasons why intervention is recommended at any given point and it is always wise to make a decision on the back of as much information as you can. "Why?" is a very useful question (or, "can you give me the references for the research that guideline is based on?" if you want to be a little less abrupt )

Had you been using ovulation sticks for the week before the 3rd? I'm thinking that if you had -ve's for a 10 days before that point and didn't BD before the 30th then the chance of the egg being fertilised on Friday 27th (as the scan date would suggest) would require an immaculate conception...

I seem to recall seeing reference to some recent research that suggested foetal growth was only uniform till 8 weeks, whereas the assumption is 12 weeks - it might be worth asking your consultant about that. I also understood that if the LMP and scan date were within a week of each other then they stayed with the LMP - again, could be worth asking.

There's also a fair chunk of information here - I know you're not planning a homebirth but a much of it is relevant regardless of planned location of birth and I've generally found it to be well written adn researched.

Good luck

Thanks Tangle and for link too, will have a good read .

Yes I POAS from the Monday (30th) and we were visiting relatives the weekend before so it would have been an immaculate conception as there was no rumpy pumpy .

They changed my date officially as I was one full week out. Said they keep LMP dates up to a week but more than 7 days difference then goes on 12-week scan.

I'm just really hoping for a VBAC and want to go as natural as I can. Not even doing raspberry leaf/pineapple etc. just want to let my body do its thing.

I am pretty pragmatic though and will go with what is in best interest for baby and me but will question and use your phrases if they point blank refuse to entertain that their dates are out. This is a longed for DC2 after two mc's last year, the last one three days before Christmas. It's been a long year!

Sorry you've had such a rough time the last 12 months . I ran up against the NHS when DD was breech and I declined a CS, so whilst I haven't had to argue on dates I have had experience of not being a nice easy patient that does what they're told... I was horrified how little research there is to support some standard practices. My pet hate is when women are told they "have" to have something when what is meant is usually "our policy is to recommend".

While you're reading you might also find this useful, just in case the consultant is of the "do what you're told and don't ask questions" school of thought .

They recommend induction if you're 10-12 days overdue as there is a higher risk of stillbirth at 42 weeks. My consultant said there's no research for after 42 so they go at 10-12 days purely for safety reasons.

My personal view was that although there's an increased risk of stillbirth, it is a very small risk. I was 42+2 when I went into labour - I told consultant I wanted a natural birth and wanted to wait to see if that would happen. Instead of induction I opted to have my DD's health monitored with a scan. Which is standard practice, according to my independant midwife.

Personally I trust nature to make birth happen when it's the right time. EDD is not an exact science and varies from country to country - I THINK it's France where you're not even considered due until 41 weeks. If you are confident you're not overdue there seems little to even worry about.

Hi! My only experience with this is that with DS2 my LMP + ovulation dates were saying a full week later than the dating scan and subsequent growth scan and I insisted that I was right and the hospital were wrong .... Of course he turned up 2 days before they predicted ie 9 days early according to me.... Good to research what you can and query what the consultant is basing his/her decision on but it maybe that bubs turns up before the critical time anyway.

Thanks everyone.

Meeting went really well. Consultant happy for me to go to at least 30th without sweeping/inducing so just hoping DC2 comes before then (but avoiding Xmas ).